Santa Chiara Regional Hospital, APSS Trento, and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Rheumatology, Trento, Italy.
Rheumatology, Université de Paris, Hôpital Cochin, Paris, France.
Rheumatology (Oxford). 2022 Nov 28;61(12):4603-4618. doi: 10.1093/rheumatology/keac175.
To systematically review the psychometric properties of outcome measurement instruments used in ANCA-associated vasculitis (AAV).
Medline, EMBASE, Cochrane, Scopus and Web of Science were searched from inception to 14 July 2020 for validation studies of instruments used in AAV. Following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) and OMERACT frameworks, different psychometric properties (validity, reliability, responsiveness and feasibility) were summarized. Risk of bias was assessed according to the COSMIN checklist.
From 2505 articles identified, 32 met the predefined selection criteria, providing information on 22 instruments assessing disease activity (n = 7), damage (n = 2), activity and damage (n = 1), health-related quality of life (HRQoL; n = 9) and function (n = 3). Most of the instruments were tested in AAV as a group or in granulomatosis with polyangiitis only.The BVAS, any version, the Vasculitis Damage Index (VDI) and the AAV-Patient-Reported Outcome (AAV-PRO) have been more extensively validated than the other instruments. BVAS for Wegener Granulomatosis (BVAS/WG) has been shown to be valid for measuring disease activity [correlation with Physician global assessment (r = 0.90)], reliability (inter-observer intraclass correlation coefficient = 0.97), responsiveness and feasibility. For damage, VDI was shown to be moderately valid (correlations with BVAS version 3 at 6 months r = 0.14, BVAS/WG at 1 year r = 0.40 and 5 years r = 0.20), and feasible. For HRQoL, AAV-PRO demonstrated validity (correlations of the six AAV-PRO domains with EQ-5D-5L: -0.78 to -0.55; discrimination between active disease and remission, P < 0.0001 for all comparisons). The overall performance of instruments assessing function was low-to-moderate.
Among the 22 outcome measurement instruments used for AAV, BVAS (any version), VDI and AAV-PRO had the strongest psychometric properties.
系统评价抗中性粒细胞胞浆抗体相关性血管炎（AAV）中使用的结局测量工具的心理测量学特性。
从建库至 2020 年 7 月 14 日，通过 Medline、EMBASE、Cochrane、Scopus 和 Web of Science 检索用于 AAV 的工具的验证研究。根据共识基础的健康状况测量工具选择标准（COSMIN）和 OMERACT 框架，总结了不同的心理测量学特性（有效性、可靠性、反应度和可行性）。根据 COSMIN 清单评估偏倚风险。
从 2505 篇文章中，有 32 篇符合预先设定的选择标准，提供了 22 种评估疾病活动（n=7）、损伤（n=2）、活动和损伤（n=1）、健康相关生活质量（HRQoL；n=9）和功能（n=3）的工具的信息。大多数工具是在 AAV 作为一个整体或仅在肉芽肿性多血管炎中进行测试的。BVAS 及其任何版本、血管炎损伤指数（VDI）和 AAV 患者报告结局（AAV-PRO）比其他工具得到了更广泛的验证。用于韦格纳肉芽肿的 BVAS（BVAS/WG）已被证明可用于测量疾病活动（与医师总体评估的相关性 r=0.90）、可靠性（观察者间内部一致性系数=0.97）、反应度和可行性。对于损伤，VDI 被证明具有中等有效性（与 BVAS 版本 3 在 6 个月时的相关性 r=0.14，与 BVAS/WG 在 1 年时的相关性 r=0.40，与 5 年时的相关性 r=0.20），并且可行。对于 HRQoL，AAV-PRO 表现出有效性（AAV-PRO 的六个领域与 EQ-5D-5L 的相关性：-0.78 至-0.55；活动期疾病与缓解期的区分，所有比较的 P<0.0001）。评估功能的工具的整体性能为低至中等。
在用于 AAV 的 22 种结局测量工具中，BVAS（任何版本）、VDI 和 AAV-PRO 具有最强的心理测量学特性。
