PsAID（银屑病关节炎疾病影响）的验证和临床可解释性。

Validation and clinical interpretability of PsAID - psoriatic arthritis impact of disease.

机构信息

Department of Rheumatology, Federal University of Uberlândia, Av. Mato Grosso, 3395, 302, Umuarama, Uberlândia, Minas Gerais, 38405-314, Brazil.

Hospital Pedro Ernesto, University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Adv Rheumatol. 2020 Sep 22;60(1):49. doi: 10.1186/s42358-020-00149-1.

DOI:10.1186/s42358-020-00149-1

PMID:32962756

Abstract

BACKGROUND

Psoriatic arthritis (PsA) is a chronic inflammatory disease of widely varying presentation, which determines functional and psychological impairment, with a high negative impact on patients' quality of life. Therefore, knowing the patient's perception of their health status is of fundamental importance for understanding the real impact of PsA. Given this context, the European League Against Rheumatism (EULAR) recently developed the Psoriatic Arthritis Impact of Disease (PsAID) - instrument to specifically assess the impact of PsA for the patient.

OBJECTIVE

Validate the brazilian portuguese version of PsAID-12 (Psoriatic Arthritis Impact of Disease) and to verify its interpretability in clinical practice, through its relation with measures of psoriatic arthritis activity.

METHODS

A multicenter cross-sectional study, which recruited 160 patients, who met the Classification criteria for Psoriatic Arthritis (CASPAR), in six Brazilian centers of rheumatology. Reliability was assessed by Cronbach's alpha coefficient and by the intraclass correlation coefficient (ICC). The construct validity was evaluated by exploratory factorial analysis and also by Spearman correlation with other PROMs and measures of disease activity evaluation.

RESULTS

Of the total number of participants, 50% were female, with a mean age (SD) of 54.0 ± 11.2 years; 68% had only peripheral arthritis and 32% had pure or mixed axial involvement. The majority (67.7%) of the patients were using biological treatment. The reliability of internal consistency (alpha-Cronbach = 0.93) and test-retest (ICC = 0.996) were good. Factor analysis revealed two factors, named physical and psychosocial, which included the skin evaluation item. PsAID-12 correlated significantly with other PROMs, demonstrating good construct validity. PsAID-12 was also significantly associated with the disease activity assessment instruments (DAS28-ESR, ASDAS, and BASDAI) and the MDA status: "Minimum Disease Activity". Fibromyalgia did not significantly affect the final PsAID-12 score.

CONCLUSION

The brazilian version of PsAID-12 has been shown to be a reliable and valid measure of the impact of the disease in patients with psoriatic arthritis. Moreover, it associated significantly with the scores of disease activity assessment.

摘要

背景

银屑病关节炎（PsA）是一种表现形式多样的慢性炎症性疾病，会导致功能和心理障碍，对患者的生活质量产生重大负面影响。因此，了解患者对自身健康状况的认知对于理解 PsA 的真实影响至关重要。鉴于此，欧洲抗风湿病联盟（EULAR）最近开发了一种专门用于评估 PsA 对患者影响的工具——银屑病关节炎疾病影响（PsAID）量表。

目的

验证 PsAID-12（银屑病关节炎疾病影响）的巴西葡萄牙语版本，并通过其与银屑病关节炎活动度评估指标的关系来验证其在临床实践中的可解释性。

方法

这是一项多中心横断面研究，共纳入了来自巴西 6 个风湿病中心的 160 名符合银屑病关节炎分类标准（CASPAR）的患者。通过 Cronbach's alpha 系数和组内相关系数（ICC）评估信度。通过探索性因子分析以及与其他 PROMs 和疾病活动度评估指标的 Spearman 相关性评估结构效度。

结果

在所有参与者中，50%为女性，平均年龄（标准差）为 54.0±11.2 岁；68%仅患有外周关节炎，32%患有单纯或混合性轴性受累。大多数（67.7%）患者正在使用生物制剂治疗。内部一致性的信度（Cronbach's alpha 系数=0.93）和重测信度（ICC=0.996）良好。因子分析显示，有两个因子，分别命名为生理和心理社会，其中包含皮肤评估项目。PsAID-12 与其他 PROMs 显著相关，表明具有良好的结构效度。PsAID-12 与疾病活动度评估指标（DAS28-ESR、ASDAS 和 BASDAI）和 MDA 状态（“最小疾病活动度”）显著相关。纤维肌痛并不会显著影响最终的 PsAID-12 评分。