Interdisciplinary Clinical Practice Guidelines for patient-centred management of juvenile-onset systemic lupus erythematosus
Bibliographic record
Abstract
Objectives: To develop updated interdisciplinary clinical practice guidelines for the management of juvenile-onset systemic lupus erythematosus (jSLE) in a patient-centred, treat-to-target (T2T) approach. Methods: Recommendations were developed based on T2T principles around shared decision-making by a multidisciplinary team of experts including paediatric and adult rheumatologists, paediatric nephrologists, neurologists, cardiologists, pneumologists, radiologists, immunologists, and infectious disease specialists, geneticists, and ophthalmologists from Germany, Switzerland, Austria, the United Kingdom and Ireland, a psychologist, and a patient representative. The process followed the standard operating procedures of the German AWMF (Association of the Scientific Medical Societies in Germany). The team conducted an extensive literature review (2012-2024) of 40 clinically selected Population/Intervention/Comparison/Outcome questions. Overarching principles (OAP), overarching treatment strategies (OATS), and recommendations were formulated and explored in 2 online preconsensus meeting Delphi surveys with the experts. The results were discussed in 3 virtual consensus meetings using a modified nominal group technique to discuss, modify and vote on the OAP, OATS, and recommendations. All final document was approved by 2 external reviewers and the AWMF. Results: We reached consensus on 45 recommendations on the general assessment, diagnosis, monitoring, nonpharmacologic, and pharmacologic management of jSLE. We highlight organ-specific manifestations, such as central nervous system disease, jSLE-related antiphospholipid antibody syndrome, and juvenile lupus nephritis, and consider disease severity for treatment recommendations. Conclusions: We have developed updated interdisciplinary clinical practice guidelines to facilitate a patient-centred T2T approach to the management of patients with jSLE.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".