Spondyloarthritis & psoriatic arthritis
Validation of patient-reported outcome measures for dactylitis, psoriatic skin and nail disease, and uveitis in patients with psoriatic arthritis in routine care
Authors' conclusion
Patients reliably self-report dactylitis, psoriasis, and uveitis and the PROMs are valuable for monitoring NMMs in routine care.
Study context
- Population
- Patients with PsA in routine care monitored in the Danish DANBIO registry (51% female, median age 55 years, median disease duration 8 years, 43% on biologic treatment)
- Participants
- 300 patients
- Comparison
- Patient-reported patient-reported outcome measures (PROMs) vs physician's assessment
- Outcome
- Sensitivity, specificity, PPV, NPV, accuracy and Cohen's kappa of PROMs for current dactylitis, skin and nail psoriasis and recent uveitis vs physician's assessment
Methodological detailsadaptive cross-sectional, physician assessment as gold standard, physician blinded to PROs from patient 200, dactylitis photo added to PROM after 134 patients, With 134 patients included, 20% had incorrectly reported dactylitis; a dactylitis photo was then added to the PROM
- Adaptive cross-sectional
- Physician assessment as gold standard
- Physician blinded to PROs from patient 200
- Dactylitis photo added to PROM after 134 patients
- With 134 patients included, 20% had incorrectly reported dactylitis; a dactylitis photo was then added to the PROM
Performance
As reported in the abstract
Diagnostic performance of PROMs vs physician's assessment
| Test or model | Sensitivity | Specificity | Cohen's kappa |
|---|---|---|---|
| Dactylitis PROM | 0.89 | 0.81 | 0.57 |
| Psoriasis PROM | 1.0 | 0.94 | 0.95 |
| Nail psoriasis PROM | 0.76 | 0.94 | 0.66 |
| Uveitis PROM | 1.00 | 0.99 | 0.59 |
Sensitivity
Dactylitis PROM0.89
Psoriasis PROM1.0
Nail psoriasis PROM0.76
Uveitis PROM1.00
Specificity
Dactylitis PROM0.81
Psoriasis PROM0.94
Nail psoriasis PROM0.94
Uveitis PROM0.99
Cohen's kappa
Dactylitis PROM0.57
Psoriasis PROM0.95
Nail psoriasis PROM0.66
Uveitis PROM0.59
Further findings
| Outcome | Average difference (unit) |
|---|---|
| Dactylitis count, patient- vs physician-reported (Bland-Altman)Decreased to 0.7 after adding the dactylitis photo | 1.0 |
Prevalence by physician's assessment
- Current dactylitis
- 41 (14%)
- Psoriasis
- 164 (55%)
- Nail psoriasis
- 163 (54%)
- Recent uveitis
- 3 (1%)
Agreement on psoriasis extent
- Agreement
- 90%
Effect of blinding
- Results were similar irrespective of blinding
Original publication
Validation of patient-reported outcome measures for dactylitis, psoriatic skin and nail disease, and uveitis in patients with psoriatic arthritis in routine care. RMD Open. Published 5 July 2025. doi:10.
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