用于外周型脊柱关节炎疾病活动度的3种复合测量方法的性能
Performance of 3 Composite Measures for Disease Activity in Peripheral Spondyloarthritis.
作者信息
Beckers Esther, Been Marin, Webers Casper, Boonen Annelies, Ten Klooster Peter M, Vonkeman Harald E, van Tubergen Astrid
机构信息
E. Beckers, MSc, M. Been, MD, C. Webers, MD, PhD, A. Boonen, MD, PhD, Professor, A. van Tubergen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht;
E. Beckers, MSc, M. Been, MD, C. Webers, MD, PhD, A. Boonen, MD, PhD, Professor, A. van Tubergen, MD, PhD, Professor, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, and Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht.
出版信息
J Rheumatol. 2022 Mar;49(3):256-264. doi: 10.3899/jrheum.210075. Epub 2021 Sep 1.
OBJECTIVE
To investigate concurrent validity and discrimination of the Disease Activity Index for Psoriatic Arthritis (DAPSA) score, Psoriatic Arthritis Disease Activity Score (PASDAS), and Ankylosing Spondylitis Disease Activity Score (ASDAS) in peripheral spondyloarthritis (pSpA) in clinical practice.
METHODS
Data from a Dutch registry for SpA (SpA-Net) were used. Predefined hypotheses on concurrent validity of the composite measures with 15 other outcome measures of disease activity, physical function, and health-related quality of life were tested. Concurrent validity was considered acceptable if ≥ 75% of the hypotheses were confirmed. Discrimination was assessed by stratifying patients in DAPSA, PASDAS, and ASDAS predefined disease activity states and studying mean differences in health outcomes by 1-way ANOVA. Further, the concordance in disease activity states was determined. All analyses were repeated in subgroups with and without psoriasis (PsO).
RESULTS
DAPSA, PASDAS, and ASDAS scores were available for 191, 139, and 279 patients with pSpA, respectively. The concurrent validity and discrimination of all composite measures were acceptable, as the strength of correlations were as hypothesized in ≥ 75% of the studied correlations. With increasing disease activity states, scores in nearly all outcome measures worsened significantly. The DAPSA, PASDAS, and ASDAS classified 22%, 56%, and 48% of the patients, respectively, in the 2 highest disease activity states. Stratified analyses for concomitant PsO revealed no relevant subgroup differences.
CONCLUSION
The performance of DAPSA, PASDAS, and ASDAS in pSpA was acceptable, and independent of concomitant PsO. Due to discrepancy in classification, the validity of existing thresholds for disease activity states warrants further study in pSpA.
目的
在临床实践中研究银屑病关节炎疾病活动指数（DAPSA）评分、银屑病关节炎疾病活动度评分（PASDAS）和强直性脊柱炎疾病活动度评分（ASDAS）在外周型脊柱关节炎（pSpA）中的同时效度和区分度。
方法
使用来自荷兰脊柱关节炎注册库（SpA-Net）的数据。对这些综合指标与其他15项疾病活动、身体功能及健康相关生活质量结局指标的同时效度进行预定义假设检验。若≥75%的假设得到证实，则认为同时效度可接受。通过将患者按DAPSA、PASDAS和ASDAS预定义的疾病活动状态分层，并采用单因素方差分析研究健康结局的平均差异来评估区分度。此外，确定疾病活动状态的一致性。在有和无银屑病（PsO）的亚组中重复所有分析。
结果
分别有191例、139例和279例pSpA患者获得了DAPSA、PASDAS和ASDAS评分。所有综合指标的同时效度和区分度均可接受，因为在≥75%的研究相关性中，相关性强度如假设的那样。随着疾病活动状态增加，几乎所有结局指标的评分均显著恶化。DAPSA、PASDAS和ASDAS分别将22%、56%和48%的患者归为2个最高疾病活动状态。伴有PsO的分层分析未显示相关亚组差异。
结论
DAPSA、PASDAS和ASDAS在pSpA中的表现可接受，且独立于伴发的PsO。由于疾病活动状态分类存在差异，现有疾病活动状态阈值的效度在pSpA中值得进一步研究。
Zotero 插件