机构地区:[1]Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730,China [2]Department of Epidemiology and Bio-statistics,Institute of Basic Medical Sciences,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100005,China [3]Department of Rheumatology,Peking Union Medical College Hospital(PUMCH),Peking Union Medical College&Chinese Academy of Medical Sciences,National Clinical Research Center for Dermatologic and Immunologic Diseases(NCRC-DID),Ministry of Science&Technology,Key Laboratory of Rheumatology and Clinical Immunology,Ministry of Education,State Key Laboratory of Complex Severe and Rare Diseases,Ministry of Science&Technology,Beijing 100730,China [4]Department of Rheumatology,The Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi 330006,China [5]Department of Rheumatology,The Affiliated Hospital of Inner Mongolia Medical College,Hohhot,Inner Mongolia 010050,China [6]不详
出 处:《Chinese Medical Journal》2021年第12期1465-1470,共6页中华医学杂志(英文版)
基 金:supported by grants from the Chinese National Key Research R&D Program(Nos.2017YFC0907601,2017YFC0907604);the CAMS Innovation Fund for Medical Sciences(CIFMS)(No.2019-I2M-2-008);the Fundamental Research Funds for CAMS&PUMC(No.2019PT330004).
摘 要:Background:Disease activity indices(DAIs)including disease activity score 28(DAS28),simplified disease activity index(SDAI),and clinical disease activity index(CDAI)have been widely used in clinical practice and research studies of rheumatoid arthritis(RA).The objective of our study was to evaluate the correlation and concordance among different DAIs in Chinese patients with RA.Methods:A cross-sectional study,including patients enrolled in the Chinese registry of rheumatoid arthritis from November 2016 to August 2018,was conducted.The correlations were evaluated using Spearman correlation coefficient and concordance with Bland-Altman plots,quadratic weighted kappa,and discordance rates in the crosstab.For other indices,the optimal cutoff points corresponding to SDAI remission were explored through receiver operating characteristic curve analysis.Results:A total of 30,501 patients were included,of whom 80.46%were women.Most individuals were with moderate disease activity or high disease activity.High correlations among DAS28-erythrocyte sedimentation rate(ESR)and DAS28-C-reactive protein(CRP),SDAI and CDAI were observed.Similarly,the weighted kappa value among the indices was high.In Bland-Altman plots,a positive difference between DAS28-ESR and DAS28-CRP was observed,with an absolute difference of>1.2 in 3079(10.09%)patients.In crosstab,approximately 30%of the patients were classified into different groups.Concordance values between SDAI remission and the optimal cutoff points of DAS28-ESR,DAS28-CRP,and CDAI were 3.06,2.37,and 3.20,respectively.Conclusions:Although DAIs had high correlations and weighted kappa values,the discordance between DAIs was significant in Chinese patients with RA.The four DAIs are not interchangeable.
关 键 词:Disease activity indices Rheumatoid arthritis Chinese registry of rheumatoid arthritis
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