Construct validity of the ASAS health index in psoriatic arthritis: a cross-sectional analysis

Rheumatology ◽  
2020 ◽  
Author(s):  
Isla Morante ◽  
Elena Aurrecoechea ◽  
Ignacio Villa ◽  
Montserrat Santos ◽  
Leyre Riancho ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Global Health ◽  
Construct Validity ◽  
Activity Index ◽  
High Impact ◽  
Measurement Properties ◽  
Health Index ◽  
Cross Sectional ◽  
Optimal Criterion ◽  
Active Disease

Abstract Objectives The Assessment of SpondyloArthritis international Society health index (ASAS-HI) was designed to assess the global health of patients with spondyloarthritis, but its performance in psoriatic arthritis (PsA) is hardly known. We addressed the clinimetric properties of this instrument in patients with PsA. Methods This was a cross-sectional observational study that included 90 consecutive patients with PsA. The measurement properties of ASAS-HI were analysed against the Disease Activity index for PSoriatic Arthritis (DAPSA) and the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire. A multivariate analysis was performed to weigh the ASAS-HI items associated with DAPSA active disease and PsAID high impact. Results Mean ASAS-HI was 5.8 (4.3). Convergent validity was high both against DAPSA (ρ 0.78, P < 0.0001) and PsAID (ρ 0.80, P < 0.0001). ASAS-HI showed a high discriminant capacity for both DAPSA remission [optimal criterion ≤ 2, area under the receiver operating characteristic curve (AUC) 0.92 (95% CI: 0.85, 0.97), P < 0.0001], and low activity [optimal criterion ≤6, AUC 0.87 (95% CI: 0.79, 0.94), P < 0.0001]. The ASAS-HI items significantly associated with DAPSA active disease were: ‘I find it hard to stand for long’ (β 4.48, P < 0.0001), ‘I find it hard to concentrate’ (β 2.94, P = 0.042) and ‘I sleep badly at night’ (β 1.86, P = 0.044). As for PsAID, the only item significantly associated with a high impact was ‘I sleep badly at night’ (β −3.29, P = 0.015). Conclusion We demonstrated construct validity of ASAS-HI, a spondyloarthritis instrument, for the assessment of global health in patients with PsA.

Performance of the ASAS Health Index for the Evaluation of Spondyloarthritis in Daily Practice

2020 ◽  
Vol 47 (10) ◽  
pp. 1483-1489 ◽  
Author(s):  
Sara Alonso-Castro ◽  
Estefanía Pardo ◽  
Lilyan Charca ◽  
Marina Pino ◽  
Sabela Fernández ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Convergent Validity ◽  
Activity Index ◽  
Positive Likelihood Ratio ◽  
Daily Practice ◽  
Measurement Properties ◽  
Health Index ◽  
Cross Sectional ◽  
Active Disease

ObjectiveThe Assessment of SpondyloArthritis international Society Health Index (ASAS HI) is a tool designed to assess disease impact in spondyloarthritis (SpA), but its clinical performance is barely known. We aimed to test the clinimetric properties of ASAS HI in a real clinical setting.MethodsThis cross-sectional study included 111 consecutive patients with SpA. The measurement properties of ASAS HI were tested against conventional assessment measures. Convergent validity was assessed by Spearman rho correlations, while discriminative validity was analyzed through receiver-operating characteristic (ROC) curves. A multivariate regression analysis was designed to identify ASAS HI items associated with active disease.ResultsThe average ASAS HI was 5.4 ± 3.8 (interquartile range 3–8). ASAS HI showed high convergent validity against other SpA measures (rho ≥ 0.70, p < 0.0005). The optimal criteria for detecting high/very high disease activity Ankylosing Spondylitis Disease Activity Score (ASDAS) categories was an ASAS HI score > 6, area under the ROC curve 0.86 (95% CI 0.78–0.92), positive likelihood ratio 7.3 (95% CI 3.1–17.1), p < 0.0001. The ASAS HI items significantly associated with Bath Ankylosing Spondylitis Disease Activity Index active disease were “I often get frustrated” (OR 9.2, 95% CI 1.2–69.4, p = 0.032), and “I sleep badly at night” (OR 7.7, 95% CI 1.4–41.6, p = 0.018). As for ASDAS, it was “pain sometimes disrupts my normal activities” (OR 8.7, 95% CI 1.7–45.2, p = 0.010).ConclusionThe ASAS HI is a useful and simple instrument for its application in daily practice. Given its good clinimetric properties, it could be used as an additional instrument to evaluate SpA.

