Background: There is a lack of consensus as to the best way of monitoring psoriasis severity in clinical trials. The Psoriasis Area and Severity Index (PASI) is the most frequently used system and the Physician’s Glo...Background: There is a lack of consensus as to the best way of monitoring psoriasis severity in clinical trials. The Psoriasis Area and Severity Index (PASI) is the most frequently used system and the Physician’s Global Assessment (PGA) is also often used. However, both instruments have some drawbacks and neither has been fully evaluated in terms of ‘validity’and ‘reliability’as a psoriasis rating scale. The Lattice System Physician’s Global Assessment (LS-PGA) scale has recently been developed to address some disadvantages of the PASI and PGA. Objectives: To evaluate the inter-rater and intra rater reliability of the PASI, PGA and LS-PGA. Methods: On the day before the study, 14 dermatologists (raters), with varied experience of assessing psoriasis, received detailed training (2.5 h) on use of the scales. On the study day, each rater evaluated 16 adults with chronic plaque psoriasis in the morning and again in the afternoon. Raters were randomly assigned to assess subjects using the scales in a specific sequence, either PGA, LS-PGA, PASI or PGA, PASI, LS-PGA. Each rater used one sequence in the morning and the other in the afternoon. The primary endpoint was the inter-rater and intrarater reliability as determined by intraclass correlation coefficients (ICCs). Results: All three scales demonstrated ‘substantial’(a priori defined as ICC > 80%) intrarater reliability. The inter-rater reliability for each of the PASI and LS-PGA was also ‘substantial’and for the PGA was ‘moderate’(ICC 75%). Conclusions: Each one of the three scales provided reproducible psoriasis severity assessments. In terms of both intrarater and inter-rater reliability values, the three scales can be ranked from highest to lowest as follows: PASI, LS-PGA and PGA.展开更多
[目的]对简明骨骼肌肉功能评估量表(Short Musculoskeletal Function Assessment,SMFA)进行汉化,并检验其在严重创伤病人中应用的信效度。[方法]根据Brislin原则对英文版SMFA进行翻译和回译,通过专家咨询法进行评定及文化调试,形成中文...[目的]对简明骨骼肌肉功能评估量表(Short Musculoskeletal Function Assessment,SMFA)进行汉化,并检验其在严重创伤病人中应用的信效度。[方法]根据Brislin原则对英文版SMFA进行翻译和回译,通过专家咨询法进行评定及文化调试,形成中文版SMFA。通过对278例严重创伤病人进行调查,并分析其内容效度、结构效度、构念效度、内在一致性以及重测信度。[结果]中文版SMFA共包括36个条目,经探索性因子分析可提取3个公因子,累计方差贡献率为68.492%;各条目的内容效度(I-CVI)为0.742~1.000,平均内容效度(S-CVI)为0.893;与生活质量评估量表(WHOQOL-BREF)、事件影响量表-修订版(Impact of Event Scale-Revised,IES-R)及医院焦虑抑郁量表(Hospitals Anxiety and Depression Scale,HADS)的相关系数依次为为-0.672、0.398、0.324和0.462;量表的总Cronbach’sα系数为0.816,上肢功能障碍、下肢功能障碍和情绪功能障碍的Cronbach’sα系数依次为0.913、0.924及0.874;量表的总重测信度为0.853,各维度的重测信度为0.903、0.854和0.829。[结论]中文版SMFA的信效度较好,适用于对严重创伤病人的功能评估及研究。展开更多
