常规评估患者指数数据 3（RAPID3）在评估中轴型脊柱关节炎的结构效度。
Construct Validity of the Routine Assessment of Patient Index Data 3 (RAPID3) in the Evaluation of Axial Spondyloarthritis.
机构信息
A. García-Valle, MD, A.J. Fariña-González, MD, R.D. González-Benítez, xxx, Rheumatology Division. Complejo Asistencial Universitario de Palencia, Palencia.
J.M. Andrés-de Llano, MD, Clinical Research Unit, Complejo Asistencial Universitario de Palencia, Palencia.
出版信息
J Rheumatol. 2022 Jan;49(1):36-43. doi: 10.3899/jrheum.201362. Epub 2021 Jul 15.
OBJECTIVE
Although there are different tools to evaluate axial spondyloarthritis (axSpA), they are hardly used in routine clinical practice due to time constraints. The Routine Assessment of Patient Index Data 3 (RAPID3) is a composite measure feasible for use as a sole metric in busy clinics. We aimed to test its measurement properties in patients with axial SpA in a real-world clinical setting.
METHODS
This cross-sectional study included 131 consecutive patients with axial SpA. The convergent (Spearman ρ) and discriminant (receiver-operating characteristic [ROC] curve analysis) validity of RAPID3 were tested against several axSpA-specific measures (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score [ASDAS], Bath Ankylosing Spondylitis Functional Index [BASFI], and modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS]). A multivariate model was built to detect disease factors associated with RAPID3 remission (values ≤ 3).
RESULTS
The study included 82 men and 49 women, with a median age of 55 (IQR 46-61) years, and a median disease duration of 11 (IQR 6-24) years. Mean RAPID3 was 9.45 ± 6.7. The BASDAI showed moderate correlation with ASDAS (ρ 0.66, < 0.0001), but higher correlations with BASFI (ρ 0.78, < 0.0001) and RAPID3 (ρ 0.75, < 0.0001). The ASDAS had moderate correlations with BASFI, BASDAI, and RAPID3 (ranges 0.66-0.68, < 0.0001). Higher correlations were found between BASFI and BASDAI (ρ 0.78, < 0.0001), and BASFI and RAPID3 (ρ 0.73, < 0.0001). The mSASSS did not show any correlation with any of the above composite measures. κ agreement between RAPID3 remission and other SpA remission criteria was moderate (κ 0.46-0.56). The RAPID3 thresholds to define remission ranged from values ≤ 2 to ≤ 6 with areas under the ROC curve between 0.86-0.91. Female sex (OR 0.34, 95% CI 0.12-0.90, = 0.03) and nonsteroidal antiinflammatory drug intake (OR 0.26, 95% CI 0.10-0.66, = 0.005) were independently associated with lower odds of achieving RAPID3 remission.
CONCLUSION
RAPID3 demonstrated construct validity in this cross-sectional study. This index can be useful for a more comprehensive assessment of axSpA in busy clinical settings.
目的
尽管有不同的工具可用于评估中轴型脊柱关节炎（axSpA），但由于时间限制，它们在常规临床实践中几乎未被使用。简化疾病活动度指数 3（RAPID3）是一种综合指标，可在繁忙的诊所中用作单一指标。我们旨在在真实临床环境中测试其在 axSpA 患者中的测量特性。
方法
本横断面研究纳入了 131 例连续的 axSpA 患者。通过与几种 axSpA 特定指标（Bath 强直性脊柱炎疾病活动指数[BASDAI]、强直性脊柱炎疾病活动评分[ASDAS]、Bath 强直性脊柱炎功能指数[BASFI]和改良 Stoke 强直性脊柱炎脊柱评分[mSASSS]）进行比较，测试了 RAPID3 的收敛（Spearman ρ）和判别（ROC 曲线分析）有效性。建立了一个多变量模型来检测与 RAPID3 缓解（值≤3）相关的疾病因素。
结果
该研究纳入了 82 名男性和 49 名女性，平均年龄为 55（IQR 46-61）岁，平均病程为 11（IQR 6-24）年。平均 RAPID3 为 9.45±6.7。BASDAI 与 ASDAS 呈中度相关（ρ 0.66，<0.0001），但与 BASFI（ρ 0.78，<0.0001）和 RAPID3（ρ 0.75，<0.0001）相关性更高。ASDAS 与 BASFI、BASDAI 和 RAPID3 呈中度相关（范围 0.66-0.68，<0.0001）。BASFI 与 BASDAI（ρ 0.78，<0.0001）和 BASFI 与 RAPID3（ρ 0.73，<0.0001）之间的相关性更高。mSASSS 与上述任何综合指标均无相关性。RAPID3 缓解与其他 SpA 缓解标准之间的κ一致性为中度（κ 0.46-0.56）。定义缓解的 RAPID3 阈值范围为≤2 至≤6，ROC 曲线下面积为 0.86-0.91。女性（OR 0.34，95%CI 0.12-0.90， = 0.03）和非甾体抗炎药（OR 0.26，95%CI 0.10-0.66， = 0.005）的摄入与 RAPID3 缓解的可能性降低独立相关。
结论
在本横断面研究中，RAPID3 表现出了结构有效性。该指标可用于在繁忙的临床环境中更全面地评估 axSpA。
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