用于银屑病关节炎常规临床实践的综合指标：在一项英国多中心研究中对简化版本的测试。

Composite Measures for Routine Clinical Practice in Psoriatic Arthritis: Testing of Shortened Versions in a UK Multicenter Study.

机构信息

W. Tillett, BSc, MBChB, PhD, FRCP, N.J. McHugh, MBChB, MD, FRCP, FRCPath, Department of Pharmacy and Pharmacology, University of Bath, and Royal National Hospital for Rheumatic Diseases, Bath, UK;

O. FitzGerald, MD, FRCPI, FRCP(UK), Conway Institute for Biomolecular Research, University College Dublin, Dublin, Ireland.

出版信息

J Rheumatol Suppl. 2021 Jun;97:45-49. doi: 10.3899/jrheum.201675.

DOI:10.3899/jrheum.201675

PMID:34074666

Abstract

OBJECTIVE

To test shortened versions of the psoriatic arthritis (PsA) composite measures for use in routine clinical practice.

METHODS

Clinical and patient-reported outcome measures (PROMs) were assessed in patients with PsA at 3 consecutive follow-up visits in a UK multicenter observational study. Shortened versions of the Composite Psoriatic Arthritis Disease Activity Index (CPDAI) and Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) Composite Exercise (GRACE) measures were developed using PROMs and tested against the Disease Activity Score in 28 joints (DAS28), composite Disease Activity in Psoriatic Arthritis, and Routine Assessment of Patient Index Data (RAPID3). Discrimination between disease states and responsiveness were tested with the -score, standardized response mean (SRM), and effect size (ES). Data were presented to members at the GRAPPA 2020 annual meeting and members voted on the recommended composite routine practice.

RESULTS

The SRM for the GRACE, 3 visual analog scale (VAS), and 4VAS were 0.67, 0.77, and 0.63, respectively, and for CPDAI and shortened CPDAI (sCPDAI) were 0.54 and 0.55, respectively. Shortened versions of the GRACE increased the -score from 7.8 to 8.7 (3VAS) and 9.0 (4VAS), but reduced the -score in the CPDAI/sCPDAI from 6.8 and 6.1. The 3VAS and 4VAS had superior performance characteristics to the sCPDAI, DAS28, Disease Activity in Psoriatic Arthritis, and RAPID3 in all tests. Of the members, 60% agreed that the VAS scales contained enough information to assess disease and response to treatment, 53% recommended the 4VAS for use in routine care, and 26% the 3VAS, while leaving 21% undecided. Shortening the GRACE to VAS scores alone enhances the ability to detect status and responsiveness and has the best performance characteristics of the tested composite measures. GRAPPA members recommend further testing of the 3VAS and 4VAS in observational and trial datasets.

摘要

目的

测试用于常规临床实践的简化版银屑病关节炎（PsA）综合评估方法。

方法

在英国多中心观察性研究中，对连续 3 次随访的 PsA 患者进行临床和患者报告的结局测量（PROMs）评估。使用 PROMs 开发了简化版的复合银屑病关节炎疾病活动指数（CPDAI）和银屑病关节炎研究和评估组（GRAPPA）复合运动（GRACE）测量方法，并对 28 个关节疾病活动度评分（DAS28）、复合银屑病关节炎疾病活动度和常规评估患者索引数据（RAPID3）进行了测试。采用 -评分、标准化反应均值（SRM）和效应量（ES）测试疾病状态的区分能力和反应能力。研究结果在 GRAPPA 2020 年年度会议上提交给成员，并由成员投票推荐常规实践中使用的综合评估方法。

结果

GRACE、3 个视觉模拟量表（VAS）和 4 个 VAS 的 SRM 分别为 0.67、0.77 和 0.63，CPDAI 和简化 CPDAI（sCPDAI）的 SRM 分别为 0.54 和 0.55。GRACE 的简化版本使 -评分从 7.8 增加到 3VAS 的 8.7 和 4VAS 的 9.0，但使 CPDAI/sCPDAI 的 -评分从 6.8 和 6.1 降低。在所有测试中，3VAS 和 4VAS 的性能特征均优于 sCPDAI、DAS28、银屑病关节炎疾病活动度和 RAPID3。在所有成员中，60%的人认为 VAS 量表包含了评估疾病和治疗反应的足够信息，53%的人推荐使用 4VAS 进行常规护理，26%的人推荐使用 3VAS，而 21%的人未做出决定。单独使用 VAS 简化 GRACE 评分可提高检测状态和反应能力，并具有所测试综合评估方法中最佳的性能特征。GRAPPA 成员建议在观察性和试验数据集中进一步测试 3VAS 和 4VAS。