Subgrouping of patients with rheumatoid arthritis based on pain, fatigue, inflammation, and psychosocial factors.
Subgrouping of patients with rheumatoid arthritis based on pain, fatigue, inflammation, and psychosocial factors.
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DOI：
10.1002/art.38682
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发表时间：
2014-08
影响因子：
13.3
通讯作者：
Cui, Jing
中科院分区：
文献类型：
--
作者：
Lee, Yvonne C.;Frits, Michelle L.;Iannaccone, Christine K.;Weinblatt, Michael E.;Shadick, Nancy A.;Williams, David A.;Cui, Jing
在类风湿关节炎（RA）患者中，疼痛可能是由外周炎症或其他原因引起的，比如中枢性疼痛机制。目的是利用自我报告测量和体格检查来确定类风湿关节炎患者的类别，这些患者可能有不同的疼痛原因、不同的预后以及治疗选择。
对布里格姆类风湿关节炎序贯研究中的169名类风湿关节炎患者的数据进行了分析，这些患者疼痛评分>0/10，并完成了关于疼痛、疲劳和社会心理因素的问卷调查。采用基于沃德方法的层次聚类分析程序来获得亚组。使用多元方差分析来确定聚类中每个变量的贡献。使用一般线性回归模型来检验各亚组之间临床特征的差异。进行判别分析以确定将个体病例分配到聚类的变量线性组合的系数。
三个聚类最符合这些数据。聚类1由89名炎症、疼痛、疲劳和社会心理困扰程度较低的个体组成。聚类2由57名炎症程度极低但疼痛、疲劳和社会心理困扰程度较高的个体组成。聚类3由23名患有活动性炎症疾病的个体组成，表现为关节计数高、C反应蛋白高以及疼痛和疲劳程度高。
尽管大多数患者炎症、疼痛和疲劳程度较低，但仍有47.3%的患者继续报告有中度至高度的疼痛和疲劳。这些患者中的大多数炎症迹象极小，但疲劳程度高、疼痛灾难化思维严重且睡眠障碍，这表明是一种慢性广泛性疼痛综合征。
Among rheumatoid arthritis (RA) patients, pain may be due to peripheral inflammation or other causes, such as central pain mechanisms. The objective was to use self-report measures and physical examination to identify clusters of RA patients who may have different causes of pain and different prognoses and treatment options. Data were analyzed from 169 RA patients in the Brigham Rheumatoid Arthritis Sequential Study who had pain > 0/10 and completed questionnaires on pain, fatigue and psychosocial factors. A hierarchical agglomerative clustering procedure with Ward’s method was used to obtain subgroups. Multivariate analysis of variance was used to determine the contribution of each variable in a cluster. General linear regression models were used to examine differences in clinical characteristics across subgroups. Discriminant analyses were performed to determine coefficients for linear combinations of variables that assigned cluster membership to individual cases. Three clusters best fit these data. Cluster 1 consisted of 89 individuals with low inflammation, pain, fatigue and psychosocial distress. Cluster 2 consisted of 57 individuals with minimal inflammation but high pain, fatigue and psychosocial distress. Cluster 3 consisted of 23 individuals with active inflammatory disease, manifested by high joint counts, high C-reactive protein and high pain and fatigue. Although most patients had low levels of inflammation, pain and fatigue, 47.3% continued to report moderate to high pain and fatigue. Most of these patients had minimal signs of inflammation but high levels of fatigue, pain catastrophizing and sleep disturbance, indicative of a chronic widespread pain syndrome.
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影响因子：
--
作者：
Myasoedova, Elena;Crowson, Cynthia S.;Kremers, Hilal Maradit;Therneau, Terry M.;Gabriel, Sherine E.
通讯作者：
Gabriel, Sherine E.
影响因子：
4.9
作者：
Lee YC;Cui J;Lu B;Frits ML;Iannaccone CK;Shadick NA;Weinblatt ME;Solomon DH
通讯作者：
Solomon DH
DOI：
10.1007/978-3-642-12541-6_9
发表时间：
2011-01-01
期刊：
CONCISE GUIDE TO MARKET RESEARCH: THE PROCESS, DATA, AND METHODS USING IBM SPSS STATISTICS
影响因子：
--
作者：
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通讯作者：
Sarstedt, Marko
影响因子：
5.5
作者：
Houssien, DA;Stucki, G;Scott, DL
通讯作者：
Scott, DL
影响因子：
4.8
作者：
Roehrs, Timothy;Diederichs, Christina;Roth, Thomas
通讯作者：
Roth, Thomas