OBJECTIVE: To determine whether Systemic Lupus Erythematosus Disease Activity 
Index (SLEDAI) scores correlate with the clinician's impression of level of 
disease activity.
METHODS: In total, 230 patients with SLE followed at the University of Toronto 
Lupus Clinic who had 5 visits 3 months apart in 1992-93 were studied. At each 
visit a standard protocol was completed. A clinician who did not know the 
patients or their SLEDAI scores evaluated each patient record and assigned a 
clinical activity level. "Flare" was defined by new or increased therapy for 
active disease, an expression of concern, or use of the term "flare" in the 
physician's notes. The SLEDAI score was calculated from the database.
RESULTS: SLEDAI scores described a range of clinical activity as recognized by 
the clinician. Median SLEDAI scores ranged from 2 (inactive disease) to 8 
(persistently active or flare). When the clinician assessed the patient to be 
improved, the median SLEDAI score decreased by 2. When the clinician assessed 
that the patient was experiencing a flare, the SLEDAI score increased by a 
median of 4.
CONCLUSION: Based on our data we propose the following outcomes for patients 
with SLE: flare, an increase in SLEDAI > 3; improvement is a reduction in SLEDAI 
of > 3; persistently active disease is change in SLEDAI +/- 3; and remission a 
SLEDAI of 0. These outcomes will allow a more complete description of a 
patient's response to therapeutic intervention in a responder index.