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患者报告结局测量信息系统(PROMIS)在炎性肌病中的应用。

Utility of patient-reported outcomes measurement information system (PROMIS) physical function form in inflammatory myopathy.

机构信息

Division of Rheumatology, University of Chicago, Chicago, IL, United States.

Division of Rheumatology and Clinical Immunology, University of Pittsburgh Medical Center, BST S 727, 3500 Terrace Street Pittsburgh, PA 15261, United States.

出版信息

Semin Arthritis Rheum. 2021 Jun;51(3):539-546. doi: 10.1016/j.semarthrit.2021.03.018. Epub 2021 Apr 15.

Abstract

OBJECTIVE

Idiopathic inflammatory myopathies (IIM) are a group of diseases characterized by muscle weakness, which limit activities of daily living. Patient Reported Outcomes Measurement Information System (PROMIS) is a set of outcome measures developed using NIH funding, but has not yet been studied in adult IIM. Currently, the most commonly used PROs in IIM are Health Assessment Questionnaire (HAQ-DI) and SF-36 physical function-10 (PF10), both of which have several limitations. In this study, we investigated psychometric properties of PROMIS physical function-20 (PF-20) and compared to HAQ-DI and SF-36 PF10.

METHODS

Patients with IIM completed PROMIS PF-20 and six myositis core set measures [manual muscle testing (MMT), physician (MD-GDA), patient (PT-GDA) and extra-muscular global disease activity, HAQ-DI and creatine kinase], SF-36 PF10 and functional tests [six-minute walk, timed up-and-go and sit-to-stand tests] at monthly visits over 6-months. Total improvement score (TIS) using 2016 ACR/EULAR myositis response criteria was obtained as measures of change.

RESULTS

Fifty patients [mean age, 51.6; 60% females] were enrolled; 6 PM, 24 DM, 9 NM and 11 with AS. PROMIS PF-20 showed strong test-retest reliability when repeated in 1-month. PROMIS PF-20 had moderate-strong correlations with MD-GDA, PT-GDA, MMT, HAQ-DI, SF-36 PF10, and functional tests indicating good convergent validity. Change in PROMIS PF-20 strongly correlated with TIS demonstrating good responsiveness. HAQ-DI and SF-36 PF10 exhibited similar validity and responsiveness; HAQ-DI was found to have a ceiling effect.

CONCLUSION

PROMIS PF-20 demonstrates favorable psychometric properties in a large cohort of myositis patients and offers distinct advantages.

摘要

目的

特发性炎性肌病(IIM)是一组以肌肉无力为特征的疾病,这些肌肉无力限制了日常生活活动。患者报告结局测量信息系统(PROMIS)是一组使用 NIH 资金开发的结果测量工具,但尚未在成人 IIM 中进行研究。目前,IIM 中最常用的 PRO 是健康评估问卷(HAQ-DI)和 SF-36 生理功能-10(PF10),两者都有几个局限性。在这项研究中,我们研究了 PROMIS 生理功能-20(PF-20)的心理测量特性,并与 HAQ-DI 和 SF-36 PF10 进行了比较。

方法

IIM 患者在 6 个月的时间内每月接受一次 PROMIS PF-20 和六项肌炎核心组测量(手动肌肉测试(MMT)、医生(MD-GDA)、患者(PT-GDA)和肌肉外整体疾病活动、HAQ-DI 和肌酸激酶)、SF-36 PF10 和功能测试(六分钟步行、计时上下和坐立起身测试)。使用 2016 年 ACR/EULAR 肌炎反应标准获得总改善评分(TIS)作为变化的测量值。

结果

共纳入 50 名患者[平均年龄 51.6 岁;60%为女性];6 名皮肌炎、24 名多发性肌炎、9 名无肌病性皮肌炎和 11 名包涵体肌炎。PROMIS PF-20 在一个月内重复时表现出良好的重测信度。PROMIS PF-20 与 MD-GDA、PT-GDA、MMT、HAQ-DI、SF-36 PF10 和功能测试均具有中度至强相关性,表明具有良好的聚合效度。PROMIS PF-20 的变化与 TIS 呈强相关,表明具有良好的反应性。HAQ-DI 和 SF-36 PF10 具有相似的有效性和反应性;HAQ-DI 存在天花板效应。

结论

PROMIS PF-20 在肌炎患者的大样本中表现出良好的心理测量特性,并具有明显的优势。

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