Chiowchanwisawakit Praveena, Wattanamongkolsil Luksame, Srinonprasert Varalak, Petcharat Chonachan, Siriwanarangsun Palanan, Katchamart Wanruchada
Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wanglang Rd., 8th Floor Asdang Building, Bangkoknoi, Bangkok, 10700, Thailand.
Office of Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Rheumatol Int. 2016 Oct;36(10):1459-68. doi: 10.1007/s00296-016-3513-4. Epub 2016 Jun 22.
To validate the Thai language version of the Psoriasis Epidemiology Screening Tool (PEST) and the Early Arthritis for Psoriatic Patients Questionnaire (EARP), as well as also to develop a new tool for screening psoriatic arthritis (PsA) among psoriasis (Ps) patients. This was a cross-sectional study. Ps patients visiting the psoriasis clinic at Siriraj Hospital were recruited. They completed the EARP and PEST. Full musculoskeletal history, examination, and radiography were evaluated. PsA was diagnosed by a rheumatologist's evaluation and fulfillment of the classification criteria for psoriatic arthritis. Receiver operator characteristic (ROC) curves, sensitivity, and specificity were used to evaluate the performances of the tools. The Siriraj Psoriatic Arthritis Screening Tool (SiPAT) contained questions most relevant to peripheral arthritis, axial inflammation, and enthesitis, selected from multivariate analysis. Of a total of 159 patients, the prevalence of PsA was 78.6 %. The ROC curve analyses of Thai EARP, PEST, and SiPAT were 0.90 (95 % CI 0.84, 0.96), 0.85 (0.78, 0.92), and 0.89 (0.83, 0.95), respectively. The sensitivities of SiPAT, Thai EARP, and PEST were 91.0, 83.0, and 72.0 %, respectively, while the specificities were 69.0, 79.3, and 89.7 %, respectively. All screening questionnaires showed good diagnostic performances. SiPAT could be considered as a screening tool with its desirable properties: higher sensitivity and taking less time. Thai PEST and EARP could possibly be sequentially administered for people with a positive test from SiPAT to reduce the number of false positives.
验证银屑病流行病学筛查工具(PEST)和银屑病患者早期关节炎问卷(EARP)的泰语版本,并开发一种用于在银屑病(Ps)患者中筛查银屑病关节炎(PsA)的新工具。这是一项横断面研究。招募了到诗里拉吉医院银屑病诊所就诊的Ps患者。他们完成了EARP和PEST。评估了完整的肌肉骨骼病史、检查和影像学检查。PsA由风湿病学家评估并根据银屑病关节炎分类标准确诊。采用受试者操作特征(ROC)曲线、敏感性和特异性来评估这些工具的性能。诗里拉吉银屑病关节炎筛查工具(SiPAT)包含从多变量分析中选出的与外周关节炎、轴向炎症和附着点炎最相关的问题。在总共159名患者中,PsA的患病率为78.6%。泰语EARP、PEST和SiPAT的ROC曲线分析分别为0.90(95%CI 0.84,0.96)、0.85(0.78,0.92)和0.89(0.83,0.95)。SiPAT、泰语EARP和PEST的敏感性分别为91.0%、83.0%和72.0%,而特异性分别为69.0%、79.3%和89.7%。所有筛查问卷均显示出良好的诊断性能。SiPAT因其理想的特性:更高的敏感性和更短的时间,可以被视为一种筛查工具。对于SiPAT检测呈阳性者,可以依次使用泰语PEST和EARP,以减少假阳性的数量。