采用医疗结局研究简表 12 作为生活质量衡量标准，改良银屑病关节炎疾病活动评分的研究。
Development of a Modified Psoriatic Arthritis Disease Activity Score Using the Medical Outcomes Study Short Form 12 as a Measure of Quality of Life.
机构信息
University of Toronto and the Krembel Research Institute, University Health Network, Toronto, Ontario, Canada.
Krembil Research Institute, University Health Network, Toronto, Ontario, Canada.
出版信息
Arthritis Care Res (Hoboken). 2020 Apr;72(4):577-582. doi: 10.1002/acr.23876. Epub 2020 Mar 12.
OBJECTIVE
The Psoriatic Arthritis Disease Activity Score (PASDAS) is a composite measure of psoriatic arthritis (PsA) disease activity. The length of its patient-reported components raises concern about questionnaire burden. The PASDAS includes the Medical Outcomes Study Short Form 36 (SF-36) health survey. We undertook this study to investigate the agreement between the PASDAS and a modified PASDAS (mPASDAS), which substituted the SF-36 with the shortened SF-12.
METHODS
A total of 100 patients who fulfilled the criteria of the Classification of Psoriatic Arthritis Study Group for PsA were consecutively recruited. All of the PASDAS-required variables were collected. The 12 item responses for SF-12 were extracted from the SF-36 questionnaire. The PASDAS and the mPASDAS were calculated using the SF-36 and SF-12 scores, respectively. A Bland-Altman plot of the mean differences in PASDAS and mPASDAS scores was generated to evaluate agreement. Construct validity was assessed by examining correlations of the PASDAS and the mPASDAS with the Health Assessment Questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue subscale, the EuroQol 5-domain instrument (health-related quality of life), and pain scores (range 0-10, visual analog scale). The kappa statistic was used to measure agreement between disease activity states as determined by the PASDAS and mPASDAS.
RESULTS
The mean ± SD PASDAS and mPASDAS was 3.29 ± 1.39 and 3.24 ± 1.27, respectively. The correlation between the 2 scores was 0.998 (P < 0.0001), and the mean difference was -0.05 (95% confidence interval [95% CI] -0.07, -0.03). Construct validity was found, with nearly identical correlations of the PASDAS and mPASDAS with each of the external health measures. The misclassification rate with the mPASDAS was only 6%. The weighted κ = 0.90 (95% CI 0.82, 0.97).
CONCLUSION
The mPASDAS may replace the PASDAS in disease activity assessment given the excellent agreement, validity, and low misclassification rate.
目的
银屑病关节炎疾病活动评分（PASDAS）是一种银屑病关节炎（PsA）疾病活动的综合测量方法。其患者报告组成部分的长度引起了人们对问卷负担的关注。PASDAS 包括医疗结局研究短表 36（SF-36）健康调查。我们进行这项研究是为了调查 PASDAS 与改良 PASDAS（mPASDAS）之间的一致性，后者用缩短的 SF-12 替代了 SF-36。
方法
共连续招募了 100 名符合银屑病关节炎研究组分类标准的符合条件的患者。收集了所有 PASDAS 所需的变量。SF-36 问卷中提取了 SF-12 的 12 个项目反应。使用 SF-36 和 SF-12 评分分别计算 PASDAS 和 mPASDAS。生成 PASDAS 和 mPASDAS 评分均值差值的 Bland-Altman 图，以评估一致性。通过检查 PASDAS 和 mPASDAS 与健康评估问卷、慢性疾病治疗疲劳功能评估量表、欧洲五维健康量表（健康相关生活质量）和疼痛评分（范围 0-10，视觉模拟评分）之间的相关性来评估结构效度。kappa 统计用于衡量 PASDAS 和 mPASDAS 确定的疾病活动状态之间的一致性。
结果
平均±SD PASDAS 和 mPASDAS 分别为 3.29±1.39 和 3.24±1.27。两个评分之间的相关性为 0.998（P<0.0001），平均差异为-0.05（95%置信区间[95%CI]-0.07，-0.03）。发现结构效度，PASDAS 和 mPASDAS 与每个外部健康测量均具有几乎相同的相关性。mPASDAS 的错误分类率仅为 6%。加权κ=0.90（95%CI 0.82，0.97）。
结论
鉴于良好的一致性、有效性和低错误分类率，mPASDAS 可能替代 PASDAS 用于疾病活动评估。
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