Classification criteria of joint activity using joint index vector for patients with rheumatoid arthritis: An evaluation and verification

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-02-22 DOI:10.1016/j.semarthrit.2025.152659

Ichiro Yoshii , Susumu Nishiyama , Naoya Sawada , Tatsumi Chijiwa

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引用次数: 0

Abstract

Objectives

We developed an activity classification of the joint index vector (JIV) for rheumatoid arthritis (RA) using monitoring data of RA cases at our institute. We verified its validity using an external big dataset (BD).

Methods

JIV is a novel joint involvement evaluation method that presents three-axis coordinates. We have set JIV classification criteria to determine a cut-off index (COI) of the combined vector on the x-y axis (Vxy). The z-axis (Vz) in the JIV was determined by Receiver Operating Characteristic analysis (ROC) in referring to the Clinical Disease Activity Index (CDAI) disease activity threshold and Health Assessment Questionnaire Disability Index (HAQ-DI) remission criteria. The criteria of JIV were evaluated in relation to indicators such as the CDAI and HAQ-DI. After determining the criteria, the validity was verified by referring to the simplified disease activity index (SDAI) classification and the HAQ score in BD.

Results

A total of 617 patients were studied. These were defined as 0.1>Vxy as remission (REM), 0.45>Vxy≥0.1 and 0.125≥Vz as low joint activity (LJA), 1.0>Vxy≥0.45 or 0.45>Vxy and Vz>0.125 as moderate joint activity (MJA), and Vxy≥1.0 was defined as high joint activity (HJA). The external big dataset consists of 11,013 RA patients. Vxy and the SDAI score correlated significantly (p < 0.0001). Mean values of SDAI and HAQ-DI increase stepwise as the criteria upgrade. It has been suggested that JIV may be able to pick up patients at risk of being missed by SDAI when large joints are involved.

Conclusions

JIV has been assessed and verified for its appropriateness, unbiased evaluation of the joints, and advantages in covering an unmet need in SDAI.

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类风湿关节炎患者关节活动的关节指数向量分类标准：评价与验证

目的利用我院类风湿关节炎（RA）病例监测资料，建立类风湿关节炎（RA）关节指数载体（JIV）的活动分类。我们使用外部大数据集（BD）验证了其有效性。方法jiv是一种新颖的三轴坐标关节介入评价方法。我们设置了JIV分类标准，以确定组合向量在x-y轴（Vxy）上的截止指数（COI）。参考临床疾病活动指数（CDAI）疾病活动阈值和健康评估问卷残疾指数（HAQ-DI）缓解标准，采用受试者工作特征分析（ROC）确定JIV中的z轴（Vz）。结合CDAI、HAQ-DI等指标对JIV标准进行评价。确定标准后，参照简化疾病活动指数（SDAI）分级和bd的HAQ评分，验证其有效性。结果共纳入617例患者。这些定义为0.1>；Vxy为缓解（REM）， 0.45>Vxy≥0.1和0.125≥Vz为低关节活动（LJA）， 1.0>Vxy≥0.45或0.45>；Vxy和Vz>；0.125为中度关节活动（MJA）， Vxy≥1.0定义为高关节活动（HJA）。外部大数据集由11013名RA患者组成。Vxy与SDAI评分显著相关(p <；0.0001)。SDAI和HAQ-DI的平均值随着标准的升级而逐步增大。有人建议，当涉及大关节时，JIV可能能够发现有被SDAI遗漏风险的患者。结论jiv已被评估和验证其适宜性，对关节的公正评价，以及在覆盖SDAI未满足需求方面的优势。

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.