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Thibault T, Rajillah A, Bourredjem A, Corneloup M, Maurier F, Wahl D, Muller G, Aumaitre O, Sève P, Blaison G, Besancenot JF, Martin T, Magy-Bertrand N, Samson M, Arnaud L, Amoura Z, Devilliers H. Health-related quality of life, remission and low lupus disease activity state in patients with systemic lupus erythematosus. Rheumatology (Oxford) 2024; 63:1447-1455. [PMID: 37589711 DOI: 10.1093/rheumatology/kead407] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVES To measure the association between SLE remission and scores of patients-reported outcome (PRO) measures. METHODS We performed a prospective cohort study of SLE patients with a 2-year follow-up, using Lupus Patient-Reported Outcome (LupusPRO), Lupus Quality of Life (LupusQoL), Systemic Lupus Erythematosus Quality of Life (SLEQOL) and 36-item Short Form (SF-36) questionnaires. Remission was defined as remission off treatment (ROFT) and remission on treatment (RONT) according to the definitions of remission in SLE consensus. Mixed models accounting for repeated measures were used to compare groups as follow: ROFT and RONT vs no remission and lupus low disease activity state (LLDAS) vs no LLDAS. RESULTS A total of 1478 medical visits and 2547 PRO questionnaires were collected during the follow-up from the 336 recruited patients. A between-group difference in PRO scores reaching at least 5 points on a 0-100 scale was obtained in the following domains: lupus symptoms (LLDAS: +5 points on the 0-100 scale, RONT: +9, ROFT: +5), lupus medication (LLDAS: +5, RONT: +8, ROFT: +9), pain vitality (LLDAS: +6, RONT: +9, ROFT: +6) of LupusPRO; role emotional (LLDAS: +5, RONT: +8), role physical (RONT: +7 and ROFT: +7), bodily pain (RONT: +6), mental health (RONT: +5) and social functioning (RONT: +6) of SF-36. In contrast, a between-group difference reaching at least 5 points was not achieved for any of the LupusQoL and SLEQOL domains. CONCLUSIONS RONT, ROFT and LLDAS were associated with significant and clinically relevant higher QoL in most PRO domains of the LupusPRO (disease specific) and SF-36 (generic) questionnaires, but not with LupusQoL and SLEQOL disease-specific questionnaires.
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Affiliation(s)
- Thomas Thibault
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon, France
| | - Abdessamad Rajillah
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
| | - Abderrahmane Bourredjem
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon, France
| | - Marie Corneloup
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon, France
| | - François Maurier
- Department of Internal Medicine and Clinical Immunology, Hôpital Robert Schuman, Metz-Vantoux, 57070, France
| | - Denis Wahl
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Inserm UMR_S 1116, CHRU de Nancy, University of Lorraine, Nancy, France
| | - Geraldine Muller
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
| | - Olivier Aumaitre
- Department of Internal Medicine, Centre Hospitalier Universitaire, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Pascal Sève
- Department of Internal Medicine, Lyon University Hospital, Hôpital Croix Rousse, Lyon, France
- Research on Healthcare Performance, INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
| | - Gilles Blaison
- Department of Internal Medicine, Hôpital Louis Pasteur, Colmar, France
| | | | - Thierry Martin
- Internal Medicine and Clinical Immunology Department, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest Strasbourg University Hospital, Strasbourg, France
| | - Nadine Magy-Bertrand
- Department of Internal Medicine, University Hospital Jean Minjoz, Besançon, France
| | - Maxime Samson
- Internal Medicine and Clinical Immunology Unit, University Hospital Dijon-Burgundy, Dijon, France
| | - Laurent Arnaud
- Department of Rheumatology, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM UMR-S 1109, Strasbourg, France
| | - Zahir Amoura
- Department of Internal Medicine, National Referral Center for Systemic Lupus Erythematosus and Anti-Phospholipid Syndrome, Pitié-Salpêtrière University Hospital, Paris, France
| | - Hervé Devilliers
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon, France
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Toor IK, Rastogi K, Ajmani S. Integrating spiritual disposition intervention into behavioral medicine: A case report on systemic lupus erythematosus from India. Lupus 2024; 33:420-429. [PMID: 38166465 DOI: 10.1177/09612033231225895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Background: Systemic Lupus Erythematosus (SLE) is a chronic inflammatory systemic autoimmune disease. The disease manifests as the body's immune cells start attacking healthy connective tissue, which affects the skin, kidneys, blood vessels, brain, and other vital organs. As with any other chronic illness, the disease has psychological implications.Purpose: Literature suggests patients with SLE experience anxiety, depression, anger, and stress along with physiological symptoms. There is a strong association between the occurrence of stress and the onset of the disease. These psychological symptoms can be ameliorated through spiritual activities such as meditation, mindfulness, journaling, and reading.Mehtod: This case report is based on the importance of spirituality in the healthcare system. The study focuses on the concept of a whole-person-centered approach to the medical care industry. Spirituality has been proven to have a positive effect on health and illness. Hence, a 10-week intervention with 30 sessions focusing on spiritual dispositions was provided to the patient for this study, along with regular pharmacological treatment. The present case report is of a 56-year-old woman from New Delhi, India, who was diagnosed with SLE 2 years ago.Results: The results reveal the positive effect of the intervention, as it led to a significant decrease in stress levels and depressive symptoms; it also resulted in improved quality of life, an enhanced coping style, and bolstered health hardiness. There was an increase in the score of a spiritual personality.Conlcusion: Spiritual Disposition as an intervention was sucessfull in reducing psychological implications of the disease thus leading to overall positve growth in the patient.
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Affiliation(s)
- Ishanpreet Kaur Toor
- Department of Psychology, CHRIST (Deemed to be University) Delhi-NCR, Ghaziabad, India
| | - Kritika Rastogi
- Department of Psychology, CHRIST (Deemed to be University) Delhi-NCR, Ghaziabad, India
| | - Sajal Ajmani
- Rheumatology Department at BLK-Max Super Speciality Hospital, New Delhi, India
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Thibault T, Bourredjem A, Maurier F, Wahl D, Muller G, Aumaitre O, Sève P, Blaison G, Pennaforte JL, Martin T, Magy-Bertrand N, Audia S, Arnaud L, Amoura Z, Devilliers H. The mediating effect of fatigue in impaired quality of life in systemic lupus erythematosus: mediation analysis of the French EQUAL cohort. Rheumatology (Oxford) 2023; 62:3051-3058. [PMID: 36655762 DOI: 10.1093/rheumatology/kead020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES Mediation analyses were conducted to measure the extent to which musculoskeletal (MSK) flares and depression affected physical health through excessive fatigue. METHODS Mediation analyses were performed in a large multicentre cohort of SLE patients. Domains of the LupusQoL and SLEQOL questionnaires were selected as outcomes, MSK flares according to the SELENA-SLEDAI flare index (SFI-R) score and depression defined by Center for Epidemiologic Studies-Depression scale (CES-D) scale as exposures and different fatigue domains from MFI-20 and LupusQoL questionnaires as mediators. For each model, total, direct, indirect effects and proportion of effect mediated by fatigue (i.e. proportion of change in health-related quality of life) were determined. RESULTS Of the 336 patients, 94 (28%) had MSK flares at inclusion and 99 (29.5%) were considered with depression. The proportion of the total effect of MSK flares on physical health impairment explained by fatigue ranged from 59.6% to 78% using the LupusQOL 'Physical health' domain and from 51.1% to 73.7% using the SLEQOL 'Physical functioning' domain, depending on the fatigue domain selected. The proportion of the total effect of depression on physical health impairment explained by fatigue ranged from 68.8% to 87.6% using the LupusQOL 'Physical health' domain and from 79.3% to 103.2% using the SLEQOL 'Physical functioning' domain, depending on the fatigue domain selected. CONCLUSIONS The effect of MSK flares and depression on physical health impairment is largely mediated by fatigue. Thus, the patient's perception of disease activity as measured by physical health is largely influenced by fatigue. In addition, fatigue has a significant negative impact on quality of lifeof SLE patients with depression. TRIAL REGISTRATION ClinicalTrials.gov, http://clinicaltrials.gov, NCT01904812.