背景脓毒症是由感染因素引发机体免疫反应失调而导致的全身炎症反应,可能会导致潜在的危及生命的器官功能障碍。目前对于未成熟血小板比率(IPF)在脓毒症严重程度及预后方面已有一些研究,但关于IPF联合其他指标在脓毒症中应用的研究较少...背景脓毒症是由感染因素引发机体免疫反应失调而导致的全身炎症反应,可能会导致潜在的危及生命的器官功能障碍。目前对于未成熟血小板比率(IPF)在脓毒症严重程度及预后方面已有一些研究,但关于IPF联合其他指标在脓毒症中应用的研究较少。目的探讨IPF联合其他指标在脓毒症严重程度及其预后中的预测价值。方法收集2020年11月—2022年11月复旦大学附属中山医院厦门医院重症医学科收治的60例脓毒症患者的临床资料进行回顾性分析。分组情况:严重程度按定义划分,可分为严重脓毒症组24例与脓毒性休克组36例;严重程度按序贯器官衰竭评估(SOFA)评分划分,可分为低SOFA组26例(SOFA评分<6分)与高SOFA组34例(SOFA评分≥6分);按预后划分,可分为生存组39例与死亡组21例。对比不同分组患者IPF及其他血液指标[中性粒细胞与白蛋白比值(NAR)、血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、乳酸与白蛋白比值(LAR)]的差异,绘制不同联合指标评估脓毒症严重程度和预后的受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC)并比较其评估价值。结果死亡组患者肺部疾病所占比例、基线急性生理学与慢性健康状况量表系统Ⅱ(APACHEⅡ)评分、基线SOFA评分高于生存组(P<0.05)。高SOFA组患者肺部疾病所占比例、基线APACHEⅡ评分、死亡所占比例高于低SOFA组(P<0.05)。对于治疗开始48hIPF,脓毒性休克组患者高于严重脓毒症组,高SOFA组患者高于低SOFA组,死亡组患者高于生存组(P<0.05)。因不同组患者治疗开始48 h IPF均存在统计学差异,故截取48 h各实验室检查指标进行进一步研究分析:IPF在预测脓毒性休克及高SOFA评分的AUC分别为0.70(95%CI=0.55~0.83,截断值为3.95%)、0.72(95%CI=0.60~0.86,截断值7.70%),预测死亡的AUC为0.73(95%CI=0.58~0.89,截断值为6.10%)。IPF+基线APACHEⅡ评分+NLR、IPF+基线APACHEⅡ评分+LAR预测高SOFA评分的AUC分别为0.91(95%CI=0.84~0.98)和0.93(95%CI=0.84~0.99);IPF+NAR+PLR预测脓毒症患者死亡的AUC为0.90(95%CI=0.81~0.98)。结论IPF联合不同血液指标能够提高临床实践中对脓毒症患者病情严重程度及预后的评估能力,治疗开始48 h IPF+基线APACHEⅡ评分+治疗开始48 h NLR及治疗开始48 h IPF+基线APACHEⅡ评分+治疗开始48 h LAR在脓毒症严重程度预测中具有较高效能;而治疗开始48h的IPF+NAR+PLR在预测脓毒症患者预后方面效能较好。展开更多
文摘Background: There is a lack of consensus as to the best way of monitoring psoriasis severity in clinical trials. The Psoriasis Area and Severity Index (PASI) is the most frequently used system and the Physician’s Global Assessment (PGA) is also often used. However, both instruments have some drawbacks and neither has been fully evaluated in terms of ‘validity’and ‘reliability’as a psoriasis rating scale. The Lattice System Physician’s Global Assessment (LS-PGA) scale has recently been developed to address some disadvantages of the PASI and PGA. Objectives: To evaluate the inter-rater and intra rater reliability of the PASI, PGA and LS-PGA. Methods: On the day before the study, 14 dermatologists (raters), with varied experience of assessing psoriasis, received detailed training (2.5 h) on use of the scales. On the study day, each rater evaluated 16 adults with chronic plaque psoriasis in the morning and again in the afternoon. Raters were randomly assigned to assess subjects using the scales in a specific sequence, either PGA, LS-PGA, PASI or PGA, PASI, LS-PGA. Each rater used one sequence in the morning and the other in the afternoon. The primary endpoint was the inter-rater and intrarater reliability as determined by intraclass correlation coefficients (ICCs). Results: All three scales demonstrated ‘substantial’(a priori defined as ICC > 80%) intrarater reliability. The inter-rater reliability for each of the PASI and LS-PGA was also ‘substantial’and for the PGA was ‘moderate’(ICC 75%). Conclusions: Each one of the three scales provided reproducible psoriasis severity assessments. In terms of both intrarater and inter-rater reliability values, the three scales can be ranked from highest to lowest as follows: PASI, LS-PGA and PGA.
