Comparison of the responsiveness of lupus disease activity measures to changes in systemic lupus erythematosus activity relevant to patients and physicians
Comparison of the responsiveness of lupus disease activity measures to changes in systemic lupus erythematosus activity relevant to patients and physicians
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DOI：
10.1016/s0895-4356(01)00509-1
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发表时间：
2002-05-01
影响因子：
7.2
通讯作者：
Fortin, PR
中科院分区：
文献类型：
--
作者：
Chang, E;Abrahamowicz, M;Fortin, PR
修订后的系统性红斑狼疮活动性量表（SLAM-R）和系统性红斑狼疮疾病活动性指数（SLEDAI）都是系统性红斑狼疮（SLE）疾病活动性的有效和可靠的测量方法。然而，需要对他们的反应能力进行更多的研究。本研究的目的是比较SLAM-R和SLEDAI对与医生和患者相关的疾病活动性变化的反应性。患者每月接受一次评估，持续12个月。每次就诊时，医生完成SLAM-R和SLEDAI。患者和医生评估自上次就诊以来疾病活动是否出现相关改善或恶化。基于重复测量，计算每个反应类别的效应大小（ES）、标准化反应均值（SRM）和对照标准化反应均值（CSRM），并采用基于bootstrap的95%置信区间（ci）。76例患者贡献了471次评分变化。对于医生的反应，SLAM-R和SLEDAI的CSRMs在改善方面分别为-0.47和-0.42，在无变化方面分别为0.04和0.003，在恶化方面分别为0.65和0.66。对于患者，SLAM-R和SLEDAI的CSRMs在改善组为-0.31比-0.18，在无变化组为-0.08比0.06，在恶化组为0.48比0.05。只有SLAM-R在检测到改善或恶化时95% ci排除为零。ES和SRM的结果相似。SLAM-R和SLEDAI都对SLE疾病活动性的变化有反应，这对医生来说很重要。只有SLAM-R对对患者重要的变化有反应。这些差异可能是由于SLAM-R中包含了主观SLE表现。(C) 2002爱思唯尔科学有限公司版权所有。
Both the revised Systemic Lupus Activity Measure (SLAM-R) and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) are valid and reliable measures of disease activity in systemic lupus erythematosus (SLE). However, more study of their responsiveness is needed. The purpose of this study was to compare the responsiveness of SLAM-R and SLEDAI to disease activity changes relevant to physicians and patients. Patients were evaluated monthly for up to 12 months. At each visit, the physician completed SLAM-R and SLEDAI. Patients and physicians assessed whether relevant improvement or worsening of disease activity had occurred since the previous visit. Based on repeated measurements, effect size (ES), standardized response mean (SRM), and control-standardized response mean (CSRM) were calculated for each response category, with bootstrap-based 95% confidence intervals (CIs). Seventy-six patients contributed 471 score changes. For physicians' responses, the CSRMs for SLAM-R and SLEDAI were -0.47 versus -0.42 for improvement, 0.04 versus 0.003 for no change, and 0.65 versus 0.66 for deterioration. For patients, the CSRMs for SLAM-R and SLEDAI were -0.31 versus -0.18 for improvement, -0.08 versus 0.06 for no change, and 0.48 versus 0.05 for deterioration. Only for SLAM-R did the 95% CIs exclude zero when improvement or deterioration were detected. Similar results were found for ES and SRM. Both SLAM-R and SLEDAI are responsive to changes in SLE disease activity important to physicians. Only SLAM-R is responsive to changes important to patients. These differences may result from the inclusion of subjective SLE manifestations in SLAM-R. (C) 2002 Elsevier Science Inc. All rights reserved.