scholarly journals THU0629-HPR COULD THE ASAS HEALTH INDEX BE A USEFUL INSTRUMENT IN ASSESSING PATIENTS WITH PSORIATIC ARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 559.2-559
Author(s):  
I. Morante Bolado ◽  
E. Aurrecoechea ◽  
I. Villa-Blanco ◽  
M. Santos Gómez ◽  
L. Riancho-Zarrabeitia ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Roc Curve ◽  
Convergent Validity ◽  
Health Index ◽  
Research Support ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Optimal Criterion ◽  
The Impact ◽  
Low Activity

Background:At present, there is a growing tendency to use instruments that capture, in the best possible way, the impact that the spondyloarthritides (SpA) generate on patients´ lives. For that purpose, tools such as the Psoriatic Arthritis Impact of Disease (PsAID), for psoriatic arthritis (PsA), and the Assessment of SpondyloArthritis international Society-Health Index (ASAS-HI), for SpA, have been recently developed and validated. However, the performance of the ASAS-HI to assess the impact of disease in psoriatic arthritis is barely known.Objectives:To determine the possible application of ASAS HI to assess PsA by comparing its results to other PsA measurement tools.Methods:In this observational, cross-sectional study, 89 consecutive patients with PsA (CASPAR criteria) were included. The convergent validity of ASAS-HI (Spearman’s rho) and its discriminative validity (ROC curves) was analyzed against other PsA measures (DAPSA and PsAID).Results:ASAS HI showed a high convergent validity both against DAPSA (rho 0.78, p <0.0001) and PsAID (rho 0.80, p <0.0001). PsAID and DAPSA also showed high convergent validity (rho 0.79, p <0.0001). ASAS HI showed a high discriminative capacity for both DAPSA remission [optimal criterion ≤ 2, area under the ROC curve 0.92 (95%CI: 0.85-0.97), sensitivity 73%, specificity 94%, p < 0.0001] (fig 1) and DAPSA low activity state [optimal criterion ≤ 10.6, area under the ROC curve 0.87 (95%CI: 5-10.6), sensitivity 93%, specificity 61%, p < 0.0001]. PsAID also demonstrated a high discriminative capacity for DAPSA remission [optimal criterion ≤ 0.8, area under the ROC curve 0.94 (95%CI: 0.55-0.95), sensitivity 76%, specificity 100%, p < 0.0001] and DAPSA low activity [optimal criteria ≤ 4.9, area under the ROC curve 0.83 (95%CI: 3.4-5.2), sensitivity 92%, specificity 61%, p < 0.0001].Figure 1.ROC curve analysis between DAPSA remission and ASAS HIConclusion:ASAS HI could be used as an appropriate tool in the assessment of patients with PsA.Disclosure of Interests:Isla Morante Bolado: None declared, Elena Aurrecoechea: None declared, Ignacio Villa-Blanco Consultant of: UCB, Speakers bureau: Novartis, MSD, Lilly, Montserrat Santos Gómez: None declared, Leyre Riancho-Zarrabeitia Grant/research support from: Yes, Speakers bureau: Yes, José Luis Martín-Varillas Grant/research support from: AbbVie, Pfizer, Janssen and Celgene, Speakers bureau: Pfizer and Lilly, Rubén Queiró Silva: None declared

Cut off point of neutrophil-to-lymphocyte ratio as a marker of active disease in systemic lupus erythematosus

Lupus ◽  
2020 ◽  
Vol 29 (12) ◽  
pp. 1566-1570
Author(s):  
Akhmad Syaikhu Firizal ◽  
Adhi Kristianto Sugianli ◽  
Laniyati Hamijoyo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Inflammatory Diseases ◽  
Activity Index ◽  
Disease Activity Index ◽  
Neutrophil To Lymphocyte Ratio ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Lymphocyte Ratio ◽  
Active Disease

