The University of Pennsylvania, Penn Vasculitis Center, Division of Rheumatology, Philadelphia, PA, USA.
Marmara University, Department of Rheumatology, Istanbul, Turkey.
Clin Exp Rheumatol. 2018 Mar-Apr;36 Suppl 111(2):51-57. Epub 2017 Sep 18.
The need to include patients' perspectives as key outcomes in clinical trials is widely accepted. No disease-specific patient-reported outcomes have been developed in Takayasu's arteritis. This project was designed to identify outcomes of importance to patients with Takayasu's arteritis during active disease and remission across 2 different cultures.
Patients with Takayasu's arteritis from the US and Turkey were recruited to participate in semi-structured, one-on-one interviews or focus groups. The interviews and group sessions were recorded, transcribed, and entered into an Nvivo database. A line-by-line review of narrative data was used to develop themes describing the impact of Takayasu's arteritis on patients' life. US Patients were invited to freelist terms that they associated with disease states (active disease and remission). The Smith's Salience Index (SSI) was used to identify the most salient terms.
Results. A total of 31 patients with Takayasu's arteritis participated in this study. Interviews and focus groups identified pain, fatigue, and emotional impact as common themes. Outcomes did not differ between the 2 countries. The most salient terms identified through freelisting were pain/discomfort and fatigue/low energy levels (SSI=0.56 and 0.33, respectively) during active disease and pain/discomfort and emotional impact (SSI=0.51 and 0.37, respectively) during remission.
Patients with Takayasu's arteritis report a range of disease-specific symptoms across different cultures and disease states that are generally not specifically captured by generic patient-reported outcome tools currently used in research. Identifying disease-specific outcomes would advance clinical trials methodology to best capture the full spectrum of disease activity in Takayasu's arteritis.
将患者视角纳入临床试验的关键结局已被广泛接受。尚无针对大动脉炎的特定疾病患者报告结局。本项目旨在确定美国和土耳其的大动脉炎患者在活动期和缓解期的重要结局,并横跨两种不同文化进行评估。
从美国和土耳其招募大动脉炎患者参与半结构式一对一访谈或焦点小组。访谈和小组会议被录音、转录并输入 Nvivo 数据库。通过对叙述性数据进行逐行审查,开发出描述大动脉炎对患者生活影响的主题。美国患者受邀自由列举他们与疾病状态(活动期和缓解期)相关的术语。使用 Smith 显著指数(SSI)确定最显著的术语。
共有 31 名大动脉炎患者参与了这项研究。访谈和焦点小组确定了疼痛、疲劳和情绪影响是常见的主题。这两个国家的结果没有差异。通过自由列举确定的最显著术语是活动期的疼痛/不适和疲劳/低能量水平(SSI 分别为 0.56 和 0.33),缓解期的疼痛/不适和情绪影响(SSI 分别为 0.51 和 0.37)。
大动脉炎患者在不同文化和疾病状态下报告了一系列特定于疾病的症状,这些症状通常无法被当前用于研究的通用患者报告结局工具特异性捕捉。确定特定于疾病的结局将推进临床试验方法学,以最佳捕捉大动脉炎的疾病活动全貌。