用于检测银屑病患者中银屑病关节炎的土耳其语版银屑病流行病学筛查工具的效度和信度
Validity and reliability of the Turkish version of Psoriasis Epidemiology Screening Tool for the detection of psoriatic arthritis in patients with psoriasis.
作者信息
Kaymaz Serdar, Karasu Uğur, Kaçar Nida, Alkan Hakan
机构信息
Department of Internal Medicine, Division of Rheumatology, Medicine Faculty of Pamukkale University, Denizli, Türkiye.
Department of Dermatology, Medicine Faculty of Pamukkale University, Denizli, Türkiye.
出版信息
Arch Rheumatol. 2022 Mar 30;37(4):483-494. doi: 10.46497/ArchRheumatol.2022.8221. eCollection 2022 Dec.
OBJECTIVES
The Psoriasis Epidemiology Screening Tool (PEST) is a simple and useful questionnaire designed to screen arthritis in patients with psoriasis. This study aims to evaluate the validity and reliability of the PEST questionnaire in Turkish patients with psoriasis.
PATIENTS AND METHODS
Between August 2019 and September 2019, a total of 158 adult patients with psoriasis (61 males, 68 females; mean age: 43.1±13.3 years; range, 29.8 to 56.4 years) who were not previously diagnosed with PsA were included. The testing procedure for translation and cultural adaptation was carried out according to the following steps: preparation, forward translation, reconciliation, back-translation/back-translation review, harmonization, finalization, and proofreading. Patients' demographic parameters, comorbidities, PEST, and Toronto Psoriatic Arthritis Screen (ToPAS 2) results were recorded. The patients were, then, assessed by a rheumatologist who was blinded to their PEST scores. The diagnosis of PsA was made according to the Classification criteria for Psoriatic Arthritis (CASPAR). The receiver operating characteristic (ROC) was assessed to obtain the sensitivity and specificity of the PEST questionnaire.
RESULTS
Of the patients, 42 had PsA, while 87 did not. Each parameter of PEST showed a low-high internal consistency ranging from 0.366 to 0.781. When the Question 3 was excluded, Cronbach alpha value increased to 0.866. The Cronbach alpha value of the whole scale was 0.829. The test-retest reliability of the Turkish version of PEST was determined as 0.86 for the total score (ICC=0.866 95% CI: 0.601-0.955; p<0.0001). There was a strong positive correlation between PEST and ToPAS 2 (r=0.763; p<0.001) and a moderate positive correlation between PEST and CASPAR (r=0.455; p<0.001). A cut-off value of ≥3 yielded a sensitivity of 93% and a specificity of 89% for the diagnosis of PsA with the highest Youden's index. The PEST scale was found to have a higher sensitivity, but lower specificity in the head-to-head comparison with ToPAS 2.
CONCLUSION
The Turkish version of PEST is a reliable and valid tool for screening PsA in Turkish patients with psoriasis.
目的
银屑病流行病学筛查工具（PEST）是一种简单且有用的问卷，旨在筛查银屑病患者的关节炎。本研究旨在评估PEST问卷在土耳其银屑病患者中的有效性和可靠性。
患者与方法
2019年8月至2019年9月期间，纳入了158例既往未被诊断为银屑病关节炎（PsA）的成年银屑病患者（61例男性，68例女性；平均年龄：43.1±13.3岁；范围29.8至56.4岁）。翻译和文化调适的测试程序按以下步骤进行：准备、正向翻译、核对、反向翻译/反向翻译审核、协调、定稿和校对。记录患者的人口统计学参数、合并症、PEST及多伦多银屑病关节炎筛查（ToPAS 2）结果。然后，由一位对患者PEST评分不知情的风湿病学家对患者进行评估。根据银屑病关节炎分类标准（CASPAR）做出PsA诊断。评估受试者工作特征（ROC）以获得PEST问卷的敏感性和特异性。
结果
患者中，42例患有PsA，87例未患。PEST的每个参数显示出0.366至0.781的低至高内部一致性。排除问题3后，Cronbach α值增至0.866。整个量表的Cronbach α值为0.829。PEST土耳其语版本的重测信度确定为总分0.86（组内相关系数=0.866，95%置信区间：0.601 - 0.955；p<0.0001）。PEST与ToPAS 2之间存在强正相关（r = 0.763；p<0.001），PEST与CASPAR之间存在中度正相关（r = 0.455；p<0.001）。≥3的截断值对PsA诊断的敏感性为93%，特异性为89%，约登指数最高。在与ToPAS 2的直接比较中，发现PEST量表具有更高的敏感性，但特异性较低。
结论
PEST土耳其语版本是筛查土耳其银屑病患者PsA的可靠且有效的工具。
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