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Affiliation(s)
- Thomas Thibault
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon, France
| | - Abderrahmane Bourredjem
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon, France
| | - François Maurier
- Department of Internal Medicine and Clinical Immunology, Hôpital Robert Schuman, Metz-Vantoux, France
| | - Denis Wahl
- Inserm UMR_S 1116, CHRU de Nancy, Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, University of Lorraine, Nancy, France
| | - Geraldine Muller
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
| | - Olivier Aumaitre
- Department of Internal Medicine, Centre Hospitalier Universitaire, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Pascal Sève
- Department of Internal Medicine, Lyon University Hospital, Hôpital Croix Rousse, Lyon, France
| | - Gilles Blaison
- Department of Internal Medicine, Hôpital Louis Pasteur, Colmar, Alsace, France
| | - Jean-Loup Pennaforte
- Department of Internal Medicine, Centre Hospitalier Universitaire de Reims, Hôpital Robert Debré, Reims, France
| | - Thierry Martin
- Internal Medicine and Clinical Immunology Department, Strasbourg University Hospital, Strasbourg, France
| | - Nadine Magy-Bertrand
- Department of Internal Medicine, University Hospital Jean Minjoz, Besançon, France
| | - Sylvain Audia
- Internal Medicine and Clinical Immunology Unit, University Hospital Dijon-Burgundy, Dijon, France
| | - Laurent Arnaud
- Department of Rheumatology, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest (RESO), Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- INSERM UMR-S 1109, Strasbourg, France
| | - Zahir Amoura
- Department of Internal Medicine, National Referral Center for Systemic Lupus Erythematosus and Anti-Phospholipid Syndrome, Pitié-Salpêtrière University Hospital, Paris, France
| | - Hervé Devilliers
- Internal Medicine and Systemic Diseases Unit, University Hospital Dijon-Burgundy, Dijon, France
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon, France
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Ahmad Pouzi NA, Shaharir SS, Mohd Tamil A, Mustafar R, Ahmad Maulana S, Mageswaren E, Wan Ghazali WS. Validation and the associated factors of the Malay version of systemic lupus erythematosus-specific health-related quality of life questionnaires (SLEQoL and LupusQoL). PLoS One 2023; 18:e0285461. [PMID: 37186611 PMCID: PMC10184909 DOI: 10.1371/journal.pone.0285461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/25/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES To assess the reliability and validity of two disease-specific questionnaires that assess the quality of life (QoL) among patients with Systemic Lupus Erythematosus (SLE); SLEQoL and LupusQoL in Malay language. This study also identified the factors affecting each domain of the questionnaires. METHODS This cross-sectional study was conducted from June 2021 until April 2022, and SLE patients were recruited to complete the SLEQoL, LupusQoL and Short Form Health Survey (SF-36) in Malay language. Disease activity were recorded using the modified SLE Disease Activity Index (M- SLEDAI) and British Isles Lupus Assessment Group 2004 (BILAG-2004) index. Presence of organ damage was determined using the SLICC Damage index. Cronbach's alpha was calculated to determine internal consistency while exploratory factor analysis was done to determine the construct validity. Concurrent validity was evaluated using correlation with SF-36. Multiple linear regression analysis was deployed to determine the factors affecting each domain of SLEQoL and LupusQoL. RESULTS A total of 125 subjects were recruited. The Cronbach's α value for the Malay-SLEQoL (M-SLEQoL) and Malay-LupusQOL (M-LupusQoL) was 0.890 and 0.944 respectively. Exploratory factor analysis found formation of similar number of components with the original version of questionnaires and all items have good factor loading of >0.4. Both instruments also had good concurrent validity with SF-36. M-SLEQoL had good correlations with BILAG-2004 and M-SLEDAI scores. Musculoskeletal (MSK) involvement was independently associated with lower M-SLEQoL in physical function, activity and symptom domains. Meanwhile, MSK and NPSLE were associated with fatigue in M-LupusQoL. CONCLUSION Both M-SLEQoL and M-LupusQoL are reliable and valid as disease -specific QoL instruments for Malaysian patients. The M-Lupus QoL has better discriminative validity compared to the M-SLEQoL. SLE patients with MSK involvement are at risk of poor QoL in multiple domains including physical function, activity, symptoms and fatigue.
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Affiliation(s)
- Nur Aqeelah Ahmad Pouzi
- Department of Internal Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia
| | - Syahrul Sazliyana Shaharir
- Department of Internal Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia
| | - Azmi Mohd Tamil
- Department of Public Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia
| | - Ruslinda Mustafar
- Department of Internal Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Cheras, Kuala Lumpur, Malaysia
| | | | - Eashwary Mageswaren
- Medical Department, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia
| | - Wan Syamimee Wan Ghazali
- Department of Internal Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Nguyen MH, Huang FF, O’Neill SG. Patient-Reported Outcomes for Quality of Life in SLE: Essential in Clinical Trials and Ready for Routine Care. J Clin Med 2021; 10:jcm10163754. [PMID: 34442047 PMCID: PMC8396817 DOI: 10.3390/jcm10163754] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/17/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022] Open
Abstract
Patient-reported outcome (PRO) instruments are widely used to assess quality of life in Systemic Lupus Erythematosus (SLE) research, and there is growing evidence for their use in clinical care. In this review, we evaluate the current evidence for their use in assessing quality of life in SLE in both research and clinical settings and examine the different characteristics of the commonly used PRO tools. There are now several well-validated generic and SLE-specific tools that have demonstrated utility in clinical trials and several tools that complement activity and damage measures in the clinical setting. PRO tools may help overcome physician–patient discordance in SLE and are valuable in the assessment of fibromyalgia and type 2 symptoms such as widespread pain and fatigue. Future work will identify optimal PRO tools for different settings but, despite current limitations, they are ready to be incorporated into patient care.
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Affiliation(s)
- Matthew H. Nguyen
- Liverpool Hospital, Liverpool, NSW 2170, Australia;
- Pathology Department, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Kensington, NSW 2052, Australia
| | - Frank F. Huang
- Rheumatology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia;
| | - Sean G. O’Neill
- Rheumatology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia;
- Northern Clinical School, Faculty of Medicine and Health, University of Sydney, St Leonards, NSW 2065, Australia
- Correspondence: ; Tel.: +61-02-94631890
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Hernández-Doño S, Jakez-Ocampo J, Márquez-García JE, Ruiz D, Acuña-Alonzo V, Lima G, Llorente L, Tovar-Méndez VH, García-Silva R, Granados J, Zúñiga J, Vargas-Alarcón G. Heterogeneity of Genetic Admixture Determines SLE Susceptibility in Mexican. Front Genet 2021; 12:701373. [PMID: 34413879 PMCID: PMC8369992 DOI: 10.3389/fgene.2021.701373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/12/2021] [Indexed: 12/11/2022] Open
Abstract
Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory disorder for which Major Histocompatibility Complex (MHC) genes are well identified as risk factors. SLE patients present different clinical phenotypes, which are partly explained by admixture patterns variation among Mexicans. Population genetic has insight into the high genetic variability of Mexicans, mainly described through HLA gene studies with anthropological and biomedical importance. A prospective, case-control study was performed. In this study, we recruited 146 SLE patients, and 234 healthy individuals were included as a control group; both groups were admixed Mexicans from Mexico City. The HLA typing methods were based on Next Generation Sequencing and Sequence-Based Typing (SBT). The data analysis was performed with population genetic programs and statistical packages. The admixture estimations based on HLA-B and -DRB1 revealed that SLE patients have a higher Southwestern European ancestry proportion (48 ± 8%) than healthy individuals (30 ± 7%). In contrast, Mexican Native American components are diminished in SLE patients (44 ± 1%) and augmented in Healthy individuals (63 ± 4%). HLA alleles and haplotypes' frequency analysis found variants previously described in SLE patients from Mexico City. Moreover, a conserved extended haplotype that confers risk to develop SLE was found, the HLA-A∗29:02∼C∗16:01∼B∗44:03∼DRB1∗07:01∼DQB1∗02:02, pC = 0.02, OR = 1.41. Consistent with the admixture estimations, the origin of all risk alleles and haplotypes found in this study are European, while the protection alleles are Mexican Native American. The analysis of genetic distances supported that the SLE patient group is closer to the Southwestern European parental populace and farthest from Mexican Native Americans than healthy individuals. Heterogeneity of genetic admixture determines SLE susceptibility and protection in Mexicans. HLA sequencing is helpful to determine susceptibility alleles and haplotypes restricted to some populations.
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Affiliation(s)
- Susana Hernández-Doño
- Immunogenetics Division, Department of Transplant, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Juan Jakez-Ocampo
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - José Eduardo Márquez-García
- Molecular Biology Core Facility, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico
| | - Daniela Ruiz
- Department of Dermatology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
| | - Víctor Acuña-Alonzo
- Laboratory of Physiology, Biochemistry, and Genetics, Escuela Nacional de Antropología e Historia, Mexico City, Mexico
| | - Guadalupe Lima
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Luis Llorente
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Víctor Hugo Tovar-Méndez
- Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Rafael García-Silva
- Department of Internal Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Julio Granados
- Immunogenetics Division, Department of Transplant, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Joaquín Zúñiga
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.,Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico City, Mexico
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Carrión-Nessi FS, Marcano-Rojas MV, Freitas-DeNobrega DC, Romero Arocha SR, Antuarez-Magallanes AW, Fuentes-Silva YJ. Validation of the LupusQoL in Venezuela: A specific measurement of quality of life in patients with systemic lupus erythematosus. ACTA ACUST UNITED AC 2021; 18:355-360. [PMID: 34373232 DOI: 10.1016/j.reumae.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/14/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Traditionally, the health-related quality of life (HRQoL) of patients with systemic lupus erythematosus (SLE) has been assessed using instruments that neglect the specific characteristics of the disease. This study determines the validity of the Lupus Quality of Life (LupusQoL) questionnaire as a psychometrically stable instrument to measure the HRQoL of patients with SLE in Venezuela and establishes the cutoff points of the questionnaire for the Venezuelan population. PATIENTS AND METHODS A cross-sectional study was conducted that included patients with SLE from April to July 2018. Patients completed the LupusQoL and the "Generalitat de Catalunya" (GENCAT) scale; sociodemographic data, activity index (SLEDAI) and accumulated damage (SLICC), were obtained. Reliability was evaluated by internal consistency and the convergent validity of the LupusQoL was determined with the GENCAT scale. RESULTS Of the 100 patients, 93% were women, the mean age was 42 years old (SD: 13) and the mean duration of the disease was 11 years (SD: 9); the mean of SLEDAI and SLICC was 3 and 1, respectively. The cutoff point that defined a "better" or "worse" HRQoL for LupusQoL was 64.55 points. A moderate convergence was found after grouping, according to the cutoff points, of the LupusQoL with the GENCAT scale (Cohen's kappa coefficient = .556; p = .000). CONCLUSIONS The LupusQoL is a valid psychometrically stable instrument to measure the HRQoL of patients with SLE in Venezuela. Cutoff points were established to stratify the HRQoL in the Venezuelan population with LES, being useful to complement a comprehensive evaluation.