Aim We aimed to measure sensitivity, specificity, and to determine the cut-off value (COV) ratio of neutrophil-to-lymphocyte (NLR) in patients with active systemic lupus erythematosus (SLE). Methods A cross sectional study was conducted using the retrospective data from Hasan Sadikin Lupus Registry (HSLR). The inclusion criteria were SLE patients aged 18 years or older who had documented data of neutrophil, lymphocyte, and SLE disease activity index (SLEDAI). Patients with infections, malignancies, and other inflammatory diseases recorded in registry were excluded. SLEDAI with a score of ≤ 4 is considered inactive and score of > 4 is considered active. The neutrophil-to-lymphocyte ratio was calculated by dividing the absolute number of neutrophils by the absoulte number of lymphocytes. Receiver Operating Characteristic (ROC) curve was used to analyze and determine optimal COV of NLR. Results The total sample in this study were 112 subjects with a dominant of female (95.54%) and the mean age of 34.45 ± 9.40 years. The median of SLEDAI was 4.5 with a range from 0 to 16, while the median of NLR was 2.68 with a range of 0.59 to 19.02. The ROC analysis showed the optimal cut-off in this study was 2.94 with sensitivity and specificity as high as 60.71% and 76.79%, respectively. Conclusion Neutrophil-to-lymphocyte ratio with cut off value of 2.94 can be used to determine active disease of systemic lupus eythematousus.

The 12-item Psoriatic Arthritis Impact of Disease Questionnaire: Construct Validity, Reliability, and Interpretability in a Clinical Setting

2016 ◽  
Vol 44 (3) ◽  
pp. 279-285 ◽  
Author(s):  
Marco Di Carlo ◽  
Andrea Becciolini ◽  
Valentina Lato ◽  
Chiara Crotti ◽  
Ennio Giulio Favalli ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Construct Validity ◽  
Disease Activity ◽  
Convergent Validity ◽  
Activity Index ◽  
Multivariable Analysis ◽  
Real Life ◽  
Life Quality ◽  
Biologic Treatment ◽  
Patient Reported

Objective.To study, in a real-life setting, the construct validity, the reliability, and the interpretability of the 12-item Psoriatic Arthritis Impact of Disease (PsAID-12) questionnaire in patients with psoriatic arthritis (PsA).Methods.In 144 consecutive patients with PsA (81 men and 63 women, mean age of 51.4 ± 12.8 yrs, and 77 receiving biologic treatment), the PsAID-12 and other patient-reported outcomes (PRO) were collected, such as the Dermatology Life Quality Index. Each patient underwent articular and skin assessment.Results.Construct validity: Factor analysis revealed a 2-factor result defined as the PsAID Symptom Score and the PsAID Skin Score. In determining convergent validity, significant correlations were found between the PsAID-12 and the clinical Disease Activity index for Psoriatic Arthritis (cDAPSA; ρ = 0.867, p < 0.0001). Multivariable analysis showed that the PsAID-12 is determined by the articular disease activity (cDAPSA, p < 0.0001), severity of psoriasis (PsO; physician’s global assessment, p < 0.0001), and the presence of a coexisting fibromyalgia (FM; p < 0.0001). Reliability: Cronbach’s alpha coefficient was 0.93 for the total PsAID-12. Interpretability: Applying the cDAPSA categorization of disease activity states, the PsAID-12 cutoff values resulted in 1.4 between remission and low disease activity (LDA), 4.1 between LDA and moderate disease activity (MDA), and 6.7 between MDA and high disease activity.Conclusion.The PsAID-12 is an excellent PRO to evaluate the effect of PsA. It should be carefully handled in patients with coexisting FM.

scholarly journals Association Between Housing Instability and Severity of Psoriasis and Psoriatic Arthritis: A Cross-Sectional Study

