Table 5.

Application of Published Rule-Based SLE Algorithms from Vanderbilt University Medical Center to an External EHR at Partners HealthCare

	Outcome: Definite SLE vs. Probable or Non-SLE (First Definition), N=85						Outcome: Definite/Probable SLE vs Non-SLE (Second Definition), N=124
Algorithms	Sens. (%)	Spec. (%)	PPV (%)	Sens. (%) Excl. DM, SSc	Spec. (%) Excl. DM, SSc	PPV (%) Excl. DM, SSc	Sens. (%)	Spec. (%)	PPV (%)	Sens. (%) Excl. DM, SSc	Spec. (%) Excl. DM, SSc	PPV (%) Excl. DM, SSc
≥3 ICD-9 codes for SLE plus ANA ≥1:40 and ever DMARD* and ever steroid use	58	81	57	43	83	53	53	86	74	39	87	69
≥4 ICD-9 codes for SLE plus ANA ≥1:40 and ever DMARD and ever steroid use	57	84	61	42	85	56	51	89	78	38	89	73
≥4 ICD-9 codes for SLE plus ANA ≥1:40 and ever antimalarial use	83	73	60	58	76	51	77	85	79	56	82	71
≥4 ICD-9 codes for SLE and ever antimalarial use	86	66	50	60	73	47	81	73	68	56	78	65
≥3 ICD-9 codes for SLE and ever antimalarial use	86	60	46	60	71	45	84	69	65	58	77	64
≥3 ICD-9 codes for SLE and ever DMARD use and ever steroid use	61	70	45	45	80	47	56	73	59	40	82	60
≥4 ICD-9 codes for SLE and ever DMARD use and ever steroid use	60	76	50	44	82	49	54	80	65	39	85	64
≥4 ICD-9 codes for SLE plus ANA ≥1:160	80	75	58	60	75	51	73	82	76	55	79	68

Sens., sensitivity; Spec, specificity; Excl., excluding; DM, dermatomyositis; SSc, systemic Sclerosis; DMARD, disease modifying anti-rheumatic drug.

^*DMARD category includes azathioprine, methotrexate, mycophenolate, cyclophosphamide, rituximab, etanercept, adalimumab, infliximab, and abatacept, including generic and brand names, as per the original paper.(3)

For algorithms including ANA titers, n=277 with 84 definite cases and 121 definite plus probable cases; charts without ANAs available within our EHR system were excluded. ANAs were obtained from structured data, and the highest ANA titer was counted.