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Affiliation(s)
- Fhabián S Carrión-Nessi
- Escuela de Ciencias de la Salud «Dr. Francisco Battistini Casalta», Universidad de Oriente-Núcleo Bolívar, Ciudad Bolívar, Venezuela.
| | - María V Marcano-Rojas
- Programa de Enfermedades Endocrino-Metabólicas, Instituto de Salud Pública, Ciudad Bolívar, Venezuela
| | - Diana C Freitas-DeNobrega
- Escuela de Ciencias de la Salud «Dr. Francisco Battistini Casalta», Universidad de Oriente-Núcleo Bolívar, Ciudad Bolívar, Venezuela
| | - Sinibaldo R Romero Arocha
- Programa de Formación de Científicos Médicos (MD/PhD), Facultad de Medicina, Universidad de Minnesota, MN, United States
| | - Allen W Antuarez-Magallanes
- Escuela de Ciencias de la Salud «Dr. Francisco Battistini Casalta», Universidad de Oriente-Núcleo Bolívar, Ciudad Bolívar, Venezuela
| | - Yurilís J Fuentes-Silva
- Escuela de Ciencias de la Salud «Dr. Francisco Battistini Casalta», Universidad de Oriente-Núcleo Bolívar, Ciudad Bolívar, Venezuela; Centro Clínico Universitario de Oriente, Ciudad Bolívar, Venezuela
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Annapureddy N, Jolly M. Patient-Reported Outcomes in Lupus. Rheum Dis Clin North Am 2021; 47:351-378. [PMID: 34215368 DOI: 10.1016/j.rdc.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Patient-reported outcome (PRO) was identified as a core systemic lupus erythematosus (SLE) outcome in 1999. More than 20 years later, however, generic PRO measures evaluating impact in SLE are used mainly for research. Generic and disease-targeted PRO tools have unique advantages. Significant progress in identification of patient disease-relevant PRO concepts and development of new PRO tools for SLE has occurred over the past 20 years. Further research needs to focus on responsiveness and minimally important differences of existing, promising PRO tools to facilitate their use in SLE patient care and research.
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Affiliation(s)
- Narender Annapureddy
- Department of Medicine, Vanderbilt University, 1160 21st Avenue, Suite T3113 MCN, Nashville, TN 37232, USA
| | - Meenakshi Jolly
- Department of Medicine, Rush University, 1611 West Harrison Street, Suite 510, Chicago, IL 60615, USA.
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Lai NS, Lu MC, Chang HH, Lo HC, Hsu CW, Huang KY, Tung CH, Hsu BB, Wu CH, Koo M. A Comparison of the Correlation of Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) with Health-Related Quality of Life. J Clin Med 2021; 10:jcm10102137. [PMID: 34063379 PMCID: PMC8157030 DOI: 10.3390/jcm10102137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/03/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Aim: The aim of this study was to compare the correlation of a recently developed systemic lupus erythematosus disease activity score (SLE-DAS) with the SLE disease activity index 2000 (SLEDAI-2K) with the Lupus Quality of Life questionnaire (LupusQoL) in Taiwanese patients with SLE. Methods: A cross-sectional study was conducted in a regional teaching hospital in Taiwan from April to August 2019. Adult patients with a clinician-confirmed diagnosis of SLE based on the 1997 American College of Rheumatology revised criteria or the 2012 Systemic Lupus International Collaborating Clinics Classification Criteria were recruited. SLE disease activity was measured with both SLEDAI-2K and SLE-DAS. Disease-specific quality of life was assessed using the LupusQoL. Results: Of the 333 patients with SLE in this study, 90.4% were female and 40% were between the ages of 20 and 39 years. The median SLEDAI-2K score was 4.00 (interquartile range [IQR] 2.00–7.50) and the median SLE-DAS score was 2.08 (IQR 1.12–8.24) in our patients with SLE. After adjusting for sex and age intervals, both SLEDAI-2k and SLE-DAS were significantly and inversely associated with all eight domains of LupusQoL. The magnitudes of the mean absolute error, root mean square error, Akaike Information Criterion, Bayesian Information Criterion, and coefficient of determination were comparable between SLEDAI-2K and SLE-DAS. Conclusions: There were no clear differences in the use of SLE-DAS over SLEDAI-2K in assessing HRQoL in patients with SLE. We suggest that, in this aspect, both SLEDAI-2K and SLE-DAS are effective tools for measuring disease activity in patients with SLE.
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Affiliation(s)
- Ning-Sheng Lai
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (N.-S.L.); (M.-C.L.); (K.-Y.H.); (C.-H.T.); (B.-B.H.); (C.-H.W.)
- School of Medicine, Tzu Chi University, Hualien City, Hualien 97004, Taiwan
| | - Ming-Chi Lu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (N.-S.L.); (M.-C.L.); (K.-Y.H.); (C.-H.T.); (B.-B.H.); (C.-H.W.)
- School of Medicine, Tzu Chi University, Hualien City, Hualien 97004, Taiwan
| | - Hsiu-Hua Chang
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (H.-H.C.); (H.-C.L.); (C.-W.H.)
| | - Hui-Chin Lo
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (H.-H.C.); (H.-C.L.); (C.-W.H.)
| | - Chia-Wen Hsu
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (H.-H.C.); (H.-C.L.); (C.-W.H.)
| | - Kuang-Yung Huang
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (N.-S.L.); (M.-C.L.); (K.-Y.H.); (C.-H.T.); (B.-B.H.); (C.-H.W.)
- School of Medicine, Tzu Chi University, Hualien City, Hualien 97004, Taiwan
| | - Chien-Hsueh Tung
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (N.-S.L.); (M.-C.L.); (K.-Y.H.); (C.-H.T.); (B.-B.H.); (C.-H.W.)
- School of Medicine, Tzu Chi University, Hualien City, Hualien 97004, Taiwan
| | - Bao-Bao Hsu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (N.-S.L.); (M.-C.L.); (K.-Y.H.); (C.-H.T.); (B.-B.H.); (C.-H.W.)
| | - Cheng-Han Wu
- Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi 622401, Taiwan; (N.-S.L.); (M.-C.L.); (K.-Y.H.); (C.-H.T.); (B.-B.H.); (C.-H.W.)
| | - Malcolm Koo
- Graduate Institute of Long-Term Care, Tzu Chi University of Science and Technology, Hualien City, Hualien 973302, Taiwan
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Correspondence:
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Carrión-Nessi FS, Marcano-Rojas MV, Freitas-DeNobrega DC, Romero Arocha SR, Antuarez-Magallanes AW, Fuentes-Silva YJ. Validation of the LupusQoL in Venezuela: A Specific Measurement of Quality of Life in Patients with Systemic Lupus Erythematosus. REUMATOLOGIA CLINICA 2021; 18:S1699-258X(21)00061-9. [PMID: 33931336 DOI: 10.1016/j.reuma.2021.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/02/2020] [Accepted: 02/14/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Traditionally, the health-related quality of life (HRQoL) of patients with systemic lupus erythematosus (SLE) has been assessed using instruments that neglect the specific characteristics of the disease. This study determines the validity of the Lupus Quality of Life (LupusQoL) questionnaire as a psychometrically stable instrument to measure the HRQoL of patients with SLE in Venezuela and establishes the cutoff points of the questionnaire for the Venezuelan population. PATIENTS AND METHODS A cross-sectional study was conducted that included patients with SLE from April to July 2018. Patients completed the LupusQoL and the Generalitat de Catalunya (GENCAT) scale; sociodemographic data, activity index (SLEDAI) and accumulated damage (SLICC), were obtained. Reliability was evaluated by internal consistency and the convergent validity of the LupusQoL was determined with the GENCAT scale. RESULTS Of the 100 patients, 93% were women, the mean age was 42years old (SD: 13) and the mean duration of the disease was 11years (SD: 9); the mean of SLEDAI and SLICC was 3 and 1, respectively. The cutoff point that defined a "better" or "worse" HRQoL for LupusQoL was 64.55 points. A moderate convergence was found after grouping, according to the cutoff points, of the LupusQoL with the GENCAT scale (Cohen's kappa coefficient=.556; p=.000). CONCLUSIONS The LupusQoL is a valid psychometrically stable instrument to measure the HRQoL of patients with SLE in Venezuela. Cutoff points were established to stratify the HRQoL in the Venezuelan population with LES, being useful to complement a comprehensive evaluation.
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Affiliation(s)
- Fhabián S Carrión-Nessi
- Escuela de Ciencias de la Salud «Dr. Francisco Battistini Casalta», Universidad de Oriente-Núcleo Bolívar, Ciudad Bolívar, Venezuela.
| | - María V Marcano-Rojas
- Programa de Enfermedades Endocrino-Metabólicas, Instituto de Salud Pública, Ciudad Bolívar, Venezuela
| | - Diana C Freitas-DeNobrega
- Escuela de Ciencias de la Salud «Dr. Francisco Battistini Casalta», Universidad de Oriente-Núcleo Bolívar, Ciudad Bolívar, Venezuela
| | - Sinibaldo R Romero Arocha
- Programa de Formación de Científicos Médicos (MD/PhD), Facultad de Medicina, Universidad de Minnesota, Minnesota, Estados Unidos
| | - Allen W Antuarez-Magallanes
- Escuela de Ciencias de la Salud «Dr. Francisco Battistini Casalta», Universidad de Oriente-Núcleo Bolívar, Ciudad Bolívar, Venezuela
| | - Yurilís J Fuentes-Silva
- Escuela de Ciencias de la Salud «Dr. Francisco Battistini Casalta», Universidad de Oriente-Núcleo Bolívar, Ciudad Bolívar, Venezuela; Centro Clínico Universitario de Oriente, Ciudad Bolívar, Venezuela
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Izadi Z. Health‐Related Quality of Life Measures in Adult Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:577-592. [DOI: 10.1002/acr.24245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/28/2020] [Indexed: 12/31/2022]
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Corneloup M, Maurier F, Wahl D, Muller G, Aumaitre O, Seve P, Blaison G, Pennaforte JL, Martin T, Magy-Bertrand N, Berthier S, Arnaud L, Bourredjem A, Amoura Z, Devilliers H. Disease-specific quality of life following a flare in systemic lupus erythematosus: an item response theory analysis of the French EQUAL cohort. Rheumatology (Oxford) 2020; 59:1398-1406. [PMID: 31620787 DOI: 10.1093/rheumatology/kez451] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/30/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore, at an item-level, the effect of disease activity (DA) on specific health-related quality of life (HRQoL) in SLE patients using an item response theory longitudinal model. METHODS This prospective longitudinal multicentre French cohort EQUAL followed SLE patients over 2 years. Specific HRQoL according to LupusQoL and SLEQOL was collected every 3 months. DA according to SELENA-SLEDAI flare index (SFI) and revised SELENA-SLEDAI flare index (SFI-R) was evaluated every 6 months. Regarding DA according to SFI and each SFI-R type of flare, specific HRQoL of remitting patients was compared with non-flaring patients fitting a linear logistic model with relaxed assumptions for each domain of the questionnaires. RESULTS Between December 2011 and July 2015, 336 patients were included (89.9% female). LupusQoL and SLEQOL items related to physical HRQoL (physical health, physical functioning, pain) were most affected by musculoskeletal and cutaneous flares. Cutaneous flares had significant influence on self-image. Neurological or psychiatric flares had a more severe impact on specific HRQoL. Patient HRQoL was impacted up to 18 months after a flare. CONCLUSION Item response theory analysis is able to pinpoint items that are influenced by a given patient group in terms of a latent trait change. Item-level analysis provides a new way of interpreting HRQoL variation in SLE patients, permitting a better understanding of DA impact on HRQoL. This kind of analysis could be easily implemented for the comparison of groups in a clinical trial. TRIAL REGISTRATION ClinicalTrials.gov, http://clinicaltrials.gov, NCT01904812.
