Dipartimento di Scienze Mediche, Università di Cagliari, ss 554, Monserrato, Italy.
J Rheumatol. 2011 May;38(5):898-903. doi: 10.3899/jrheum.100857. Epub 2011 Feb 15.
During OMERACT 8, delegates selected patient global assessment (PGA) of disease as a domain to be evaluated in randomized controlled trials in psoriatic arthritis (PsA). This study assessed the reliability of the PGA, measured by means of 0-100 mm visual analog scale (VAS), and the additional utility of separate VAS scales for joints (PJA) and skin (PSA).
In total, 319 consecutive patients with PsA (186 men, 133 women, mean age 51 ± 13 yrs) were enrolled. PGA, PJA, and PSA were administered at enrolment (W0) and after 1 week (W1). Detailed clinical data, including ACR joint count, Psoriasis Area and Severity Index (PASI), and Hospital Anxiety and Depression Scale, were recorded.
Comparison of W0 and W1 scores showed no significant variations (intraclass correlation coefficients for PGA 0.87, PJA 0.86, PSA 0.78), demonstrating the reliability of the instrument. PGA scores were not influenced by patient anxiety or depression, but were dependent on PJA and PSA (p = 0.00001). PJA was dependent on the number of swollen and tender joints (p < 0.00001). PSA scores were influenced by the extent of skin psoriasis and by hand skin involvement (p = 0.00001). Joint and skin disease were found not to correlate in terms of disease activity as evidenced by the swollen joint count compared to PASI (r = 0.11) and by the PJA compared to PSA (r = 0.38).
PGA assessed by means of VAS is a reliable tool related to joint and skin disease activity. Because joint and skin disease often diverge it is suggested that in some circumstances both PJA and PSA are also assessed.
在 OMERACT8 会议期间，代表们选择患者整体评估（PGA）作为评估银屑病关节炎（PsA）随机对照试验的领域。本研究评估了 PGA 的可靠性，通过 0-100mm 视觉模拟量表（VAS）进行测量，并评估了关节（PJA）和皮肤（PSA）单独 VAS 量表的额外效用。
共纳入 319 例连续的 PsA 患者（186 名男性，133 名女性，平均年龄 51±13 岁）。在入组时（W0）和第 1 周（W1）进行 PGA、PJA 和 PSA 评估。记录详细的临床数据，包括 ACR 关节计数、银屑病面积和严重程度指数（PASI）和医院焦虑和抑郁量表。
W0 和 W1 评分的比较显示没有显著差异（PGA 的组内相关系数为 0.87，PJA 为 0.86，PSA 为 0.78），表明该仪器具有可靠性。PGA 评分不受患者焦虑或抑郁的影响，但受 PJA 和 PSA 的影响（p=0.00001）。PJA 取决于肿胀和触痛关节的数量（p<0.00001）。PSA 评分受皮肤银屑病程度和手部皮肤受累的影响（p=0.00001）。关节和皮肤疾病在活动度方面没有相关性，这可以从肿胀关节计数与 PASI（r=0.11）相比，以及 PJA 与 PSA（r=0.38）相比得到证明。
通过 VAS 评估的 PGA 是一种与关节和皮肤疾病活动相关的可靠工具。由于关节和皮肤疾病通常不同，建议在某些情况下同时评估 PJA 和 PSA。
