Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
Rheumatology Department, National Hospital of Sri Lanka, Colombo, Sri Lanka.
Clin Rheumatol. 2021 Aug;40(8):3127-3134. doi: 10.1007/s10067-021-05633-7. Epub 2021 Feb 16.
INTRODUCTION/OBJECTIVES: Psoriatic arthritis (PsA) occurs in one-third of patients with psoriasis and mostly remains undetected leading to debilitating deforming arthritis, eventually. The Psoriasis Epidemiology Screening Tool (PEST) is a quick and valid tool, widely used to detect PsA in clinical practice, and it has been validated to many languages. In this study, we intended to validate a Sinhala version of the PEST and assess its psychometric properties.
The Sinhala version of the questionnaire was tested on 199 patients with psoriasis attending the dermatology clinic at a tertiary care National Hospital in Sri Lanka. Patients who were detected to have PsA previously (n = 5) and those with other rheumatologic conditions (n = 12) were excluded. All patients were examined by a dermatologist, and demographic and disease characteristics were obtained. All patients were assessed by two rheumatologists who were blinded to the answers provided in the questionnaire. The diagnosis of PsA was made based on the CASPAR criteria.
We observed the total PEST score of 3 or more to be the best cutoff value to screen for PsA. This cutoff value showed the highest Youden index (sensitivity = 0.89, specificity = 0.95). In the ROC analysis, the area under the curve of the PEST_sv was 0.95 (SE 0.02, p < 0.001). PEST_sv total score showed a significant correlation with body surface area involved but not with Dermatology Life Quality Index or Psoriasis area and severity index score.
The Sinhala version of PEST demonstrated satisfactory performance as a screening tool for PsA. Key Points • Psoriatic arthritis (PsA) is the most debilitating complication of psoriasis and lack of quick, valid screening tool is a limiting factor for early identification in Sri Lankan context. • Sinhala version of the Psoriasis Epidemiology Screening Tool (PEST_sv) was tested on 199 patients with psoriasis and examined for the diagnosis of PsA according to Classification of Psoriatic Arthritis (CASPAR) criteria. • PEST_sv score of 3 or more was observed to be the best cutoff value to screen for PsA with sensitivity and specificity of 0.89 and 0.95 respectively. • PEST_sv demonstrated satisfactory performance as a screening tool for PsA.
简介/目的：银屑病关节炎（PsA）发生在三分之一的银屑病患者中，大多数情况下未被发现，最终导致致残性变形关节炎。银屑病流行病学筛查工具（PEST）是一种快速有效的工具，广泛用于临床实践中检测 PsA，并且已经验证了多种语言。在这项研究中，我们旨在验证 PEST 的僧伽罗语版本，并评估其心理测量特性。
该问卷的僧伽罗语版本在 199 名在斯里兰卡一家三级护理国家医院皮肤科就诊的银屑病患者中进行了测试。先前发现有 PsA 的患者（n = 5）和患有其他风湿病的患者（n = 12）被排除在外。所有患者均由皮肤科医生检查，并获得人口统计学和疾病特征。所有患者均由两名对问卷答案一无所知的风湿病学家进行评估。根据 CASPAR 标准诊断 PsA。
我们观察到总分 3 或更高是筛查 PsA 的最佳截断值。该截断值显示出最高的 Youden 指数（灵敏度 = 0.89，特异性 = 0.95）。在 ROC 分析中，PEST_sv 的曲线下面积为 0.95（SE 0.02，p < 0.001）。PEST_sv 总分与体表面积受累显著相关，但与皮肤病生活质量指数或银屑病面积和严重程度指数评分无关。
僧伽罗语版本的 PEST 作为 PsA 的筛查工具表现出令人满意的性能。
银屑病关节炎（PsA）是银屑病最致残的并发症，在斯里兰卡缺乏快速、有效的筛查工具是早期识别的限制因素。
测试了 199 名银屑病患者的僧伽罗语版银屑病流行病学筛查工具（PEST_sv），并根据银屑病关节炎分类（CASPAR）标准检查 PsA 的诊断。
观察到 PEST_sv 评分 3 或更高是筛查 PsA 的最佳截断值，其灵敏度和特异性分别为 0.89 和 0.95。
PEST_sv 作为 PsA 的筛查工具表现出令人满意的性能。