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Affiliation(s)
- Marie Corneloup
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
| | - François Maurier
- Department of Internal Medicine and Clinical Immunology, Site Belle Isle, Metz
| | - Denis Wahl
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, CHRU de Nancy.,Inserm UMR_S 1116 at Lorraine University, Nancy
| | - Geraldine Muller
- Internal Medicine and Systemic Diseases Unit, University Hospital Centre Dijon, Dijon
| | - Olivier Aumaitre
- Department of Internal Medicine, Centre Hospitalier Universitaire, Hôpital Gabriel Montpied, Clermont-Ferrand
| | - Pascal Seve
- Department of Internal Medicine, University Hospital, Hôpital Croix Rousse, Lyon
| | - Gilles Blaison
- Department of Internal Medicine, Hopital Louis Pasteur, Colmar, Alsace
| | | | - Thierry Martin
- Internal Medicine and Clinical Immunology Department, Strasbourg University Hospital, Strasbourg
| | | | - Sabine Berthier
- Internal Medicine and Clinical Immunology Unit, University Hospital Dijon-Burgundy, Dijon
| | - Laurent Arnaud
- Department of Rheumatology, Hôpitaux Universitaires de Strasbourg.,INSERM UMR-S 1109, Strasbourg
| | - Abderrahmane Bourredjem
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
| | - Zahir Amoura
- Department of Internal Medicine, National Referral Center for Systemic Lupus Erythematosus and Anti-Phospholipid Syndrome, Pitie-Salpetriere University Hospital, Paris, France
| | - Hervé Devilliers
- Clinical Investigation Center, INSERM CIC-EC 1432, University Hospital Dijon-Burgundy, Dijon
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Mao YM, Shi PL, Wu L, Hu YQ, He YS, Xiang K, Tao JH, Pan HF, Wu GC. Prevalence and influential factors of thrombocytopaenia in systemic lupus erythematosus patients: a retrospective analysis of 3140 cases in a Chinese population. Lupus 2020; 29:743-750. [DOI: 10.1177/0961203320922301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction The present study aimed to investigate the prevalence and influential factors of thrombocytopaenia in systemic lupus erythematosus (SLE) patients among the Chinese population in order to provide evidence for improving the treatment and nursing of SLE patients. Methods A retrospective analysis of 3140 SLE patients admitted to two large tertiary hospitals was conducted in Anhui, China, from 2011 to 2018. In addition, the influential factors related to SLE with thrombocytopaenia were analysed through univariate and multivariate analysis. Results A total of 804 SLE patients had thrombocytopaenia (25.6%). The top 5 clinical manifestations of SLE inpatients were proteinuria (51.0%), lupus nephritis (45.9%), new rash (38.4%), haematuria (36.7%) and pyuria (32.2%). The incidence of neurological manifestations, oral mucosal ulceration, pleurisy, pericarditis, hyperglycaemia, leucocytopaenia, urinary casts, haematuria, pyuria and high disease activity in the thrombocytopaenia group were higher than those in the non-thrombocytopaenia group ( p < 0.05). Multivariate analysis showed age (odds ratio (OR) = 1.009, p = 0.005), neurological manifestations (OR = 1.373, p = 0.048), pericarditis (OR = 1.394, p = 0.048), hyperglycaemia (OR = 1.717, p < 0.001), leucocytopaenia (OR = 2.551, p < 0.001), haematuria (OR = 1.582, p < 0.001), serum C3 level <0.85 g/L (OR = 1.525, p = 0.001), serum C4 concentration <0.10 g/L (OR = 1.287, p = 0.020), serum CRP concentration <8 ng/L (OR = 1.314, p = 0.005), prothrombin time >15.30 seconds (OR = 1.479, p = 0.032), activated partial thromboplatin time >45 seconds (OR = 1.924, p < 0.001) and thrombin time >21 seconds (OR = 1.629, p = 0.015) were associated with thrombocytopaenia. Conclusion Thrombocytopaenia has a high prevalence in SLE patients and is related to some baseline, clinical and laboratory characteristics, affecting multiple organs and systems.
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Affiliation(s)
- Yan-Mei Mao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Pei-Li Shi
- School of Nursing, Anhui Medical University, Anhui, PR China
| | - Li Wu
- School of Nursing, Anhui Medical University, Anhui, PR China
| | - Yu-Qian Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Yi-Sheng He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Kun Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Jin-Hui Tao
- Department of Rheumatology and Immunology, The First Affiliated Hospital of University of Science and Technology of China, Hefei, PR China
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, PR China
| | - Guo-Cui Wu
- School of Nursing, Anhui Medical University, Anhui, PR China
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Abstract
Background and PurposeSystemic Lupus Erythematosus negatively affects health related quality of life (HRQOL). The purpose of this review is to synthesize and evaluate findings related to the psychometric properties of the LupusQoL and its variations.MethodsA search of CINAHL, PubMed, and Medline for the timeframe of 2007–2019 for English-language articles using any form of the LupusQoL was completed. Thirty-five studies were reviewed to determine psychometric soundness.ResultsCronbach alpha results supported the internal consistency with test–retest data supporting stability. Factor structure and Scree plots varied. Content, construct, criterion, convergent, and discriminate validity were supported. Ceiling and floor effects occurred.ConclusionsThe LupusQoL and its variations offer a disease-specific measure with supported reliability and validity for use in culturally disparate populations. Factor structure and ceiling/floor effects need further edification.
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Adherence to hydroxychloroquine in patients with systemic lupus: Contrasting results and weak correlation between assessment tools. Joint Bone Spine 2020; 87:603-610. [PMID: 32438061 DOI: 10.1016/j.jbspin.2020.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 04/24/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Hydroxychloroquine (HCQ) is an anchor drug in the treatment of systemic lupus erythematosus (SLE). Adherence to HCQ is key for efficacy. Inaccurate evaluation of adherence could lead to non-justified switch to more expensive or less tolerated drugs. METHODS Severe non-adherence rate to HCQ was estimated in a sample of SLE patients during a routine visit using blood HCQ concentration<200μg/L. Adherence was assessesd by the Medication Adherence Self-Report Inventory (MASRI)<80/100, 8-item Morisky Medication Adherence Scale (MMAS-8) ≤6/8, Health Care Provider (HCP) visual analog scale (VAS)<80/100. Same procedures were to be repeated during a further routine visit 6 to 12 months later. We described agreement and correlations between tools and compared severely non-adherent patients and others on their characteristics. RESULTS The study involved 158 patients (86.1% females) aged 42.2±12.6 years treated with HCQ for 9.6±6.9 years. Blood HCQ concentration (mean±standard deviation) was 1046±662μg/L at visit 1 and 855±577μg/L at visit 2. At visit 1, the non-adherence rate varied from 3.2% (blood HCQ level<200μg/L) to 7.7% (MASRI), 12.4% (HCP-VAS) or 32.5% (MMAS-8). 37.8% of patients met at least one of the definitions of non-adherence. Patients' characteristics including SLE activity, damage and quality of life were similar between severely non-adherent patients and others. Correlations between blood HCQ-concentration and self-questionnaires were weak (r<0.25) and agreement between methods was poor. CONCLUSION Blood HCQ concentration<200μg/L reveals severe non-adherence. Combining blood HCQ concentration with MASRI and MMAS-8 may help to better identify non-adherence in SLE. Agreement between methods was poor and correlations with HCQ level and SLE activity were weak.
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Predictive factors of quality of life among systemic lupus erythematosus patients in Thailand: a web-based cross-sectional study. Qual Life Res 2020; 29:2415-2423. [PMID: 32270369 DOI: 10.1007/s11136-020-02494-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE This study aimed to assess mental health status (depression, anxiety, and stress) and explore factors associated with the disease-specific quality of life among Systemic Lupus Erythematosus (SLE) patients in Thailand. METHODS This cross-sectional study used an online convenience sampling of 650 SLE patients who were registered members of the Thailand SLE Club. The study survey comprised of demographic information, health history, Depression, Anxiety, Stress Scale (DASS), and Lupus Quality of Life Scale (LupusQoL). RESULTS The survey response rate was 61.2%. Out of 344 respondents, most were female (96.9%). The scores were suggestive of the presence of mild depression and stress, but moderate anxiety. The higher depression, anxiety, and stress levels were associated with lower education and income (r = - .14 to - .29, p < .01) and higher number of SLE symptoms (r = .17 to .33, p < .05). Better quality of life was significantly related to lower number of symptoms, lower levels of stress/anxiety/depression, higher education, and better income. Also, the longer the patients were kept out of the hospital (last hospitalization), the better their quality of life. By using hierarchical multiple regression, four predictors of the quality of life were identified; the number of symptoms, stress, anxiety, and depression. These predictors combined explained 51% of the variance, F(5,108) = 24.34, p < .001, adjusted R2 = .51. CONCLUSIONS To improve the quality of life, SLE patients should focus on self-management of their symptoms. Health care providers should include SLE self-care health education in the plan of care. They also should use multidisciplinary approach in order to provide holistic treatment, including psychological care.
