系统性硬化症三种医生总体评估工具的比较。

IF 3.7 2区 医学 Q1 RHEUMATOLOGY
Laura Ross, Dylan Hansen, Susanna Proudman, Jennifer Walker, Kimti Kumar, Wendy Stevens, Nava Ferdowsi, Joanne Sahhar, Gene-Siew Ngian, Diane Apostolopoulos, Lauren V Host, Kathleen Morrisroe, Gabor Major, Murray Baron, Mandana Nikpour
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引用次数: 0

摘要

目的:在系统性硬化症(SSc)临床试验中,医生全局评估(PhyGA)的应用各不相同。不同 PhyGA 结果的可比性尚不清楚。我们试图评估同时应用于澳大利亚硬皮病队列研究(ASCS)的三种不同 PhyGA 工具得出的结果的可比性:方法:我们利用 1,965 名 ASCS 参与者的数据,评估了三种 PhyGA 评估结果之间的相关性:(1) 整体健康;(2) 活动;(3) 损伤。我们还评估了研究访问期间每项 PhyGA 变化的一致性。我们使用有序逻辑回归分析来评估每项PhyGA的临床关联性:结果:在各次检查中,每个 PhyGA 的绝对得分都有很强的相关性。50%的研究访问中,PhyGA评分出现了一致的变化。只有患者报告的呼吸困难与所有三项 PhyGA 评分相关(总体健康:OR 1.67,P<0.05):OR 1.67,p结论:医生对总体健康、活动和损害的全面评估与不同的 SSc 特征相关,不同 PhyGA 评分的变化在 50% 的时间内不一致。我们的研究结果表明,不同措辞的PhyGAs结果不能直接互换,因此支持开发标准化的PhyGA。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of Three Physician Global Assessment Instruments in Systemic Sclerosis.

Objective: Physician global assessments (PhyGAs) are variably applied in systemic sclerosis (SSc) clinical trials. The comparability of different PhyGA results is unknown. We sought to assess the comparability of results from three different PhyGA instruments simultaneously applied in the Australian Scleroderma Cohort Study (ASCS).

Methods: Using data from 1,965 ASCS participants, we assessed the correlation between results of three PhyGA assessments: (1) overall health, (2) activity, and (3) damage. We evaluated the concordance of change in each PhyGA between study visits. Ordered logistic regression analysis was used to evaluate the clinical associations of each PhyGA.

Results: The absolute scores of each PhyGA were strongly correlated at individual study visits. Concordant changes of the PhyGA scores occurred between 50% of study visits. Only patient-reported breathlessness was associated with all three PhyGA scores (overall health: odds ratio [OR] 1.67, P < 0.01; activity: OR 1.44, P < 0.01; damage: OR 1.32, P < 0.01). Changes in physician-assessed activity scores were also associated with patient-reported worsening skin disease (OR 1.25, P = 0.03) and fecal incontinence (OR 1.23, P = 0.01), whereas damage scores were associated with respiratory disease (pulmonary arterial hypertension: OR 1.25, P = 0.03; chronic obstructive pulmonary disease: OR 1.37, P = 0.04), as well as skin scores (OR 1.02, P < 0.01) and fecal incontinence (OR 1.21, P = 0.02).

Conclusion: PhyGAs of overall health, activity, and damage are each associated with different SSc features, and changes in different PhyGA scores are discordant 50% of the time. Our findings suggest results of variably worded PhyGAs are not directly interchangeable and support the development of a standardized PhyGA.

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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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