Hieronymus Fredrik, Kølbæk Pernille, Correll Christoph U, Østergaard Søren D
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark.
NPJ Schizophr. 2021 Aug 27;7(1):41. doi: 10.1038/s41537-021-00168-x.
In order for measurement-based care to be implemented, there is a need for brief rating instruments that can be administered in a short amount of time, but that are still sufficiently informative. Here, we assessed the drug-placebo sensitivity of the six-item subscale (PANSS-6) of the 30-item Positive and Negative Syndrome Scale (PANSS-30) using a large collection of patient-level data (n = 6685) from randomized controlled trials of risperidone and paliperidone. When analyzing the data by study, we found no material difference in mean effect sizes (ES) between the two measures (PANSS-30 ES = 0.45, PANSS-6 ES = 0.44; p = 0.642). Stratifying the pooled population according to several putative effect moderators (e.g., age, formulation, dose, or diagnosis) generally yielded no meaningful ES differences between the two measures. Similarly, early improvement (≥20% improvement at week 1) on the PANSS-6 predicted subsequent response (≥40% improvement at endpoint) as well as the analog prediction using PANSS-30. Finally, cross-sectional symptom remission assessed via the PANSS-6 showed very good agreement (sensitivity = 100%, specificity = 98%) with cross-sectional symptom remission defined by the Remission in Schizophrenia Working Group.
为了实施基于测量的护理，需要简短的评定工具，这些工具可以在短时间内进行施测，但仍具有足够的信息量。在此，我们使用来自利培酮和帕利哌酮随机对照试验的大量患者水平数据（n = 6685），评估了30项阳性和阴性症状量表（PANSS - 30）的6项子量表（PANSS - 6）的药物 - 安慰剂敏感性。在按研究分析数据时，我们发现两种测量方法之间的平均效应大小（ES）没有实质性差异（PANSS - 30的ES = 0.45，PANSS - 6的ES = 0.44；p = 0.642）。根据几种假定的效应调节因素（如年龄、剂型、剂量或诊断）对合并人群进行分层，通常在两种测量方法之间没有产生有意义的ES差异。同样，PANSS - 6上的早期改善（第1周改善≥20%）预测了后续反应（终点时改善≥40%），以及使用PANSS - 30的类似预测。最后，通过PANSS - 6评估的横断面症状缓解与精神分裂症缓解工作组定义的横断面症状缓解显示出非常好的一致性（敏感性 = 100%，特异性 = 98%）。