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Wu GC, Cao F, Shen HH, Hu LQ, Hu Y, Sam NB. Global public interest in systemic lupus erythematosus: an investigation based on internet search data. Lupus 2019; 28:1435-1440. [DOI: 10.1177/0961203319878502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective This study aims at investigating the global public interest in seeking information about systemic lupus erythematosus (SLE) using Google Trends (GT). Methods An electronic search was performed using GT with the search term lupus as well as the option of disease from January 2004 to December 2018. Cosinor analysis was applied to detect the seasonality of SLE-related relative search volume (RSV). In addition, analysis on SLE-related topics including “hot topics” and “top rising topics” was also conducted. Results Overall, SLE-related RSV showed a decreasing trend from January 2004 to December 2013 and then demonstrated a slowly increasing trend from January 2014 to December 2018. Cosinor test showed no significant seasonal variation in SLE-related RSV ( p > .025). RSV peaked in May and reached the trough in November. The top seven rising topics were Selena Gomez, Sjögren syndrome, autoimmunity, rheumatoid arthritis, rheumatology, antinuclear antibody and autoimmune disease. Conclusion The results from GT analysis showed slowly increasing internet searches for SLE in recent years. This trend was followed by a peak of RSV in May and reached its lowest level in November. However, globally, the results did not reveal a significant seasonal variation in GT for SLE. Additionally, the top fast-growing topics regarding SLE may be valuable for doctors and nurses to provide timely education of the disease to patients, as well as promote the development of public health.
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Affiliation(s)
- G C Wu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - F Cao
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China
| | - H H Shen
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, Hefei, Anhui, China
| | - L Q Hu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - Y Hu
- School of Nursing, Anhui Medical University, Hefei, Anhui, China
| | - N B Sam
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, China
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Clinical characteristics and health related quality of life (HRQoL) in Egyptian patients with systemic lupus erythematosus. THE EGYPTIAN RHEUMATOLOGIST 2019. [DOI: 10.1016/j.ejr.2018.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Izadi Z, Gandrup J, Katz PP, Yazdany J. Patient-reported outcome measures for use in clinical trials of SLE: a review. Lupus Sci Med 2018; 5:e000279. [PMID: 30167315 PMCID: PMC6109821 DOI: 10.1136/lupus-2018-000279] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/19/2018] [Accepted: 07/21/2018] [Indexed: 12/16/2022]
Abstract
Inclusion of patient-reported outcomes is important in SLE clinical trials as they allow capture of the benefits of a proposed intervention in areas deemed pertinent by patients. We aimed to compare the measurement properties of health-related quality of life (HRQoL) measures used in adults with SLE and to evaluate their responsiveness to interventions in randomised controlled trials (RCTs). A systematic review was undertaken using full original papers in English identified from three databases: MEDLINE, EMBASE and PubMed. Studies describing the validation of HRQoL measures in English-speaking adult patients with SLE and SLE drug RCTs that used an HRQoL measure were retrieved. Twenty-five validation papers and 26 RCTs were included in the indepth review evaluating the measurement properties of 4 generic (Medical Outcomes Study Short-Form 36 (SF36), Patient Reported Outcomes Measurement Information System (PROMIS) item-bank, EuroQol-5D, and Functional Assessment of Chronic Illness Therapy-Fatigue) and 3 disease-specific (Lupus Quality of Life (LupusQoL), Lupus Patient Reported Outcomes, Lupus Impact Tracker (LIT)) instruments. All measures had good convergent and discriminant validity. PROMIS provided the strongest evidence for known-group validity and reliability among generic instruments; however, data on its responsiveness have not been published. Across measures, standardised response means were generally indicative of poor-moderate sensitivity to longitudinal change. In RCTs, clinically important improvements were reported in SF36 scores from baseline; however, between-arm differences were frequently non-significant and non-important. SF36, PROMIS, LupusQoL and LIT had the strongest evidence for acceptable measurement properties, but few measures aside from the SF36 have been incorporated into clinical trials. This review highlights the importance of incorporating a broader range of SLE-specific HRQoL measures in RCTs and warrants further research that focuses on longitudinal responsiveness of newer instruments.
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Affiliation(s)
- Zara Izadi
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Julie Gandrup
- Division of Rheumatology, University of California, San Francisco, California, USA
| | - Patricia P Katz
- Division of Rheumatology, University of California, San Francisco, California, USA
| | - Jinoos Yazdany
- Division of Rheumatology, University of California, San Francisco, California, USA
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Legris N, Devilliers H, Daumas A, Carnet D, Charpy JP, Bastable P, Giroud M, Béjot Y. French validation of the Stroke Specific Quality of Life Scale (SS-QoL). NeuroRehabilitation 2018; 42:17-27. [PMID: 29400672 DOI: 10.3233/nre-172178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To adapt the SS-QoL into French and test its psychometric properties. METHODS Seventy-seven patients from a population-based registry were enrolled 3 months after their stroke. SS-QoL, NIHSS score, Barthel index, HAD, FSS, SF-36 scales, and MMSE were administered at enrolment. SS-QoL was re-administered at 15 days and 2 months. Internal consistency was assessed by Cronbach's α coefficients, factorial validity by an exploratory factor analysis and external validity by Mann-Whitney test and Spearman's correlations (ρ), comparing SS-QoL scores with those obtained from established scales. Reliability was assessed by intra-class correlation coefficients (ICC) and responsiveness by standardized effect sizes (ES). RESULTS Test-retest and inter-observer reliabilities were excellent (ICC> 0.88). Internal consistency was acceptable (α= 0.65-0.91), except for the Personality domain (α= 0.58). Factor analysis individualized eight homogenous axes. SS-QoL scores were different between groups opposed by their modified Rankin score at enrolment or their overall quality of life compared with pre-stroke status (p < 0.001). Ten of the twelve domains correlated moderately (ρ> 0.35) to strongly (ρ> 0.5) with established measures. Nine domains were mildly to moderately responsive to change (ES> 0.3). CONCLUSION The French version of the SS-QoL is a valid, reliable and moderately responsive instrument.
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Affiliation(s)
- Nicolas Legris
- Department of Neurology, Dijon Stroke Registry, University Hospital and Medical School of Dijon, University of Burgundy, France
| | - Hervé Devilliers
- Department of Internal Medicine and Systemic Disease, University Hospital and Medical School of Dijon, University of Burgundy, France.,Clinical Investigation Center INSERM CIC 1423, University Hospital and Medical School of Dijon, University of Burgundy, France
| | - Anaïs Daumas
- Department of Neurology, Dijon Stroke Registry, University Hospital and Medical School of Dijon, University of Burgundy, France
| | - Didier Carnet
- Department of Medical English, Medical School of Dijon, University of Burgundy, France
| | - Jean-Pierre Charpy
- Department of Medical English, Medical School of Dijon, University of Burgundy, France
| | - Philip Bastable
- Department of Internal Medicine and Systemic Disease, University Hospital and Medical School of Dijon, University of Burgundy, France
| | - Maurice Giroud
- Department of Neurology, Dijon Stroke Registry, University Hospital and Medical School of Dijon, University of Burgundy, France
| | - Yannick Béjot
- Department of Neurology, Dijon Stroke Registry, University Hospital and Medical School of Dijon, University of Burgundy, France
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The Role of Patient-Reported Outcomes in Systemic Lupus Erythematosus. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2017. [DOI: 10.1007/s40674-017-0079-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Chamberlain C, Colman PJ, Ranger AM, Burkly LC, Johnston GI, Otoul C, Stach C, Zamacona M, Dörner T, Urowitz M, Hiepe F. Repeated administration of dapirolizumab pegol in a randomised phase I study is well tolerated and accompanied by improvements in several composite measures of systemic lupus erythematosus disease activity and changes in whole blood transcriptomic profiles. Ann Rheum Dis 2017; 76:1837-1844. [DOI: 10.1136/annrheumdis-2017-211388] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 06/01/2017] [Accepted: 06/10/2017] [Indexed: 01/15/2023]
Abstract
ObjectivesSystemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease associated with diffuse immune cell dysfunction. CD40–CD40 ligand (CD40L) interaction activates B cells, antigen-presenting cells and platelets. CD40L blockade might provide an innovative treatment for systemic autoimmune disorders. We investigated the safety and clinical activity of dapirolizumab pegol, a polyethylene glycol conjugated anti-CD40L Fab' fragment, in patients with SLE.MethodsThis 32-week randomised, double-blind, multicentre study (NCT01764594) evaluated repeated intravenous administration of dapirolizumab pegol in patients with SLE who were positive for/had history of antidouble stranded DNA/antinuclear antibodies and were on stable doses of immunomodulatory therapies (if applicable). Sixteen patients were randomised to 30 mg/kg dapirolizumab pegol followed by 15 mg/kg every 2 weeks for 10 weeks; eight patients received a matched placebo regimen. Randomisation was stratified by evidence of antiphospholipid antibodies. Patients were followed for 18 weeks after the final dose.ResultsNo serious treatment-emergent adverse events, thromboembolic events or deaths occurred. Adverse events were mild or moderate, transient and resolved without intervention. One patient withdrew due to infection.Efficacy assessments were conducted only in patients with high disease activity at baseline. Five of 11 (46%) dapirolizumab pegol-treated patients achieved British Isles Lupus Assessment Group-based Composite Lupus Assessment response (vs 1/7; 14% placebo) and 5/12 (42%) evaluable for SLE Responder Index-4 responded by week 12 (vs 1/7; 14% placebo). Mechanism-related gene expression changes were observed in blood RNA samples.ConclusionsDapirolizumab pegol could be an effective biological treatment for SLE. Further studies are required to address efficacy and safety.Trial registration numberNCT01764594.
