Doi Hiroshi, Ohmura Koichiro, Hashimoto Motomu, Ueno Kentaro, Takase Yudai, Inaba Ryuta, Kozuki Tomohiro, Iwasaki Takeshi, Taniguchi Masashi, Tabuchi Yuya, Shirakashi Mirei, Onizawa Hideo, Tsuji Hideaki, Onishi Akira, Watanabe Ryu, Kitagori Koji, Akizuki Shuji, Murakami Kosaku, Nakashima Ran, Yoshifuji Hajime, Yamamoto Wataru, Itaya Takahiro, Uozumi Ryuji, Tanaka Masao, Morinobu Akio
Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Rheumatology, Kobe City Medical Center General Hospital, Hyogo, Japan.
Lupus. 2024 Oct;33(12):1336-1344. doi: 10.1177/09612033241281909. Epub 2024 Sep 14.
There are often discrepancies in the evaluation of disease activity between patients and physicians in systemic lupus erythematosus (SLE). In this study, we examined the factors that affect those evaluations.
Physician visual analogue scale (Ph-VAS), patient VAS (Pt-VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2k), glucocorticoid (GC) usage and dose, age, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, and three patient-reported outcomes (SLE symptom checklist [SSC], short-form 36 questionnaire [SF-36], and LupusPRO) were obtained from a study performed in 2019 using 225 SLE outpatients of the Kyoto Lupus Cohort at Kyoto University Hospital. Correlations among Ph-VAS, Pt-VAS, or dif (Pt-VAS-Ph-VAS) (Pt-VAS minus Ph-VAS) and other factors were examined.
We found a significant discrepancy between Pt-VAS (median 38.0 mm) and Ph-VAS (median 18.7 mm) scores ( < 0.001). SSC score showed a significant correlation with Pt-VAS and dif (Pt-VAS-Ph-VAS) ( < 0.001). Among SSC items, fatigue showed the most significant correlation with dif (Pt-VAS-Ph-VAS). We also showed that higher dif (Pt-VAS-Ph-VAS) was associated with lower quality of life (QOL) evaluated by SF-36 and LupusPRO.
Pt-VAS scores tended to be higher than Ph-VAS scores, and the discrepancy was influenced mainly by fatigue. Higher dif (Pt-VAS-Ph-VAS) was associated with lower patient QOL.
在系统性红斑狼疮（SLE）患者与医生对疾病活动度的评估之间，常常存在差异。在本研究中，我们探究了影响这些评估的因素。
从2019年对京都大学医院京都狼疮队列的225例SLE门诊患者开展的一项研究中，获取医生视觉模拟评分法（Ph-VAS）、患者视觉模拟评分法（Pt-VAS）、系统性红斑狼疮疾病活动指数2000（SLEDAI-2k）、糖皮质激素（GC）的使用情况及剂量、年龄、系统性红斑狼疮国际协作临床/美国风湿病学会损伤指数，以及三项患者报告结局（SLE症状清单[SSC]、简明健康状况调查问卷[SF-36]和LupusPRO）。研究了Ph-VAS、Pt-VAS或差值（Pt-VAS - Ph-VAS）（Pt-VAS减去Ph-VAS）与其他因素之间的相关性。
我们发现Pt-VAS（中位数38.0 mm）与Ph-VAS（中位数18.7 mm）评分之间存在显著差异（<0.001）。SSC评分与Pt-VAS及差值（Pt-VAS - Ph-VAS）显著相关（<0.001）。在SSC项目中，疲劳与差值（Pt-VAS - Ph-VAS）的相关性最为显著。我们还发现，较高的差值（Pt-VAS - Ph-VAS）与SF-36和LupusPRO评估的较低生活质量（QOL）相关。
Pt-VAS评分往往高于Ph-VAS评分，且这种差异主要受疲劳影响。较高的差值（Pt-VAS - Ph-VAS）与患者较低的QOL相关。
