The PASE questionnaire: Pilot-testing a psoriatic arthritis screening and evaluation tool

被引:161
作者
Husni, M. Elaine
Meyer, Kathryn H.
Cohen, Darel S.
Mody, Elinor
Qureshi, Abrar A.
机构
[1] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Dermatol, Boston, MA 02115 USA
[2] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Rheumat & Immunol Dis, Boston, MA 02115 USA
[3] Cleveland Clin Fdn, Cleveland, OH 44195 USA
[4] Div Rheumatol Allergy & Immunol, Boston, MA USA
[5] Ctr Skin & Related Musculoskeletal, Boston, MA USA
关键词
D O I
10.1016/j.jaad.2007.04.001
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: Complications associated with psoriatic arthritis (PsA) may be prevented with early diagnosis and initiation of therapy. Up to one third of psoriasis patients may have PsA. There is a need to screen psoriasis patients early for symptoms of PsA. Objective. To develop and validate a patient self-administered tool to screen psoriasis patients for signs and symptoms of inflammatory arthritis. Methods: The questionnaire (PASE; Psoriatic Arthritis Screening and Evaluation) was developed using standardized methodology for the development of both functional and health-related instruments geared toward musculoskeletal diseases. A multidisciplinary team of dermatologists, rheumatologists, and patient focus groups were involved in the design of the questionnaire. Results: A total of 69 participants with known psoriasis and PsA before the initiation of systemic therapy were screened with PASE after institutional review board approval. The average age was 51 years, and 51% of the participants were female. A total of 25% (17/69) were diagnosed with PsA in this study, and 37% (24/69) were diagnosed with osteoarthritis. Patients with concomitant PsA and osteoarthritis were excluded. PASE total scores ranged from 23 to 68 (possible range, 15-75). In patients with PsA, the median total score was 53 (25th and 75th percentiles, 49 and 63, respectively) and 39 (25th and 75th percentiles, 28 and 47) in non-PsA patients (P <.001). Median PASE total score for osteoarthritis patients was 43 (25th and 75th percentiles, 37 and 5 1) and significantly different to PsA patient total median scores (P =.002). Using receiver operator curves, we determined that PASE total score >= 47 was able to distinguish PsA from non-PsA patients with 82% sensitivity and 73% specificity. Limitations: PASE is a screening tool for PsA and does not replace a comprehensive musculoskeletal evaluation by a rheumatologist. Conclusion: The PASE questionnaire is a self-administered tool that can be used to screen for PsA among patients with psoriasis. PASE can distinguish between symptoms of PsA and osteoarthritis. A larger study is needed to validate PASE in dermatology clinics in the community.
引用
收藏
页码:581 / 587
页数:7
相关论文
共 18 条
[1]  
Alenius GM, 2002, J RHEUMATOL, V29, P2577
[2]   Diagnosis and management of psoriatic arthritis [J].
Brockbank, J ;
Gladman, D .
DRUGS, 2002, 62 (17) :2447-2457
[3]   Psoriatic arthritis [J].
Brockbank, J ;
Gladman, DD .
EXPERT OPINION ON INVESTIGATIONAL DRUGS, 2000, 9 (07) :1511-1522
[4]   New topical treatments change the pattern of treatment of psoriasis: dermatologists remain the primary providers of this care [J].
Feldman, SR ;
Fleischer, AB ;
Cooper, JZ .
INTERNATIONAL JOURNAL OF DERMATOLOGY, 2000, 39 (01) :41-44
[5]   Epidemiology of psoriatic arthritis in the population of the United States [J].
Gelfand, JM ;
Gladman, DD ;
Mease, PJ ;
Smith, N ;
Margolis, DJ ;
Nijsten, T ;
Stern, RS ;
Feldman, SR ;
Rolstad, T .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2005, 53 (04) :573-577
[6]   The treatment of psoriasis and psoriatic arthritis: An interdisciplinary approach [J].
Gordon, KB ;
Ruderman, EM .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2006, 54 (03) :S85-S91
[7]   Psoriatic arthritis: performance of rheumatologists in daily practice [J].
Gorter, S ;
van der Heijde, DMFM ;
van der Linden, S ;
Houben, H ;
Rethans, JJ ;
Scherpbier, AJJA ;
van der Vleuten, CPM .
ANNALS OF THE RHEUMATIC DISEASES, 2002, 61 (03) :219-224
[8]   Management of psoriatic arthritis: The therapeutic interface between rheumatology and dermatology [J].
Mease P. .
Current Rheumatology Reports, 2006, 8 (5) :348-354
[9]   Recent advances in the management of psoriatic arthritis [J].
Mease, PJ .
CURRENT OPINION IN RHEUMATOLOGY, 2004, 16 (04) :366-370
[10]  
MOLL J M H, 1973, Seminars in Arthritis and Rheumatism, V3, P55, DOI 10.1016/0049-0172(73)90035-8