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Meseguer-Henarejos AB, Gascón-Cánovas JJ, López-Pina JA. Components of quality of life in a sample of patients with lupus: a confirmatory factor analysis and Rasch modeling of the LupusQoL. Clin Rheumatol 2017; 36:1789-1795. [DOI: 10.1007/s10067-017-3649-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 03/20/2017] [Accepted: 04/18/2017] [Indexed: 01/31/2023]
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Devilliers H, Vernier N, Muller G, Turcu A, Samson M, Bielefeld P, Besancenot JF. [Quality of life measures in SLE: An update]. Rev Med Interne 2017; 39:107-116. [PMID: 28457682 DOI: 10.1016/j.revmed.2017.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 02/28/2017] [Accepted: 03/04/2017] [Indexed: 12/20/2022]
Abstract
Systemic lupus erythematosus (SLE) is a chronic disease that considerably hampers patient's daily living. Qualitative studies with patients' interviews have been conducted to describe the experiences and perspectives of adults living with SLE. Among existing generic and disease-specific quality of life (QOL) questionnaires, none succeeded to exhaustively measure patient's preoccupations. However, these tools are useful to quantify the burden of the disease. Social precariousness, socioeconomic status and education level are intimately correlated to QOL measures, either generic or disease-specific. Musculoskeletal disease activity is also associated with a lower QOL. Using disease-specific tools may be useful because of a better aptitude to record an improvement in health status. Moreover, using generic and disease-specific questionnaires together may help to identify factors associated with a lower quality of life but not related to SLE from the patient's perspective (such as smoking or obesity). Developing new ways of recording QOL data in the future may help to evaluate the real benefit of using QOL scales in daily practice.
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Affiliation(s)
- H Devilliers
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France.
| | - N Vernier
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - G Muller
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - A Turcu
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - M Samson
- Service de médecine interne et immunologie clinique (médecine interne 1), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon, France
| | - P Bielefeld
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
| | - J-F Besancenot
- Service de médecine interne et maladies systémiques (médecine interne 2), hôpital François-Mitterrand, 14, rue Paul-Gaffarel, BP 77908, 21079 Dijon cedex, France
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Factors Associated with Health-Related Quality of Life in Mexican Lupus Patients Using the LupusQol. PLoS One 2017; 12:e0170209. [PMID: 28114336 PMCID: PMC5256863 DOI: 10.1371/journal.pone.0170209] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 01/02/2017] [Indexed: 01/10/2023] Open
Abstract
Introduction Health-related quality of life (HRQOL) is affected by numerous clinical variables, including disease activity, damage, fibromyalgia, depression and anxiety. However, these associations have not yet been described in Mexican patients with systemic lupus erythematosus (SLE). Objective To evaluate the relationship between disease activity, damage, depression and fibromyalgia and HRQOL measured by the LupusQoL-instrument in Mexican patients with SLE. Methods A cross-sectional study was conducted in women fulfilling the 1997 ACR classification criteria for SLE. HRQOL was evaluated using a disease-specific instrument for SLE, the LupusQoL (validated for the Spanish-speaking population). Patients were evaluated clinically to determine the degree of disease activity and damage using the Mexican Systemic Lupus Erythematosus Disease Activity Index (Mex-SLEDAI) and Systemic Lupus International Collaborating Clinics-Damage Index (SLICC), respectively. Fibromyalgia and depression were assessed using the ACR criteria and the CES-D scale, respectively. The relationship between HRQOL and these variables was measured using Spearman’s rank correlation coefficient and linear regression analysis. Results A total of 138 women with SLE, age 40.3±11 years, disease duration 8.8±6.4 years, with disease activity in 51.4%, depression in 50%, damage in 43% and fibromyalgia in 19.6% were included. Poorer HRQOL correlated with depression (r = -0.61; p< 0.005), fibromyalgia (r = -0.42; p< 0.005), disease activity (r = -0.37; p < 0.005) and damage (r = -0.31; p < 0.005). In the multivariate linear regression analysis, damage (β = -3.756, p<0.005), fibromyalgia (β = -0.920, p<0.005), depression (β = -0.911, p<0.005) and disease activity (β = -0.911, p<0.005) were associated with poor HRQOL. Conclusion SLE disease activity, damage, fibromyalgia and depression were associated with poor HRQOL in our sample of Mexican SLE patients.
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Anzar S, Koshy C, Abraham KM. Validation of the Malayalam Version of Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale in Cancer Patients in the Regional Cancer Centre, Thiruvananthapuram, Kerala, India. Indian J Palliat Care 2017; 23:293-299. [PMID: 28827933 PMCID: PMC5545955 DOI: 10.4103/ijpc.ijpc_119_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) is a 7-item self-report scale developed to identify pain which is of predominantly neuropathic origin. The aim of this study was to develop a Malayalam version of the LANSS and to test its validity and reliability in chronic pain patients. METHODOLOGY We enrolled 101 Malayalam-speaking chronic pain patients who visited the Division of Palliative Medicine, Regional Cancer Centre, Thiruvananthapuram, Kerala, India. The translated version of S- LANSS was constructed by standard means. Fifty-one neuropathic pain and fifty nociceptive pain patients were identified by an independent pain physician and were subjected to the new pain scale by a palliative care nurse who was blinded to the diagnosis. The "gold standard diagnosis" is what the physician makes after clinical examination. Its validation, sensitivity, specificity, and positive and negative predictive values were determined. RESULTS Fifty-one neuropathic pain and fifty nociceptive pain patients were subjected to the Malayalam version of S-LANSS pain scale for validity testing. The agreement by Cohen's Kappa 0.743, Chi-square test P < 0.001, sensitivity 89.58, specificity 84.91, positive predictive value 84.31, negative predictive value 90.00, accuracy by 87.13, and likelihood ratio 5.94. CONCLUSION The Malayalam version of S-LANSS pain scale is a validated screening tool for identifying neuropathic pain in chronic pain patients in Malayalam-speaking regions.
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Affiliation(s)
- Shoukkathali Anzar
- Department of Anaesthesiology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Cherian Koshy
- Department of Palliative Medicine, Regional Cancer Centre, Thiruvananthapuram, Kerala, India
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Machado Escobar MA, Yacuzzi MS, Martinez RN, González Lucero L, Bellomio VI, Santana M, Galindo L, Mayer MM, Barreira JC, Sarano J, Gomez G, Collado MV, Martinez A, Orozco MC, Betancur G, Dal Pra F, Sanchez A, Juarez V, Lucero EV. Validation of an Argentine version of Lupus Quality of Life questionnaire. Lupus 2016; 25:1615-1622. [PMID: 27444335 DOI: 10.1177/0961203316660202] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 06/28/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine reproducibility and validity of an Argentine version of the Lupus Quality of Life questionnaire (LupusQoL) and to determine cut-off values in the questionnaire. MATERIALS AND METHODS One hundred and forty-seven systemic lupus erythematosus patients (American College of Rheumatology 1982/1997) were assessed from April 2014 to July 2014. Demographic and socioeconomic variables were collected, as well as SELENA/SLEDAI, Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index Score, comorbidities and treatment data. Patients completed LupusQoL-Argentine version and European Quality of Life Questionnaire (EuroQoL-5D). Internal consistency and reliability were examined. Convergent validity with EuroQoL-5D was assessed through analysis of latent classes, which established homogeneous categories from the responses of each domain of LupusQoL and for the total. RESULTS Out of 147 patients, 93.2% were female, mean age 36.4 ± 11.1 years, mean disease duration 2.7 ± 9 years, mean SELENA/SLEDAI 2.7 ± 3 points. The cut-off point that defined good or bad quality of life was 0.739 for EuroQoL 5D and 63 for LupusQoL. Cut-off values for each LupusQoL domain were also defined, creating two classes in each of them. There was moderate to high concordance to classify quality of life (Kappa = 0.74, 95% confidence interval = 0.54, 0.95). CONCLUSION The Argentine version of LupusQoL is a valid, reliable and reproducible instrument to assess quality of life. In this study, cut-off points that allow the classification of patients regarding whether they have good or bad quality of life are established for the first time.
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Affiliation(s)
| | - M S Yacuzzi
- Hospital Ángel Cruz Padilla, Tucumán, Argentina
| | | | | | | | - M Santana
- Hospital Ángel Cruz Padilla, Tucumán, Argentina
| | - L Galindo
- Hospital Ángel Cruz Padilla, Tucumán, Argentina
| | - M M Mayer
- Hospital Británico de Buenos Aires, Argentina
| | | | - J Sarano
- Instituto Lanari, Buenos Aires, Argentina
| | - G Gomez
- Instituto Lanari, Buenos Aires, Argentina
| | | | - A Martinez
- Hospital de Agudos Dr E Tornú, Buenos Aires, Argentina
| | - M C Orozco
- Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - G Betancur
- Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | - F Dal Pra
- Instituto de Rehabilitación Psicofísica, Buenos Aires, Argentina
| | | | | | - E V Lucero
- Hospital Ángel Cruz Padilla, Tucumán, Argentina
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Ünlü O, Zuily S, Erkan D. The clinical significance of antiphospholipid antibodies in systemic lupus erythematosus. Eur J Rheumatol 2016; 3:75-84. [PMID: 27708976 PMCID: PMC5042235 DOI: 10.5152/eurjrheum.2015.0085] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/20/2015] [Indexed: 12/22/2022] Open
Abstract
Antiphospholipid syndrome (APS) is the association of thrombosis and/or pregnancy morbidity with antiphospholipid antibodies (aPL). Thirty to forty percent of systemic lupus erythematosus (SLE) patients are tested positive for aPL, which may have an impact on the SLE presentation, management, and prognosis. Compared with SLE patients without aPL, those with aPL have a higher prevalence of thrombosis, pregnancy morbidity, valve disease, pulmonary hypertension, livedo reticularis, thrombocytopenia, hemolytic anemia, acute/chronic renal vascular lesions, and moderate/severe cognitive impairment; worse quality of life; and higher risk of organ damage. The use of low-dose aspirin (LDA) is controversial for primary thrombosis and pregnancy morbidity prevention because of the lack of strong prospective controlled data. Similarly, the use of anticoagulation is controversial for patients with an aPL-related nephropathy. Until further studies are available, physicians should discuss the risk/benefits of LDA or anticoagulation as well as the available literature with patients.
