Value of self-performed joint counts in rheumatoid arthritis patients near remission 英文参考文献.docVIP

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Value of self-performed joint counts in rheumatoid arthritis patients near remission 英文参考文献.doc

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Value of self-performed joint counts in rheumatoid arthritis patients near remission 英文参考文献

Radneretal.ArthritisResTher2012,14:R61 /content/14/2/R61 RESEARCH ARTICLE OpenAccess Valueofself-performedjointcountsin rheumatoidarthritispatientsnearremission HelgaRadner*,JohannesGrisar,JosefSSmolen,TanjaStammandDanielAletaha Abstract Introduction:Todeterminethevalidityandreliabilityofpatients’self-performedjointcountscomparedtojoint countsbyprofessionalassessorsinrheumatoidarthritis(RA)patientsindifferentdiseaseactivitystates. Methods:InpatientswithestablishedRAwedeterminedtheinter-raterreliabilityofjointcountsperformedbyan independentevaluatorandthepatientusingintraclasscorrelation(ICC),andagreementonactivityinindividual jointsbykappastatistics.Wealsoperformedlongitudinalanalysestoassessconsistencyofassessmentsovertime. Finally,weinvestigatedtheconcordanceofjointcountsofdifferentassessorsinpatientswithdifferentlevelsof diseaseactivity. Results:Thereliabilityofpatientself-performedjointcountswashighwhencomparedtoindependentobjective assessment(ICC;95%confidenceinterval(CI))fortheassessmentofswelling(0.32;0.15to0.46)andtenderness (0.75;0.66to0.81),withhigheragreementforlargerjoints(kappa:0.57and0.45,respectively)comparedtosmaller joints(metacarpo-phalangealjoint(MCPs):0.31and0.45;andproximalinterphalangealjoint(PIPs):0.22and0.47, forswellingandtenderness,respectively). PatientsinremissionaccordingtotheSimplifiedDiseaseActivityIndex(SDAI≤3.3)showedbetterconcordanceof thejointcounts(swollenjointcount(SJC)ties25/37,tenderjointcount(TJC)ties26/37)comparedtomoderate/ highdiseaseactivitystates(SDAI11;MDA/HDA:SJCties9/72,TJCties21/72).Positiveandnegativepredictive valuesregardingthepresenceofSDAIremissionwerereasonablygood(0.86and0.95,respectively).Aseparate trainingsessionforpatientsdidnotimprovethereliabilityofjointassessment.Theresultswereconsistentinthe longitudinalanalyses. Conclusions:Self-performedjointcountsareparticularlyusefulformonitoringinpatientshavingattained remission,asthesepatientsseemabletodetectstateofremission. Introduction Inrecentyears,formaldis