2020 ◽  
Vol 4 (4) ◽  
pp. 321-327
Author(s):  
Jalal Maghfour ◽  
Frances Gill ◽  
Justin Olson ◽  
Andrea Murina
Keyword(s):  
Psoriatic Arthritis ◽  
Activity Index ◽  
Disease Activity Index ◽  
Cross Sectional Study ◽  
Equation Model ◽  
Housing Instability ◽  
Cross Sectional ◽  
Housing Status ◽  
The Impact ◽  
Question Survey

Introduction: Psoriasis and psoriatic arthritis are interrelated chronic inflammatory disorders that can be exacerbated by stress. The impact of housing instability on severity of psoriasis and psoriatic arthritis (PsA) has not been examined.Methods: An eight-question survey was administered to 59 psoriasis participants, with and without PsA, to assess participants' housing status. The severity of psoriasis and PsA diseases was assessed using Body Surface Area (BSA) and clinical Disease Activity Index of Psoriatic Arthritis (cDAPSA) measurements respectively. A multivariate linear regression model was used to predict BSA and cDAPSA scores differences among participants.Results: Housing unstable psoriasis participants had a higher average BSA than housing stable psoriasis participants (14% vs 7.1%). Using a regression equation model, housing status and smoking were significant predictors (p<0.04). Housing unstable PsA participants [13 (33%)] were also found to have a higher average cDAPSA than housing-stable psA participants [26 (66%)] (31 vs 16.7).  Housing instability was the only variable to predict differences in cDAPSA scores among PsA participants (p=0.021). Housing unstable participants had a higher BSA even on biologics (21.3% vs 1.65%; P < 0.001), oral therapy (14.6% vs 4 %; P<0.001) and phototherapy (10% vs 4%; P=0.031).Discussion: This study demonstrated that housing instability might be associated with an increased severity of psoriasis and PsA. Housing instability, as a psychosocial stressor, could be an important element to consider in the management of psoriasis patients.

scholarly journals Prolactin as a marker of active disease in systemic lupus erythematosus

2021 ◽  
Author(s):  
Jorge Medina Castillo ◽  
Nayeli Nicté López Villa
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Serum Prolactin ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Active Disease

Abstract Objetives. To determine the correlation between prolactin levels and disease activity classified based on the Mexican lupus erythematosus disease systemic activity index (MEX SLEDAI).Methods. In this cross-sectional observational study, serum prolactin, age, sex, treatment, as well as manifestations of active disease were determined. Disease activity was evaluated using the Mexican Systemic Lupus Erythematosus Activity Index (MEX-SLEDAI). The correlation of MEX-SLEDAI with prolactin was determined using the Spearman correlation coefficient. The significance of differences between continuous variables was determined with the non-paired Student’s t test and the significance of differences between categorical variables was determined with Chi-square test.Results. 55 patients were included, 10 (18.1%) had MEX-SLEDAI ≥ 7 and 45 (81.8%) less than 7. A positive correlation was found with a Spearman rho 0.387 (p = 0.004) between the MEX-SLEDAI and the levels serum prolactin. Subjects with active disease and hyperprolactinemia had 80% manifestations at the renal level (p = 0.001).Conclusion. There is significant correlation between prolactin levels and disease activity. Hyperprolactinemia were detected in patients with renal activity as well as those with MEX-SLEDAI ≥ 7.

scholarly journals Measuring Outcomes in Psoriatic Arthritis: Comparing Routine Assessment of Patient Index Data and Psoriatic Arthritis Impact of Disease

2019 ◽  
Vol 47 (10) ◽  
pp. 1496-1505 ◽  
Author(s):  
Jessica A. Walsh ◽  
Marilyn T. Wan ◽  
Christine Willinger ◽  
M. Elaine Husni ◽  
Jose U. Scher ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Construct Validity ◽  
Short Form ◽  
Contextual Factors ◽  
Correlation Coefficients ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Index Data ◽  
Patient Reported ◽  
Routine Assessment

