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新型临床计量工具的开发:PANLAR 制定的用于评估类风湿关节炎患者的患者报告疾病活动指数(PARDAI-RA)。

Development of a novel clinimetric tool: PAtient Reported Disease Activity Index in Rheumatoid Arthritis (PARDAI-RA) by PANLAR, for the assessment of patients living with rheumatoid arthritis.

机构信息

Rheumatology Division, Pontificia Universidad Javeriana - Hospital Universitario San Ignacio, Bogotá, Colombia.

Internal Medicina Department, Hospital Universitario San Ignacio, Bogotá, Colombia.

出版信息

Clin Rheumatol. 2024 Apr;43(4):1277-1285. doi: 10.1007/s10067-024-06868-w. Epub 2024 Feb 14.

Abstract

BACKGROUND

Clinical experience has shown that a single measure is not sufficient to assess disease activity in rheumatoid arthritis (RA). Various clinimetric tools are necessary to address the many clinical situations that can arise.

METHODS

In order to develop a comprehensive measurement tool, the Pan American League of Associations for Rheumatology searched for the most frequent measures of disease activity applied in RA by means of a semi-systematic review of the available literature.

RESULTS

We found that the most frequently reported measures of disease activity were the 28-joint Disease Activity Score, C-reactive protein, and the erythrocyte sedimentation rate, followed by patient-reported measures of pain and stiffness and many other composite indices and patient-reported outcome measures. The most frequent physician-reported sign of disease was the swollen joint count, and the most frequently self-reported feature was the increase in disease activity or flares.

CONCLUSION

In this article, we present a new clinimetric tool developed based on expert consensus and on data retrieved from our search. Disease activity can be better assessed by combining various data sources, such as clinical, laboratory, and self-reported outcomes. These variables were included in our novel clinimetric tool. Key Points • The goal of treatment of RA is to achieve the best possible control of inflammation, or even remission; therefore, disease management should include systematic and regular evaluation of inflammation and health status. • Clinimetric tools evaluate a series of variables (e.g., symptoms, functional capacity, disease severity, quality of life, disease progression) and can reveal substantial prognostic and therapeutic differences between patients. • Our clinimetric tool, which is based on a combination of data (e.g., clinical variables, laboratory results, PROMs), can play a relevant role in patient assessment and care.

摘要

背景

临床经验表明,单一指标不足以评估类风湿关节炎 (RA) 的疾病活动度。需要各种临床计量工具来应对可能出现的多种临床情况。

方法

为了开发一种综合的测量工具,泛美风湿病协会联盟通过对现有文献进行半系统回顾,寻找 RA 中最常用的疾病活动度测量方法。

结果

我们发现,最常报告的疾病活动度测量指标是 28 关节疾病活动度评分、C 反应蛋白和红细胞沉降率,其次是患者报告的疼痛和僵硬程度以及许多其他综合指数和患者报告的结果测量指标。最常报告的医生疾病征象是肿胀关节计数,最常自我报告的特征是疾病活动度增加或发作。

结论

在本文中,我们提出了一种新的临床计量工具,该工具基于专家共识和从我们的搜索中检索到的数据。通过结合各种数据源,如临床、实验室和自我报告的结果,可以更好地评估疾病活动度。这些变量包含在我们新的临床计量工具中。关键点:

  • RA 的治疗目标是尽可能控制炎症,甚至达到缓解;因此,疾病管理应包括系统和定期评估炎症和健康状况。

  • 临床计量工具评估一系列变量(例如症状、功能能力、疾病严重程度、生活质量、疾病进展),并可以揭示患者之间的显著预后和治疗差异。

  • 我们的临床计量工具基于数据(例如临床变量、实验室结果、PROMs)的组合,可以在患者评估和护理中发挥重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee89/10944809/2174e6d363ae/10067_2024_6868_Fig1_HTML.jpg

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