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Ann Rheum Dis. 2016 Nov;75(11):1945-1950. doi: 10.1136/annrheumdis-2015-208504. Epub 2016 Jan 25.

Development of the ClinESSDAI: a clinical score without biological domain. A tool for biological studies.

Author information

1
Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, (AP-HP), Service de Rhumatologie, Hôpitaux Universitaires Paris-Sud, Center of Research on Immunology of Viral and Autoimmune diseases (IMVA), Le Kremlin Bicêtre, France.
2
Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
3
Faculty of Medicine, AP-HP, Hôtel Dieu Hospital, Centre of Clinical Epidemiology, University of Paris Descartes,Paris, France.
4
Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
5
Rheumatology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
6
Sections of Rheumatology, Instituto San Giuseppe, Como and Casa di Cura di Lecco, Lecco, Italy.
7
Department of Rheumatology, Centre National de Référence des Maladies Auto-Immunes Rares, INSERM UMRS_1109, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg university Hospital, Université de Strasbourg, Strasbourg, France.
8
Department of Rheumatology, Skane University Hospital Malmö, Lund University, Malmö, Sweden.
9
Department of Pathophysiology, School of Medicine, University of Athens, Athens, Greece.
10
Department of Medical and Biological Sciences, Clinic of Rheumatology, Udine University, Udine, Italy.
11
Laboratory of Autoimmune Diseases 'Josep Font', CELLEX-IDIBAPS, Department of Autoimmune Diseases, ICMiD, Hospital Clinic, Barcelona, Spain.
12
Rheumatology Department, Charité, University Hospital, Berlin, Germany.

Abstract

OBJECTIVE:

To develop and validate ClinESSDAI (Clinical European League Against Rheumatism Sjögren's Syndrome Disease Activity Index), ie, ESSDAI without the biological domain.

PATIENTS AND METHODS:

The 702 fictive vignettes derived from 96 real cases of primary Sjögren's syndrome of the ESSDAI development study were used. As for ESSDAI development, the physician assessment of disease activity (0-10 scale) was used as the 'gold standard' in a multivariate model for weighting domains, after removing the biological domain. The reliability, assessed by intraclass correlation coefficient (ICC) between ClinESSDAI and ESSDAI, explored if ClinESSDAI was equivalent to ESSDAI. Its psychometric (ie, measurement) properties were compared with that of ESSDAI in an independent cohort. Also, its use was evaluated on data of two clinical trials.

RESULTS:

In multivariate modelling, all 11 domains remained significantly associated with disease activity, with slight modifications of some domain weights. Reliability between clinESSDAI and ESSDAI was excellent (ICC=0.98 and 0.99). Psychometric properties of clinESSDAI, disease activity levels and minimal clinically important improvement thresholds and its ability to detect change over time in clinical trials were very close to that of ESSDAI.

CONCLUSIONS:

ClinESSDAI appears valid and very close to the original ESSDAI. This score provides an accurate evaluation of disease activity independent of B-cell biomarkers. It could be used in various circumstances: (i) in biological/clinical studies to avoid data collinearity, (ii) in clinical trials, as secondary endpoint, to detect change independent of biological effect of the drug, (iii) in clinical practice to assess disease activity for visits where immunological tests have not been done.

KEYWORDS:

Disease Activity; Outcomes research; Sjøgren's Syndrome

PMID:
27150113
DOI:
10.1136/annrheumdis-2015-208504
[Indexed for MEDLINE]

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