文摘[目的]对简明骨骼肌肉功能评估量表(Short Musculoskeletal Function Assessment,SMFA)进行汉化,并检验其在严重创伤病人中应用的信效度。[方法]根据Brislin原则对英文版SMFA进行翻译和回译,通过专家咨询法进行评定及文化调试,形成中文版SMFA。通过对278例严重创伤病人进行调查,并分析其内容效度、结构效度、构念效度、内在一致性以及重测信度。[结果]中文版SMFA共包括36个条目,经探索性因子分析可提取3个公因子,累计方差贡献率为68.492%;各条目的内容效度(I-CVI)为0.742~1.000,平均内容效度(S-CVI)为0.893;与生活质量评估量表(WHOQOL-BREF)、事件影响量表-修订版(Impact of Event Scale-Revised,IES-R)及医院焦虑抑郁量表(Hospitals Anxiety and Depression Scale,HADS)的相关系数依次为为-0.672、0.398、0.324和0.462;量表的总Cronbach’sα系数为0.816,上肢功能障碍、下肢功能障碍和情绪功能障碍的Cronbach’sα系数依次为0.913、0.924及0.874;量表的总重测信度为0.853,各维度的重测信度为0.903、0.854和0.829。[结论]中文版SMFA的信效度较好,适用于对严重创伤病人的功能评估及研究。
文摘背景脓毒症是由感染因素引发机体免疫反应失调而导致的全身炎症反应,可能会导致潜在的危及生命的器官功能障碍。目前对于未成熟血小板比率(IPF)在脓毒症严重程度及预后方面已有一些研究,但关于IPF联合其他指标在脓毒症中应用的研究较少。目的探讨IPF联合其他指标在脓毒症严重程度及其预后中的预测价值。方法收集2020年11月—2022年11月复旦大学附属中山医院厦门医院重症医学科收治的60例脓毒症患者的临床资料进行回顾性分析。分组情况:严重程度按定义划分,可分为严重脓毒症组24例与脓毒性休克组36例;严重程度按序贯器官衰竭评估(SOFA)评分划分,可分为低SOFA组26例(SOFA评分<6分)与高SOFA组34例(SOFA评分≥6分);按预后划分,可分为生存组39例与死亡组21例。对比不同分组患者IPF及其他血液指标[中性粒细胞与白蛋白比值(NAR)、血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、乳酸与白蛋白比值(LAR)]的差异,绘制不同联合指标评估脓毒症严重程度和预后的受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC)并比较其评估价值。结果死亡组患者肺部疾病所占比例、基线急性生理学与慢性健康状况量表系统Ⅱ(APACHEⅡ)评分、基线SOFA评分高于生存组(P<0.05)。高SOFA组患者肺部疾病所占比例、基线APACHEⅡ评分、死亡所占比例高于低SOFA组(P<0.05)。对于治疗开始48hIPF,脓毒性休克组患者高于严重脓毒症组,高SOFA组患者高于低SOFA组,死亡组患者高于生存组(P<0.05)。因不同组患者治疗开始48 h IPF均存在统计学差异,故截取48 h各实验室检查指标进行进一步研究分析:IPF在预测脓毒性休克及高SOFA评分的AUC分别为0.70(95%CI=0.55~0.83,截断值为3.95%)、0.72(95%CI=0.60~0.86,截断值7.70%),预测死亡的AUC为0.73(95%CI=0.58~0.89,截断值为6.10%)。IPF+基线APACHEⅡ评分+NLR、IPF+基线APACHEⅡ评分+LAR预测高SOFA评分的AUC分别为0.91(95%CI=0.84~0.98)和0.93(95%CI=0.84~0.99);IPF+NAR+PLR预测脓毒症患者死亡的AUC为0.90(95%CI=0.81~0.98)。结论IPF联合不同血液指标能够提高临床实践中对脓毒症患者病情严重程度及预后的评估能力,治疗开始48 h IPF+基线APACHEⅡ评分+治疗开始48 h NLR及治疗开始48 h IPF+基线APACHEⅡ评分+治疗开始48 h LAR在脓毒症严重程度预测中具有较高效能;而治疗开始48h的IPF+NAR+PLR在预测脓毒症患者预后方面效能较好。
