Petri M, Hellmann D, Hochberg M
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
J Rheumatol. 1992 Jan;19(1):53-9.
As part of a cohort study of 150 patients with systemic lupus erythematosus (SLE), we investigated the validity and reliability of several indices of lupus activity, including the UCSF/JHU Lupus Activity Index (LAI), the SLE Disease Activity Index (SLEDAI), and a simple Core Index combining common elements. Validity was assessed by measuring correlations of these indices at the first cohort visit with the physician's global assessment (PGA) of SLE activity. The correlation of M-LAI (LAI modified so as not to contain PGA) and SLEDAI with PGA was 0.64 (95% CI 0.50, 0.70) and 0.55 (95% CI 0.42, 0.64), respectively. Reliability was assessed in a study of 6 patients seen twice, one week apart, by 9 physicians. The interrater reliability and test-retest reliability was greater for LAI (or M-LAI) than for SLEDAI. The Core Index performed better in its correlation with PGA (R = 0.78), although it contained no treatment data or serologic tests. Its interrater reliability and test-retest reliability were comparable with LAI. We conclude that (1) all indices have high validity; (2) LAI and the Core Index have higher reliability; and (3) these indices can be readily assimilated into routine clinic practice.
作为一项针对150例系统性红斑狼疮（SLE）患者的队列研究的一部分，我们调查了几种狼疮活动指数的有效性和可靠性，包括加州大学旧金山分校/约翰·霍普金斯大学狼疮活动指数（LAI）、SLE疾病活动指数（SLEDAI）以及一个结合了常见要素的简单核心指数。通过在队列首次访视时测量这些指数与医生对SLE活动的整体评估（PGA）之间的相关性来评估有效性。改良后不包含PGA的M-LAI与PGA的相关性为0.64（95%可信区间0.50, 0.70），SLEDAI与PGA的相关性为0.55（95%可信区间0.42, 0.64）。在一项由9名医生对6例患者进行的研究中评估了可靠性，这些患者在相隔一周的时间内接受了两次检查。LAI（或M-LAI）的评分者间信度和重测信度高于SLEDAI。核心指数与PGA的相关性更好（R = 0.78），尽管它不包含治疗数据或血清学检查。其评分者间信度和重测信度与LAI相当。我们得出结论：（1）所有指数都具有高有效性；（2）LAI和核心指数具有更高的可靠性；（3）这些指数可以很容易地应用于日常临床实践。
