根据44个关节 (DAPSA44) 开发和验证基于银病关节炎的疾病活动指数 (DAPSA44)
Dafne Capelusnik1, Clementina Lopez-Medina2, Désirée van der Heijde3
1Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands; Department of Rheumatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Annals of the rheumatic diseases
|September 26, 2025
概括
使用较少的关节的修改后的疾病活动指数 (DAPSA44) 显示了与原来的DAPSA相似的结果. 这种新工具对于评估脊椎关节炎 (SpA) 患者的外周关节炎是有效的,当关节数量有限时.
科学领域:
- 类风湿病学 类风湿病学
- 临床评估 临床评估
- 脊椎关节炎是一种脊柱性关节炎.
背景情况:
- 银病关节炎的疾病活动指数 (DAPSA) 是评估疾病活动的关键工具.
- 目前的DAPSA依赖于广泛的关节计数 (66个胀/68个柔软的关节),这可能是繁的.
- 使用较少关节的修改指数可能会提高患者评估效率.
研究的目的:
- 开发和验证使用44个关节计数的修改后的DAPSA (DAPSA44).
- 评估DAPSA44在脊椎关节炎 (SpA) 患者的构造有效性,包括轴性SPA (axSpA),外周SPA (pSpA) 和牛皮关节炎 (PsA).
主要方法:
- 来自PERSpA研究的患者被分为衍生 (n=1364) 和验证 (n=2757) 队列.
- 计算了转换因子,以将66/68关节数量调整为DAPSA 44.44关节的44关节.
- 使用类内相关系数 (ICC),加权卡帕,布兰德-阿尔特曼图表,斯皮尔曼相关性和标准化平均差异 (SMD) 评估构造有效性.
主要成果:
- 验证队列 (n=2757) 显示了原始DAPSA和DAPSA44之间的高度一致性 (ICC=0.98,kappa=0.95).
- 与外部结构的DAPSA44相关性与原始DAPSA相似.
- DAPSA44在活跃和非活跃疾病之间进行了优异的区分 (SMD>0.8).
结论:
- DAPSA44是对原始DAPSA的有效和可比的替代方案,用于评估SPA的外周关节炎.
- 这种修改后的索引在减少关节数量是必要或首选时特别有用.
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