Disease Activity in Psoriatic Arthritis : Comparison of the Discriminative Capacity and Construct Validity of Six Composite Indices in a Real World

Objective. To compare, “in a real world,” the performance of the most common composite activity indices in a cohort of PsA patients. Methods. A total of 171 PsA patients were involved. The following variables were evaluated: peripheral joint assessment, patient reported of pain, physician and patien...

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Published in:BioMed research international 2014-01, Vol.2014 (2014), p.1-12
Main Authors: Salaffi, Fausto, Ciapetti, Alessandro, Carotti, Marina, Gasparini, Stefania, Gutierrez, Marwin
Format: Article
Language:English
Subjects:
Adult
Arthritis, Psoriatic - pathology
Arthritis, Psoriatic - physiopathology
Arthritis, Psoriatic - therapy
Care and treatment
Clinical trials
Comparative analysis
Development and progression
Diagnosis
Female
Humans
Male
Middle Aged
Outcome and process assessment (Health Care)
Patients
Psoriasis
Psoriatic arthritis
Quality of life
Questionnaires
Remission (Medicine)
Remission Induction
Rheumatology
Severity of Illness Index
Skin diseases
Sociodemographics
Variables
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Carotti, Marina
Gasparini, Stefania
Gutierrez, Marwin
description Objective. To compare, “in a real world,” the performance of the most common composite activity indices in a cohort of PsA patients. Methods. A total of 171 PsA patients were involved. The following variables were evaluated: peripheral joint assessment, patient reported of pain, physician and patient assessments of disease activity, patient general health status, dactylitis digit count, Leeds Enthesitis Index, Health Assessment Questionnaire (HAQ), physical and mental component summary score of the Medical Outcome Survey (SF-36), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). To measure the disease activity, the Disease Activity Score (DAS28-ESR and DAS28-CRP), Simple Disease Activity Index (SDAI), Composite Psoriatic Disease Activity Index (CPDAI), disease activity in psoriatic arthritis (DAPSA), and Psoriatic Arthritis Disease Activity Score (PASDAS) have been calculated. The criteria for minimal disease activity (MDA) and remission were applied as external criterion. Results. The ROC were similar in all the composite measures. Only the CPDAI showed less discriminative ability. There was a high degree of correlation between all the indices (P
doi_str_mv 10.1155/2014/528105
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To compare, “in a real world,” the performance of the most common composite activity indices in a cohort of PsA patients. Methods. A total of 171 PsA patients were involved. The following variables were evaluated: peripheral joint assessment, patient reported of pain, physician and patient assessments of disease activity, patient general health status, dactylitis digit count, Leeds Enthesitis Index, Health Assessment Questionnaire (HAQ), physical and mental component summary score of the Medical Outcome Survey (SF-36), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). To measure the disease activity, the Disease Activity Score (DAS28-ESR and DAS28-CRP), Simple Disease Activity Index (SDAI), Composite Psoriatic Disease Activity Index (CPDAI), disease activity in psoriatic arthritis (DAPSA), and Psoriatic Arthritis Disease Activity Score (PASDAS) have been calculated. The criteria for minimal disease activity (MDA) and remission were applied as external criterion. Results. The ROC were similar in all the composite measures. Only the CPDAI showed less discriminative ability. There was a high degree of correlation between all the indices (P&lt;0.0001). The highest correlations were between DAPSA and SDAI (rho = 0.996) and between DAPSA and DAS28-CRP (rho = 0.957). CPDAI, DAPSA, and PASDAS had the most stringent definitions of remission and MDA category. DAS28-ESR and DAS28-CRP had the highest proportions in remission and MDA. Conclusions. Although a good concurrent validity and discriminant capacity of six disease activity indices were observed, the proportions of patients classified in the disease activity levels differed. In particular, the rate of patients in remission was clearly different among the respective indices.