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Affiliation(s)
- Ozan Ünlü
- Division of Rheumatology, Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, Weill Cornell Medicine, New York, USA
| | - Stephane Zuily
- Division of Vascular Medicine, Centre Hospitalier Universitaire de Nancy, Regional Competence Centre For RareVascular and Systemic Autoimmune Diseases, Nancy, France
| | - Doruk Erkan
- Division of Rheumatology, Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, Weill Cornell Medicine, New York, USA
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Abstract
Successful management of complex conditions such as systemic lupus erythematosus (SLE) and comorbid conditions benefit from patient-reported outcomes (PRO). Measuring health-related quality of life with PROs provides SLE patients with an opportunity to participate in their treatment and to facilitate better communication with the multidisciplinary team involved in their care. Health outcomes research has produced well-validated instruments that can be used across diseases; others have been specifically developed for SLE. The use of generic and SLE-specific PROs depends on needs, including population monitoring, treatment decision making, clinical trials research, and for evaluating and comparing the effect of therapies.
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Zuily S, Rat AC, Regnault V, Kaminsky P, Mismetti P, Ninet J, Baillet N, Magy-Bertrand N, Pasquali JL, Lambert M, Pasquier E, Lorcerie B, Lecompte T, Guillemin F, Wahl D. Impairment of quality of life in patients with antiphospholipid syndrome. Lupus 2015; 24:1161-8. [PMID: 25862730 DOI: 10.1177/0961203315580871] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/17/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Health-related quality of life (HRQoL) has not been fully explored in antiphospholipid syndrome (APS); therefore, we compared HRQoL between APS patients and the general population and assessed the impact of thromboembolic history. METHODS HRQoL was measured in a multicentre cohort study by the Medical Outcomes Study Short-Form 36 (MOS-SF-36) questionnaire. HRQoL scores were compared to the French general population norms. Factors significantly associated with an impaired HRQoL were identified. RESULTS A total of 115 patients with aPL and/or systemic lupus erythematosus (SLE) were included (mean age 42.7 ± 14.1 years old, 86 women). In 53 patients APS was diagnosed. Compared to general population norms, patients with APS had an impaired HRQoL. SLE-associated APS patients had the worst HRQoL scores (physical component summary (PCS)=40.8 ± 10.6; mental component summary (MCS)=40.6 ± 16.5) in comparison with SLE or aPL patients without thromboembolic history. In APS patients, history of arterial thrombosis significantly impaired HRQoL (PCS score: 42.2 ± 9.4 vs 49.2 ± 8.5; MCS score: 33.9 ± 13.7 vs 44.6 ± 10.3). CONCLUSION Compared to the general population, APS patients experienced a lower HRQoL. In these patients, a history of arterial thrombosis significantly impaired HRQoL. Therefore, measurements of HRQoL should be included in APS patient management to assess the burden of the disease from a patient's perspective and to provide patients with the support they need.
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Affiliation(s)
- S Zuily
- CHU de Nancy, Vascular Medicine Division and Regional Competence Centre for Systemic and Autoimmune Diseases, Nancy, France Inserm, UMR_S 1116, Nancy, France Université de Lorraine, Nancy, France
| | - A-C Rat
- Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Nancy, France Inserm, CIC-EC CIE6, Nancy, France CHU de Nancy, Clinical Epidemiology and Evaluation Department, Nancy, France CHU de Nancy, Rheumatology Department, Nancy, France
| | - V Regnault
- Inserm, UMR_S 1116, Nancy, France Université de Lorraine, Nancy, France CHU de Nancy, Contrat d'interface, Nancy, France
| | - P Kaminsky
- Université de Lorraine, Nancy, France CHU de Nancy, Orphan Disease Unit, Nancy, France
| | - P Mismetti
- CHU de Saint Etienne, Clinical Pharmacology Unit and EA 3065, Saint-Etienne, France
| | - J Ninet
- CHU de Lyon, Department of Internal Medicine, Lyon, France
| | - N Baillet
- Colmar Hospital, Department of Internal Medicine, Colmar, France
| | - N Magy-Bertrand
- CHU de Besançon, Internal Medicine and Clinical Immunology Department, Besançon, France
| | - J-L Pasquali
- CHU de Strasbourg, Internal Medicine and Clinical Immunology Department, Strasbourg, France
| | - M Lambert
- CHRU de Lille, Department of Internal Medicine, Lille, France
| | - E Pasquier
- CHU de Brest, Department of Internal Medicine and Chest Diseases and EA 3878, Brest, France
| | - B Lorcerie
- CHU de Dijon, Internal Medicine and Clinical Immunology Department, Dijon, France
| | - T Lecompte
- Université de Lorraine, Nancy, France University Hospitals of Geneva, Division of Haematology, Geneva, Switzerland (T.L. current address)
| | - F Guillemin
- Université de Lorraine, Paris Descartes University, APEMAC, EA 4360, Nancy, France CHU de Nancy, Clinical Epidemiology and Evaluation Department, Nancy, France
| | - D Wahl
- CHU de Nancy, Vascular Medicine Division and Regional Competence Centre for Systemic and Autoimmune Diseases, Nancy, France Inserm, UMR_S 1116, Nancy, France Université de Lorraine, Nancy, France
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Pamuk ON, Onat AM, Donmez S, Mengüs C, Kisacik B. Validity and reliability of the Lupus QoL index in Turkish systemic lupus erythematosus patients. Lupus 2014; 24:816-21. [PMID: 25542903 DOI: 10.1177/0961203314565412] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 11/26/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) patients have seriously impaired quality of life (QoL). In addition to activity and damage indices used in the past, tools to evaluate QoL in SLE have been developed in recent years. In this study, we test the validity of the Turkish version of the Lupus-QoL (LupusQoL-TR) score, and investigate its association with clinical findings and activity indices. METHODS A total of 132 patients diagnosed with SLE according to ACR 1997 criteria were included. The clinical and demographic features, and biochemical data were retrieved from hospital records. SLE Disease Activity Index (SLEDAI) and damage score (SLICC-ACR) were determined at the time of administration of Lupus-QoL questionnaire. The Lupus-QoL includes 34 questions divided into eight domains. We reevaluated the LupusQoL-TR and pretested its understandability. SLE patients were concomitantly administered the LupusQoL-TR and generic SF-36. Internal consistency, test-retest reliability, convergent and discriminant validity were calculated. RESULTS The mean age of our SLE patients was 37.9 ± 12.8 years. Internal consistency reliability ranged from 0.88 to 0.93, and test-retest reliability from 0.84 to 0.94. LupusQoL-related domains in SF-36 were correlated (from 0.66 to 0.74). Most LupusQoL-TR domains, except planning, were able to discriminate between active and inactive SLE groups. Scores in all domains of the LupusQoL-TR were found to be discriminative for patients with and without damage according to SLICC-ACR score. CONCLUSION The LupusQoL-TR was found to be a valid patient-reported outcome measure method when evaluating QoL in Turkish SLE patients.
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Affiliation(s)
- O N Pamuk
- Department of Rheumatology, Trakya University Medical Faculty, Edirne, Turkey
| | - A M Onat
- Department of Rheumatology, Gaziantep University Medical Faculty, Gaziantep, Turkey
| | - S Donmez
- Department of Rheumatology, Trakya University Medical Faculty, Edirne, Turkey
| | - C Mengüs
- Department of Internal Medicine, Trakya University Medical Faculty, Edirne, Turkey
| | - B Kisacik
- Department of Rheumatology, Gaziantep University Medical Faculty, Gaziantep, Turkey
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Jolly M, Sequeira W, Block JA. Health and quality of life outcomes. Health Qual Life Outcomes 2014; 12:173. [PMID: 25495461 PMCID: PMC4272785 DOI: 10.1186/s12955-014-0173-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 11/15/2014] [Indexed: 01/14/2023] Open
Affiliation(s)
- Meenakshi Jolly
- Department of Medicine/Rheumatology, Rush University Medical Center, 1611 W Harrison Street, suite 510, Chicago, IL, 60612, USA.
| | - Winston Sequeira
- Department of Medicine/Rheumatology, Rush University Medical Center, 1611 W Harrison Street, suite 510, Chicago, IL, 60612, USA.
| | - Joel A Block
- Department of Medicine/Rheumatology, Rush University Medical Center, 1611 W Harrison Street, suite 510, Chicago, IL, 60612, USA.
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Arnaud L, Fagot JP, Mathian A, Paita M, Fagot-Campagna A, Amoura Z. Prevalence and incidence of systemic lupus erythematosus in France: A 2010 nation-wide population-based study. Autoimmun Rev 2014; 13:1082-9. [DOI: 10.1016/j.autrev.2014.08.034] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 06/15/2014] [Indexed: 12/16/2022]
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Devilliers H, Amoura Z, Besancenot JF, Bonnotte B, Pasquali JL, Wahl D, Maurier F, Kaminsky P, Pennaforte JL, Magy-Bertrand N, Arnaud L, Binquet C, Guillemin F, Bonithon-Kopp C. Responsiveness of the 36-item Short Form Health Survey and the Lupus Quality of Life questionnaire in SLE. Rheumatology (Oxford) 2014; 54:940-9. [PMID: 25361539 DOI: 10.1093/rheumatology/keu410] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This study aimed to estimate the responsiveness to change of a generic [the 36-item Short Form Health Survey (SF-36)] and a specific health-related quality of life questionnaire [the Lupus Quality if Life questionnaire (LupusQoL)] according to SLE patients' self-reported changes in health status. METHODS In a cohort of 185 SLE patients, quality of life (QoL) was measured three times at 3 month intervals by the LupusQoL and SF-36 questionnaires. Anchors for responsiveness were defined by patients' global assessment of disease impact according to changes in a visual analogue scale (VAS), a 7-point Likert scale and a 0-3 scale of five patient-reported symptoms. Mean change and s.d. in worsening and improving patients according to anchors were estimated using mixed models for repeated measures. Standardized response means (SRMs) were calculated in each group. RESULTS Patients [mean age 39.6 years (s.d. 10.5), mean Safety of Estrogen in Lupus Erythematosus National Assessment-SLEDAI score 2.6 (s.d. 3.5)] answered a total of 515 questionnaires. For the VAS and Likert global anchors, worsening patients showed a significant decrease in all LupusQoL domains except for burden to others, body image and fatigue and all SF-36 domains with low to moderate responsiveness. Improving patients had a significant increase in all LupusQoL domains except for intimate relationship and all SF-36 domains except for physical functioning and global health with low to moderate responsiveness. Regarding similar domains in the SF-36 and LupusQoL, SRMs were higher in LupusQoL domains in improving patients, while SF-36 domains had larger SRMs in worsening patients. CONCLUSION Both the SF-36 and LupusQoL were responsive to changes in QoL in SLE patients over a 3 month interval. LupusQoL seems to be more appropriate to measure improvements in QoL.
