Pettersson S, Svenungsson E, Gustafsson J, Möller S, Gunnarsson I, Welin Henriksson E
a Rheumatology Clinic , Karolinska University Hospital , Stockholm , Sweden.
b Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society , Karolinska Institutet , Stockholm , Sweden.
Scand J Rheumatol. 2017 Nov;46(6):474-483. doi: 10.1080/03009742.2016.1276959. Epub 2017 Mar 15.
We compared patients' assessments of systemic lupus erythematosus (SLE) disease activity by a Swedish version of the Systemic Lupus Activity Questionnaire (SLAQ) with physicians' assessments by the Systemic Lupus Activity Measure (SLAM) and Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). We also explored the performance of the SLAQ in patients with short (< 1 year) versus long (≥ 1 year) disease duration.
Patients filled out the SLAQ before physicians' assessments. Correlations between SLAQ total, subscales (Symptom score, Flares, Patients global) and SLAM and SLEDAI-2K, as well as between the corresponding items in SLAQ and SLAM, were evaluated using Spearman's ρ. Comparisons between patients with different disease durations were performed with Mann-Whitney U or chi-squared tests.
We included 203 patients (79% women), with a median age of 45 years [interquartile range (IQR) 33-57 years] and disease duration of 5 years (IQR 0-14 years). Correlations between physicians' SLAM without laboratory items (SLAM-nolab) and patients' assessments were: SLAQ total, ρ = 0.685, Symptom score, ρ = 0.651, Flares, ρ = 0.547, and Patients global, ρ = 0.600. Of the symptom items, fatigue (ρ = 0.640), seizures (ρ = 0.635), and headache (ρ = 0.604) correlated most closely. Neurology/stroke syndrome, skin, and lymphadenopathy correlated less well (ρ < 0.24). Patients' and physicians' assessments were notably more discordant for patients with short disease durations.
We confirm that the SLAQ can be used to monitor disease activity. However, the discrepancy between patients' and physicians' assessments was greater for patients with short versus long disease duration. We encourage further use of the SLAQ, but would like to develop a shorter version which would be valuable in modern, partly web-based, clinical care.
我们将瑞典版系统性红斑狼疮活动问卷（SLAQ）对系统性红斑狼疮（SLE）疾病活动度的患者评估结果，与系统性狼疮活动度量表（SLAM）和系统性红斑狼疮疾病活动指数2000（SLEDAI - 2K）的医生评估结果进行了比较。我们还探讨了SLAQ在疾病病程短（<1年）与长（≥1年）的患者中的表现。
患者在医生评估之前填写SLAQ。使用Spearman等级相关系数ρ评估SLAQ总分、各子量表（症状评分、病情发作、患者整体评估）与SLAM和SLEDAI - 2K之间的相关性，以及SLAQ和SLAM中相应项目之间的相关性。采用Mann - Whitney U检验或卡方检验对不同病程患者进行比较。
我们纳入了203例患者（79%为女性），中位年龄为45岁[四分位间距（IQR）33 - 57岁]，病程为5年（IQR 0 - 14年）。医生的无实验室指标的SLAM（SLAM - nolab）与患者评估之间的相关性为：SLAQ总分，ρ = 0.685；症状评分，ρ = 0.651；病情发作，ρ = 0.547；患者整体评估，ρ = 0.600。在症状项目中，疲劳（ρ = 0.640）、癫痫发作（ρ = 0.635）和头痛（ρ = 0.604）的相关性最为密切。神经学/中风综合征、皮肤和淋巴结病的相关性较差（ρ < 0.24）。病程短的患者，其患者评估与医生评估之间的差异尤为明显。
我们证实SLAQ可用于监测疾病活动度。然而，病程短的患者与病程长的患者相比，其患者评估与医生评估之间的差异更大。我们鼓励进一步使用SLAQ，但希望开发一个更简短的版本，这在现代部分基于网络的临床护理中将会很有价值。
