Initial assessment of the early arthritis for psoriatic patients diagnostic questionnaire in dermatology clinics in Australia, Korea and China.

OBJECTIVES: To conduct initial assessment of the early arthritis for psoriatic patients (EARP) questionnaire for Australian, Korean and Chinese populations using translated and linguistically validated versions. To measure the proportion of patients with psoriatic arthritis (PsA) among patients with psoriasis who attended dermatology clinics. METHODS: Questionnaires were translated and culturally validated into Australian English, Korean and Chinese. A multicenter, observational, descriptive estimate of the proportion of patients with PsA among patients with psoriasis attending dermatology clinics in Australia, Korea and China was conducted. Initial assessments included evaluations of floor and ceiling effects, internal consistency (using Cronbach's alpha), test-retest reliability (using intraclass coefficient), and correlations between EARP score and rheumatology findings. If the initial EARP score was ≥3, patients were assessed by a rheumatologist for PsA within 3 months of their retest questionnaire. RESULTS: Two hundred and fifty patients participated. Translated EARP questionnaires showed satisfactory internal consistency and test-retest reliability. A potential floor effect was observed for the Chinese and Korean versions. Cronbach's alpha was 0.885 (Australian), 0.776 (Korean) and 0.789 (Chinese), indicating acceptable internal consistency. Intraclass correlation coefficients were 0.89 (Australian), 0.86 (Korean) and 0.87 (Chinese), indicating acceptable test-retest reliability. EARP summary scores had weak to moderate linear correlation with the relevant PsA assessments. Overall, 32 (12.8%) patients were diagnosed with PsA based on Classification for Psoriatic Arthritis (CASPAR) score. CONCLUSION: The Australian, Korean, and Chinese versions of the EARP questionnaire are suitable for the early detection of PsA symptoms in patients with psoriasis by dermatologists working in specialist dermatology clinics. TRIAL REGISTRATION: NCT02470481.

A critical appraisal of quantitative arthroscopy as an outcome measure in osteoarthritis of the knee.

BACKGROUND AND OBJECTIVES: To review the performance of arthroscopic assessment of articular cartilage damage in osteoarthritis. METHODS: The literature was reviewed for publications containing data regarding validity and reliability of arthroscopic systems of cartilage evaluation in knee osteoarthritis. RESULTS: Fifty-two distinct measurement systems were identified in 60 publications. There were 30 simple severity-scoring systems, 3 global visual analogue scale systems, and 19 composite systems. No systems consisted solely of measurements of lesion size or site, although 13 systems used either or both of these for the calculation of composite scores. Only 6 publications (10%) undertook any reliability evaluation and these generally used inappropriate methods of statistical analysis. Thirty-five publications (58%) evaluated validity. Construct validity was tested using several constructs (clinical in 2, magnetic resonance imaging in 10, radiographs in 10, or other arthroscopic assessments in 5 publications). Criterion validity was ascertained by using several methods including cartilage histology, histochemistry, or biomechanics in 10 publications. Responsiveness was determined in 1 publication. DISCUSSION: Many publications evaluated composite systems but only a few evaluated fundamental aspects of arthroscopic measurement. Conceptually, composite scoring systems have the best validity; however, at present, there is only enough evidence to support the use of simple chondropathy severity scores and there are little data on the responsiveness of these methods. A proposed program for comprehensive evaluation and development of valid and responsive arthroscopic assessments of articular cartilage is outlined.