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Affiliation(s)
- Hervé Devilliers
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Zahir Amoura
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Jean-François Besancenot
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Bernard Bonnotte
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Jean-Louis Pasquali
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Denis Wahl
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Francois Maurier
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Pierre Kaminsky
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Jean-Loup Pennaforte
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Nadine Magy-Bertrand
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Laurent Arnaud
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Christine Binquet
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Francis Guillemin
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
| | - Claire Bonithon-Kopp
- Department of Internal Medicine and Systemic Diseases, University Hospital of Dijon, Clinical Investigation Centre, University Hospital of Dijon, Dijon, Department of Internal Medicine, University Hospital Pitié-Salpêtrière, Paris, Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, Dijon, Clinical Immunology Department, University Hospital of Strasbourg, Strasbourg, Department of Vascular Medicine, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, Vascular Medicine and Clinical Immunology, Ste Blandine Hospital, Metz, Department of Internal Medicine Systemic Diseases and Rare Diseases, University Hospital of Nancy, Vandoeuvre-lès-Nancy, Department of Internal Medicine, University Hospital Robert Debré, Reims, Department of Internal Medicine, University Hospital Jean Minjoz, Besançon and Clinical Epidemiology and Evaluation Department, University Hospital, Nancy, France
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Linguistic Validation of the LupusQoL for the Assessment of Quality of Life in Iranian Patients with Systemic Lupus Erythematosus. Int J Rheumatol 2014; 2014:151530. [PMID: 25313310 PMCID: PMC4172886 DOI: 10.1155/2014/151530] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 08/31/2014] [Indexed: 01/29/2023] Open
Abstract
Objectives. We evaluated the psychometric properties of the Persian LupusQoL for the evaluation of quality of life in Iranian systemic lupus erythematosus (SLE) patients. Methods. The LupusQoL was translated to Persian language. Patients with SLE (n = 78) completed the LupusQoL and the Short-Form Health Survey (SF-36). Disease activity and cumulative disease damage were assessed with standard indices. The psychometric properties of the scale were evaluated. Results. The Cronbach's alpha was 0.97 for the total LupusQoL (above 0.8 for subscales). There were strong corrected item-total (r > 0.4), item-subscale (r ≥ 0.5), and subscale-total correlations (r > 0.6), as well as intersubscale correlations (r > 0.5). Patients with active disease and patients with disease damage index of ≥1 had lower scores in domains of planning, emotional health, burden to others, and body image than patients with inactive disease and those with no disease damage, respectively (P < 0.05). The LupusQoL and the SF-36 correlated well regarding comparable domains (r > 0.4). Conclusion. The psychometric characteristics of the Persian version of LupusQoL questionnaire are acceptable in Iranian population. This instrument can be used to evaluate quality of life in Iranian SLE patients.
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Bourré-Tessier J, Clarke AE, Kosinski M, Mikolaitis-Preuss RA, Bernatsky S, Block JA, Jolly M. The French-Canadian validation of a disease-specific, patient-reported outcome measure for lupus. Lupus 2014; 23:1452-9. [PMID: 25081500 DOI: 10.1177/0961203314543921] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The objective of this paper is to perform the cross-cultural validation of the French version of the LupusPRO, a disease-targeted patient-reported outcome measure, among systemic lupus erythematosus (SLE) patients in Canada. METHODS The French version of the LupusPRO and the MOS SF-36 were administered; demographic, clinical and serological characteristics were obtained. Disease activity (SELENA-SLEDAI and the Lupus Foundation of America definition of flare) and damage (SLICC/ACR SDI) were assessed. Physician disease activity and damage assessments were ascertained using visual analog scales. Internal consistency reliability (ICR), test-retest reliability (TRT), convergent and discriminant validity (against corresponding domains of the SF-36), criterion validity (against disease activity, damage or health status) and known group validity were tested. RESULTS A total of 99 French-Canadian SLE patients participated (97% women, mean (SD) age 45.2 (14.5) years). The median (IQR) SELENA-SLEDAI and SDI were 3.5 (6.0) and 1.0 (2.0), respectively. The ICR of the LupusPRO domains ranged from 0.81 to 0.93 (except for lupus symptoms, procreation and coping), while TRT ranged from 0.72 to 0.95. Convergent and discriminant validity, criterion validity and known group validity against disease activity, damage and health status measures were observed. Confirmatory factor analysis showed a good fit. CONCLUSION The LupusPRO has fair psychometric properties among French-Canadian patients with SLE.
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Affiliation(s)
- J Bourré-Tessier
- Department of Medicine, Division of Rheumatology, University of Montreal Health Center, Canada
| | - A E Clarke
- Department of Medicine, Division of Rheumatology, University of Calgary, Canada
| | - M Kosinski
- QualityMetric Inc, Outcomes Insight Consulting Division, USA
| | - R A Mikolaitis-Preuss
- Department of Medicine, Division of Rheumatology, Rush University Medical Center, USA
| | - S Bernatsky
- Department of Medicine, Division of Rheumatology, McGill University Health Centre, Canada Department of Medicine, Division of Clinical Epidemiology, McGill University Health Centre, McGill University, Canada
| | - J A Block
- Department of Medicine, Division of Rheumatology, Rush University Medical Center, USA
| | - M Jolly
- Department of Medicine, Division of Rheumatology, Rush University Medical Center, USA
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Hervier B, Devilliers H, Amiour F, Ayçaguer S, Neves Y, Ganem MC, Amoura Z, Antignac M. Évaluation des attentes des patients pour un programme d’éducation thérapeutique au cours du lupus systémique. Rev Med Interne 2014; 35:297-302. [DOI: 10.1016/j.revmed.2013.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 03/04/2013] [Accepted: 04/21/2013] [Indexed: 12/01/2022]
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Conti F, Perricone C, Reboldi G, Gawlicki M, Bartosiewicz I, Pacucci VA, Massaro L, Miranda F, Truglia S, Alessandri C, Spinelli FR, Teh LS, Ceccarelli F, Valesini G. Validation of a disease-specific health-related quality of life measure in adult Italian patients with systemic lupus erythematosus: LupusQoL-IT. Lupus 2014; 23:743-51. [PMID: 24569393 DOI: 10.1177/0961203314524466] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 01/28/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective of this paper is to assess the validity of a linguistically validated version of the Lupus Quality of Life (LupusQoL(©)) in Italian patients affected by systemic lupus erythematosus (SLE). METHODS Consecutive SLE patients completed the Italian version of the LupusQoL(©) and the Short Form (SF)-36. Disease activity was evaluated by the SLE disease activity Index-2000 (SLEDAI-2 K), and chronic damage by the Systemic Lupus International Collaborating Clinics/American College Rheumatology (ACR) Damage Index score (SDI). Internal consistency and test-retest reliability, convergent and discriminant validity were examined. Factor analysis with varimax rotation was performed. RESULTS A total of 117 Italian SLE patients (M:F 13:104; mean age 40.6 ± 11.6 years, mean disease duration 127.5 ± 94.1 months) were recruited into the study. The Italian version of the LupusQoL(©) demonstrated substantial evidence of convergent validity in these patients when compared with equivalent items of the SF-36. In addition, the LupusQoL(©) discriminated between patients with different degrees of disease activity as measured by the SLEDAI-2 K. SLE patients with higher disease activity (SLEDAI-2K ≥4) showed poor QoL compared with those with lower disease activity (SLEDAI-2K <4), with significant differences in the domains of physical health, planning, burden to others and fatigue (p = 0.001, p = 0.04, p = 0.03, p = 0.04, respectively). The confirmatory factor analysis using the eight domain loadings of the 34 items showed a poor fit (χ(2)/degree of freedom (df) 2.26, χ(2 )= 1128.6 (p < 0.001), root mean square error of approximation (RMSEA) = 0.167; goodness-of-fit index (GFI) = 0.606, comparative fit index (CFI) = 0.649)). Screeplot analysis suggested a five-factor loading structure and confirmatory factor analysis result of which is similar to the eight-factor model. A good internal consistency was observed (Cronbach's α 0.89-0.91). Test-retest reliability was good to excellent between baseline and day 15 (intraclass correlation coefficient (ICC) 0.90-0.98). CONCLUSION The Italian version of the LupusQoL(©) is a valid tool for adult patients with SLE.
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Affiliation(s)
- F Conti
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - C Perricone
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - G Reboldi
- Department of Medicine, University of Perugia, Perugia, Italy
| | - M Gawlicki
- Corporate Translations, Inc., East Hartford, CT, USA
| | - I Bartosiewicz
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - V A Pacucci
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - L Massaro
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - F Miranda
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - S Truglia
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - C Alessandri
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - F R Spinelli
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - L-S Teh
- Department of Rheumatology, Royal Blackburn Hospital, Blackburn, UK
| | - F Ceccarelli
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
| | - G Valesini
- Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy
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Dua AB, Touma Z, Toloza S, Jolly M. Top 10 Recent Developments in Health-Related Quality of Life in Patients with Systemic Lupus Erythematosus. Curr Rheumatol Rep 2013; 15:380. [DOI: 10.1007/s11926-013-0380-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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