新型医师全球视觉模拟量表在银屑病关节炎中应用的培训信息图的开发与验证。

The Development and Validation of a Novel Training Infographic for the Physician Global Visual Analog Scale in Psoriatic Arthritis.

机构信息

S. Gunawardana, BMBCh, A. Allard, MBBS, A. Akpabio, MBBCh, A. Alsaffar, MBChB, J.C. Ellis, MBChB, R. Macmillan, BSc, B. Mulhearn, MBBS, PhD, A. Gorman, MBBCh, W. Tillett, MBChS, PhD, Royal National Hospital for Rheumatic Diseases, Bath, UK.

P.S. Helliwell, MD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK.

出版信息

J Rheumatol. 2024 Nov 1;51(11):1084-1091. doi: 10.3899/jrheum.2024-0152.

DOI:10.3899/jrheum.2024-0152

PMID:39089827

Abstract

OBJECTIVE

Psoriatic arthritis (PsA) is a heterogenous condition with musculoskeletal and skin manifestations. The physician global visual analog scale (VAS) is an important component of many composite scores used in clinical trials and observational studies. Currently, no training material exists to standardize this assessment.

METHODS

The Psoriatic Arthritis Validation of Physician Global VAS (PAVLOVAS) project describes the development of a novel training infographic with stakeholder involvement, which was then evaluated in a Latin square design in which 20 patients with PsA were assessed by 10 clinicians. For each group of 10 patients, 5 assessors conducted traditional assessment (consisting of 66/68-joint count, body surface area, Leeds Enthesitis Index, and dactylitis and nail counts) and 5 assessors conducted a standardized, thorough general examination informed by the infographic. Assessors switched assessment type between groups. The 3-item (3VAS) and 4VAS informed by traditional and infographic methods were compared, alongside other composite scores.

RESULTS

There was strong agreement between traditional and infographic physician global VAS (intraclass correlation coefficient [ICC] 0.69, = 0.01). This improved to very strong agreement when incorporated into the 3VAS (ICC 0.99, < 0.001) and 4VAS (ICC 0.99, < 0.001). The duration of assessment was significantly less for the infographic vs traditional groups (6.5 vs 7.8 mins, < 0.001). There was moderately high agreement between the 3VAS and 4VAS categories of disease activity, with the same categories defined by Psoriatic Arthritis Disease Activity Score (PASDAS) and Disease Activity Index for Psoriatic Arthritis (DAPSA; χ 17.0, = 0.049).

CONCLUSION

Our group developed and validated a novel training infographic that informs a briefer assessment of the physician global VAS than traditional assessments. This tool has potential applications in training and routine clinical practice.

摘要

目的

银屑病关节炎（PsA）是一种具有肌肉骨骼和皮肤表现的异质性疾病。医师整体视觉模拟量表（VAS）是许多临床试验和观察性研究中使用的综合评分的重要组成部分。目前，尚无标准化评估的培训材料。

方法

银屑病关节炎医师整体 VAS 验证（PAVLOVAS）项目描述了一种新的培训信息图的开发，该项目涉及利益相关者的参与，然后在拉丁方设计中进行了评估，其中 20 例银屑病关节炎患者由 10 名临床医生进行评估。对于每组 10 名患者，5 名评估者进行传统评估（包括 66/68 关节计数、体表面积、利兹附着点指数、指炎和指甲计数），5 名评估者进行标准化、全面的体格检查，该检查由信息图提供信息。评估者在组间切换评估类型。比较了传统和信息图方法得出的 3 项（3VAS）和 4 项 VAS 以及其他综合评分。

结果

传统和信息图医师整体 VAS 之间具有很强的一致性（组内相关系数 [ICC] 0.69， = 0.01）。当将其纳入 3VAS（ICC 0.99， < 0.001）和 4VAS（ICC 0.99， < 0.001）时，这一结果得到了显著改善。信息图组的评估时间明显短于传统组（6.5 分钟与 7.8 分钟， < 0.001）。3VAS 和 4VAS 类别的疾病活动度之间存在中度高度一致性，同一类别由银屑病关节炎疾病活动评分（PASDAS）和银屑病关节炎疾病活动指数（DAPSA）定义（χ 17.0， = 0.049）。