Rheumatology Service, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain.
Division of Rheumatology, Rush University Medical Center, Chicago, Illinois, United States of America.
PLoS One. 2019 Apr 10;14(4):e0214717. doi: 10.1371/journal.pone.0214717. eCollection 2019.
To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria.
Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Δ) of HUPI with Δ in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (ΔGDA-Phy).
ΔHUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using ΔGDA-Phy as gold standard.
HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR's.
评估 Hospital Universitario La Princesa Index（HUPI）在相关性方面的反应性，与用于评估类风湿关节炎（RA）疾病活动的传统综合指数进行比较，并比较基于 HUPI 的反应标准与 EULAR 反应标准的性能。
对以下研究的二次数据进行分析：ACT-RAY（临床试验）、PROAR（早期 RA 队列）和 EMECAR（生物前时代长期 RA 队列）。通过以下两种方法评估反应性：1）通过计算相关系数，比较 HUPI 的基线变化（Δ）与其他评分的Δ；2）计算标准化效应大小。通过 HUPI 和 EULAR 标准的响应准确性使用线性回归进行分析，其中因变量是医生整体评估的变化（ΔGDA-Phy）。
ΔHUPI 与所有其他指数的变化相关性范围为 0.387 至 0.791）；HUPI 的标准化效应大小在每个使用的数据库中均大于其他指数。在 ACT-RAY 中，根据就诊次数，HUPI 和 EULAR 反应标准将 65%至 80%的患者同等分类。然而，HUPI 标准略为严格，尤其是在早期就诊时，更多的患者被归类为无反应者。当使用ΔGDA-Phy 作为金标准时，HUPI 反应标准的准确性略高于 EULAR 反应标准。
HUPI 在每个研究场景（临床试验、早期 RA 队列和既定 RA 队列）中均表现出良好的相关性反应性。HUPI 的反应标准似乎比 EULAR 的更严格。
