Department of Dermatology & Venerology, Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China.
Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China.
Rheumatology (Oxford). 2024 Oct 1;63(10):2776-2780. doi: 10.1093/rheumatology/kead701.
PsA is the most prevalent coexisting condition associated with psoriasis. Early-stage PsA patients always present unspecific and subtle clinical manifestations causing delayed diagnosis and leading to unfavourable health outcomes. The application of US enables precise identification of inflammatory changes in musculoskeletal structures. Hence, we constructed US models to aid early diagnosis of PsA.
This was a cross-sectional study carried out in the Department of Dermatology at West China Hospital (October 2018-April 2021). All participants underwent thorough US examinations. Participants were classified into the under 45 group (18 ≤ age ≤ 45 years) and over 45 (age >45 years) group and then randomly grouped into derivation and test cohort (7:3). Univariable logistic regression, least absolute shrinkage and selection operator, and multivariable logistic regression visualized by nomogram were conducted in order. Receiver operating characteristic (ROC), calibration curve, decision curve analysis (DCA) and clinical impact curve analysis (CICA) were performed for model verification.
A total of 1256 participants were included, with 767 participants in the under 45 group and 489 in the over 45 group. Eleven and 16 independent ultrasonic variables were finally selected to construct the under 45 and over 45 model with the area under the ROC of 0.83 (95% CI 0.78-0.87) and 0.83 (95% CI 0.78-0.88) in derivation cohort, respectively. The DCA and CICA analyses showed good clinical utility of the two models.
The implementation of the US models could streamline the diagnostic process for PsA in psoriasis patients, leading to expedited evaluations while maintaining diagnostic accuracy.
银屑病关节炎（PsA）是与银屑病最常同时存在的疾病。早期 PsA 患者常表现为非特异性和微妙的临床表现，导致诊断延迟，并导致不良的健康结局。超声（US）的应用可准确识别肌肉骨骼结构的炎症变化。因此，我们构建了 US 模型以辅助 PsA 的早期诊断。
这是一项在华西医院皮肤科进行的横断面研究（2018 年 10 月至 2021 年 4 月）。所有参与者均接受了全面的 US 检查。参与者分为 45 岁以下（18≤年龄≤45 岁）和 45 岁以上（年龄>45 岁）组，然后随机分为推导和测试队列（7：3）。进行单变量逻辑回归、最小绝对收缩和选择算子以及通过列线图显示的多变量逻辑回归。进行受试者工作特征（ROC）、校准曲线、决策曲线分析（DCA）和临床影响曲线分析（CICA）以验证模型。
共纳入 1256 名参与者，其中 45 岁以下组 767 名，45 岁以上组 489 名。最终分别选择 11 个和 16 个独立超声变量来构建 45 岁以下和 45 岁以上模型，在推导队列中 ROC 曲线下面积分别为 0.83（95%CI 0.78-0.87）和 0.83（95%CI 0.78-0.88）。DCA 和 CICA 分析表明这两个模型具有良好的临床实用性。
实施 US 模型可以简化银屑病患者 PsA 的诊断过程，在保持诊断准确性的同时加快评估速度。
