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Mosca, M.; Govoni, M.; Tomietto, P.; Aringer, M.; Boumpas, D.; Cervera, R.; ... ; Bombardieri, S. (2011)

The development of a simple questionnaire to screen patients with SLE for the presence of neuropsychiatric symptoms in routine clinical practice

Article / Letter to editor
Aim: The creation of a physician-administered questionnaire to screen patients with Systemic Lupus Erythematosus (SLE) for the presence of symptoms suggestive of neuropsychiatric involvement (NPSLE). Methods: The development of the questionnaire followed three phases. First, a list of manifestations was prepared based on the ACR case definitions for NPSLE. A first questionnaire was constructed including 119 items. To reduce their number, a Delphi analysis was carried out and a second questionnaire with 62 questions was developed. This questionnaire was administered to 139 patients with SLE (58 with NPSLE: 29 active, 29 inactive; and 81 without NPSLE: 39 active, 42 inactive). Questions relevant to the screening of patients were selected on the basis of the receiver operating characteristic (ROC) curve analysis. Results: Twenty-seven questions concerning central nervous system and psychiatric manifestations were found to be relevant; the remaining could be eliminated without...Show moreAim: The creation of a physician-administered questionnaire to screen patients with Systemic Lupus Erythematosus (SLE) for the presence of symptoms suggestive of neuropsychiatric involvement (NPSLE). Methods: The development of the questionnaire followed three phases. First, a list of manifestations was prepared based on the ACR case definitions for NPSLE. A first questionnaire was constructed including 119 items. To reduce their number, a Delphi analysis was carried out and a second questionnaire with 62 questions was developed. This questionnaire was administered to 139 patients with SLE (58 with NPSLE: 29 active, 29 inactive; and 81 without NPSLE: 39 active, 42 inactive). Questions relevant to the screening of patients were selected on the basis of the receiver operating characteristic (ROC) curve analysis. Results: Twenty-seven questions concerning central nervous system and psychiatric manifestations were found to be relevant; the remaining could be eliminated without significantly affecting AUC. The area under the ROC curve (AUC) was 0.69 (95% CI 0.61-0.78). A score above 17 was considered as suggestive of the presence of NPSLE with a sensitivity of 92.9% (95% CI 85.1-97.3 %) and specificity of 25.4% (95% CI 14.7-39.00 %). Conclusions: This questionnaire could represent a 'core set' of questions that could help in clinical practice to identify patients with neuropsychiatric symptoms requiring further evaluation. Lupus (2011) 20, 485-492.Show less
Clinical practice neuropsychiatric lupus questionnaire screening systemic lupus erythematosus systemic-lupus-erythematosus migraine-act questionnaire response inventory ansri central-nervous-system to-day impact inception cohort psychometric evaluation cognitive impairment multiple-sclerosis seizure severity
All authors
Mosca, M.; Govoni, M.; Tomietto, P.; Aringer, M.; Boumpas, D.; Cervera, R.; Conti, F.; D'Cruz, D.; Doria, A.; Fuente, D. de la; Galeazzi, M.; Houssiau, F.; Huizinga, T.W.J.; Khamashta, M.A.; Ines, L.; Duarte, C.; Couto, M.; Meroni, P.; Montecucco, C.; Norkuviene, E.; Riemekasten, G.; Rios, V.; Schneider, M.; Shoenfeld, Y.; Steup-Beekman, G.M.; Szmyrka-Kaczmarek, M.; Tani, C.; Tincani, A.; Tzioufas, A.G.; Voll, R.; Bencivelli, W.; Salaffi, F.; Bombardieri, S.
Date
2011-04-30
Journal
Lupus
Volume
20
Issue
5
Pages
485 - 492
DOI
doi:10.1177/0961203310389097