Evaluating psoriasis with psoriasis area and severity index, psoriasis global assessment, and lattice system physician's global assessment
Evaluating psoriasis with psoriasis area and severity index, psoriasis global assessment, and lattice system physician's global assessment
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DOI：
10.1016/j.jaad.2004.04.012
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发表时间：
2004-10-01
影响因子：
13.8
通讯作者：
Ellis, CN
中科院分区：
文献类型：
--
作者：
Langley, RG;Ellis, CN
背景：可靠的评估银屑病的严重程度对于临床研究中记录治疗反应是必不可少的。目前临床结果测量的可靠性是不确定的。目的：量化常用结果测量的相对变化（Psample-Area and Severity Index [PASI]和Psample-Global Assessment [PGA]的一个版本），以及一个较新的衡量标准，Lattice System Physician's Global Assessment（LS-PGA）。（53%; 9/17）或经验不足（47%; 8/17）的患者，采用PASI和PGA对35例银屑病患者随机进行两次评估。结果：PASI、PGA和LS-PGA高度相关（所有比较r > 0.8），总体可靠性高（Cronbach 'salpha> 0.9）。PGA和LS-PGA较PASI具有更小的变异。LS-PGA在两个评价之间的一致性系数比PGA高55%。在校正测量误差之前和之后，PGA和LS-PGA的评定者间变异均低于PASI。经验是有益的，在减少PASI分数的变化，但不需要与PGA或LS-PGA.Conclusion：LS-PGA，这是标准化的，不需要经验，并提供离散的字为基础的分数与内在的含义，是一个可靠的措施，在银屑病的治疗效果，并允许在不同的临床试验进行比较。
Background: Reliable assessment of severity in psoriasis is essential to document treatment responses in clinical research. The reliability of current clinical outcome measures is uncertain.Objective: To quantify the relative variation in commonly used outcome measures (the Psoriasis Area and Severity Index [PASI] and one version of the Psoriasis Global Assessment [PGA]), and a newer measure, the Lattice System Physician's Global Assessment (LS-PGA).Methods: Physicians who were experienced (53%; 9/17) or inexperienced (47%; 8/17) in using PASI and PGA evaluated 35 patients with psoriasis in random order twice with each rating system. We assessed the variation in scoring psoriasis severity within (intrarater) and among (interrater) physicians.Results: PASI, PGA, and LS-PGA were highly correlated (r > 0.8 for all comparisons) and had high overall reliability (Cronbach's alpha > 0.9 for each). PGA and LS-PGA had lower intrarater variation than PASI. LS-PGA had a 55% higher concordance coefficient between the two evaluations than did PGA. Interrater variation was lower for PGA and LS-PGA than for PASI both before and after correction for measurement error. Experience was beneficial in reducing variation in PASI scores but was not required with PGA or LS-PGA.Conclusion: The LS-PGA, which is standardized, does not require experience, and provides discrete word-based scores with intrinsic meaning, is a reliable measure of therapeutic effect in psoriasis, and would allow comparisons across different clinical trials.