From the Perelman School of Medicine at the University of Pennsylvania.
Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine at the University of Pennsylvania.
J Clin Rheumatol. 2022 Mar 1;28(2):e456-e461. doi: 10.1097/RHU.0000000000001760.
Sjögren's syndrome (SS) is frequently undetected or misdiagnosed as other rheumatologic diseases. We aimed to develop an SS screening questionnaire for the rheumatology practice.
We developed the Sjögren's Syndrome Screening Questionnaire (SSSQ) via secondary analysis of data from 974 participants referred by rheumatologists to the Sjögren's International Collaborative Clinical Alliance (SICCA) study. Participants answered 88 questions regarding symptoms, medical history, and demographics. They underwent ocular, dental, and serologic tests and were classified as SS or non-SS using the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria. We conducted univariate and multivariate logistic regression to identify questions most discriminative of SS, from which we derived an individual's likelihood of SS ("SSSQ score").
Five questions were significantly discriminative of SS in the multivariate analysis (p < 0.05): (1) Can you eat a cracker without drinking a fluid/liquid? (no: odds ratio [OR], 1.39; 95% confidence interval [CI], 1.06-1.82]); (2) How would you describe your dental and oral health in general? (fair/poor: OR, 1.68; 95% CI, 1.04-2.75); (3) During the last week, have you experienced tearing? (none of the time: OR, 2.26; 95% CI, 1.23-4.34); (4) Are you able to produce tears? (no: OR, 1.62; 95% CI, 1.12-2.37); and (5) Do you currently smoke cigarettes? (no: OR, 2.83; 95% CI, 1.69-4.91). SSSQ score ≥7 (possible range, 0-11) distinguishes SS from non-SS patients with 64% sensitivity and 58% specificity (area under receiver operating characteristic curve, 0.65).
The SSSQ is a simple 5-item questionnaire designed to screen for SS in clinical practice, with a potential impact to reduce delays in diagnosis.
干燥综合征（SS）常被漏诊或误诊为其他风湿性疾病。我们旨在开发一种用于风湿科实践的 SS 筛查问卷。
我们通过对 974 名由风湿病医生转诊至干燥综合征国际临床联盟（SICCA）研究的参与者的数据进行二次分析，开发了干燥综合征筛查问卷（SSSQ）。参与者回答了 88 个关于症状、病史和人口统计学的问题。他们接受了眼部、牙科和血清学检查，并根据 2016 年美国风湿病学会/欧洲抗风湿病联盟分类标准将其归类为 SS 或非 SS。我们进行了单变量和多变量逻辑回归，以确定对 SS 最具鉴别力的问题，从中我们得出了个体患 SS 的可能性（“SSSQ 评分”）。
在多变量分析中，有 5 个问题对 SS 具有显著的鉴别力（p < 0.05）：（1）你能不用液体或水吃饼干吗？（否：比值比[OR]，1.39；95%置信区间[CI]，1.06-1.82）；（2）你如何总体描述你的口腔和牙齿健康？（一般/差：OR，1.68；95%CI，1.04-2.75）；（3）在过去一周内，你是否有流泪？（从不：OR，2.26；95%CI，1.23-4.34）；（4）你能产生眼泪吗？（否：OR，1.62；95%CI，1.12-2.37）；和（5）你现在吸烟吗？（否：OR，2.83；95%CI，1.69-4.91）。SSSQ 评分≥7（可能范围，0-11）可区分 SS 与非 SS 患者，其敏感性为 64%，特异性为 58%（接受者操作特征曲线下面积，0.65）。
SSSQ 是一种简单的 5 项问卷，旨在临床实践中筛查 SS，有可能减少诊断延误。