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2014/528105</identifier><identifier>PMID: 24967375</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Puplishing Corporation</publisher><subject>Adult ; Arthritis, Psoriatic - pathology ; Arthritis, Psoriatic - physiopathology ; Arthritis, Psoriatic - therapy ; Care and treatment ; Clinical trials ; Comparative analysis ; Development and progression ; Diagnosis ; Female ; Humans ; Male ; Middle Aged ; Outcome and process assessment (Health Care) ; Patients ; Psoriasis ; Psoriatic arthritis ; Quality of life ; Questionnaires ; Remission (Medicine) ; Remission Induction ; Rheumatology ; Severity of Illness Index ; Skin diseases ; Sociodemographics ; Variables</subject><ispartof>BioMed research international, 2014-01, Vol.2014 (2014), p.1-12</ispartof><rights>Copyright © 2014 Fausto Salaffi et al.</rights><rights>COPYRIGHT 2014 John Wiley &amp; Sons, Inc.</rights><rights>Copyright © 2014 Fausto Salaffi et al. Fausto Salaffi et al. 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To compare, “in a real world,” the performance of the most common composite activity indices in a cohort of PsA patients. Methods. A total of 171 PsA patients were involved. The following variables were evaluated: peripheral joint assessment, patient reported of pain, physician and patient assessments of disease activity, patient general health status, dactylitis digit count, Leeds Enthesitis Index, Health Assessment Questionnaire (HAQ), physical and mental component summary score of the Medical Outcome Survey (SF-36), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). To measure the disease activity, the Disease Activity Score (DAS28-ESR and DAS28-CRP), Simple Disease Activity Index (SDAI), Composite Psoriatic Disease Activity Index (CPDAI), disease activity in psoriatic arthritis (DAPSA), and Psoriatic Arthritis Disease Activity Score (PASDAS) have been calculated. The criteria for minimal disease activity (MDA) and remission were applied as external criterion. Results. The ROC were similar in all the composite measures. Only the CPDAI showed less discriminative ability. There was a high degree of correlation between all the indices (P&lt;0.0001). The highest correlations were between DAPSA and SDAI (rho = 0.996) and between DAPSA and DAS28-CRP (rho = 0.957). CPDAI, DAPSA, and PASDAS had the most stringent definitions of remission and MDA category. DAS28-ESR and DAS28-CRP had the highest proportions in remission and MDA. Conclusions. Although a good concurrent validity and discriminant capacity of six disease activity indices were observed, the proportions of patients classified in the disease activity levels differed. 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To compare, “in a real world,” the performance of the most common composite activity indices in a cohort of PsA patients. Methods. A total of 171 PsA patients were involved. The following variables were evaluated: peripheral joint assessment, patient reported of pain, physician and patient assessments of disease activity, patient general health status, dactylitis digit count, Leeds Enthesitis Index, Health Assessment Questionnaire (HAQ), physical and mental component summary score of the Medical Outcome Survey (SF-36), Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). To measure the disease activity, the Disease Activity Score (DAS28-ESR and DAS28-CRP), Simple Disease Activity Index (SDAI), Composite Psoriatic Disease Activity Index (CPDAI), disease activity in psoriatic arthritis (DAPSA), and Psoriatic Arthritis Disease Activity Score (PASDAS) have been calculated. The criteria for minimal disease activity (MDA) and remission were applied as external criterion. Results. The ROC were similar in all the composite measures. Only the CPDAI showed less discriminative ability. There was a high degree of correlation between all the indices (P&lt;0.0001). The highest correlations were between DAPSA and SDAI (rho = 0.996) and between DAPSA and DAS28-CRP (rho = 0.957). CPDAI, DAPSA, and PASDAS had the most stringent definitions of remission and MDA category. DAS28-ESR and DAS28-CRP had the highest proportions in remission and MDA. Conclusions. Although a good concurrent validity and discriminant capacity of six disease activity indices were observed, the proportions of patients classified in the disease activity levels differed. 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subjects Adult
Arthritis, Psoriatic - pathology
Arthritis, Psoriatic - physiopathology
Arthritis, Psoriatic - therapy
Care and treatment
Clinical trials
Comparative analysis
Development and progression
Diagnosis
Female
Humans
Male
Middle Aged
Outcome and process assessment (Health Care)
Patients
Psoriasis
Psoriatic arthritis
Quality of life
Questionnaires
Remission (Medicine)
Remission Induction
Rheumatology
Severity of Illness Index
Skin diseases
Sociodemographics
Variables
title Disease Activity in Psoriatic Arthritis : Comparison of the Discriminative Capacity and Construct Validity of Six Composite Indices in a Real World
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