ObjectiveTo examine the construct validity of Routine Assessment of Patient Index Data 3 (RAPID3) and Psoriatic Arthritis Impact of Disease (PsAID) in patients with psoriatic arthritis (PsA). In examining construct validity, we also addressed scores among subgroups with severe psoriasis, poly articular disease, enthesitis, and dactylitis, and evaluated influences of sociodemographic factors and comorbidities (contextual factors) on these patient-reported outcomes (PRO).MethodsPatients with PsA were enrolled in the Psoriatic Arthritis Research Consortium (PARC) between 2014 and 2016. PARC is a longitudinal observational cohort study conducted at 4 US institutions. In this cross-sectional study, construct validity was assessed by examining Spearman correlation coefficients for RAPID3 and PsAID with physician-reported disease activity measures and other PRO [e.g., Medical Outcomes Study Short Form-12 physical component summary/mental component summary (SF-12 PCS/MCS), Functional Assessment of Chronic Illness Therapy–Fatigue scale (FACIT-F)]. Contextual factors and disease subgroups were assessed in multivariable linear regression models with RAPID3 or PsAID12 as outcomes of interest and the hypothesized contextual factors as covariates.ResultsAmong 401 patients enrolled in PARC, 347 completed RAPID3 or PsAID12. Of these, most were white females with a mean age of 51.7 years (SD 14.02). RAPID3 and PsAID were highly correlated (r = 0.90). These measures were also correlated with the SF-12 PCS (r = −0.67) and FACIT-F (r = −0.77). Important contextual factors and disease subgroups included enthesitis, joint counts, education, insurance type, and depression.ConclusionRAPID3 and PsAID12 have excellent construct validity in PsA and are strongly correlated despite differing items. Contextual factors (i.e., the presence of depression and obesity) should be considered when interpreting raw scores of the RAPID3 and PsAID12.

scholarly journals What Should Be the Primary Target of “Treat to Target” in Psoriatic Arthritis?

2018 ◽  
Vol 46 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Laura C. Coates ◽  
Ennio Lubrano ◽  
Fabio Massimo Perrotta ◽  
Paul Emery ◽  
Philip G. Conaghan ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Residual Disease ◽  
Activity Index ◽  
Disease Activity Index ◽  
Inactive Disease ◽  
Treat To Target ◽  
Recent Onset ◽  
Treatment Groups ◽  
Active Disease

Objective.Recommendations regarding “treat to target” in psoriatic arthritis (PsA) have stated that the target should be remission or inactive disease. Potential definitions include very low disease activity (VLDA), PsA Disease Activity Score (PASDAS) near remission, Disease Activity Index for PsA (DAPSA) or clinical DAPSA (cDAPSA) remission. Our aim was to investigate the proportion of patients who fulfill these definitions and how much residual active disease remained.Methods.This analysis used 2 datasets: first, trial data from the Tight Control of PsA (TICOPA) study, which included 206 patients with recent-onset (< 2 yrs) PsA receiving standard and biological disease-modifying antirheumatic drugs (DMARD); and second, an observational clinical dataset from Italy of patients receiving biological DMARD. Proportions achieving each of the 4 potential targets were calculated in each dataset and comparisons between treatment groups were performed in the TICOPA dataset. Levels of residual disease were established for key clinical domains of PsA.Results.All measures could differentiate the TICOPA trial treatment groups (p < 0.03). Lower proportions of patients fulfilled the VLDA criteria compared to DAPSA or cDAPSA remission. PASDAS results were different between the cohorts. Residual active disease was low across all definitions although higher levels were seen in DAPSA and cDAPSA compared to VLDA, particularly for psoriasis. In all measures, the proportion with elevated C-reactive protein was similar and low.Conclusion.VLDA appears the most stringent measure. It ensures that significant active arthritis, enthesitis, and psoriasis are not present, in contrast with DAPSA and PASDAS, in which composite scores can “hide” active disease in some domains.

The Effect of the Presence of Fibromyalgia on Common Clinical Disease Activity Indices in Patients with Psoriatic Arthritis: A Cross-sectional Study

2016 ◽  
Vol 43 (9) ◽  
pp. 1749-1754 ◽  
Author(s):  
Shay Brikman ◽  
Victoria Furer ◽  
Jonathan Wollman ◽  
Sara Borok ◽  
Hagit Matz ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Cross Sectional Study ◽  
Clinical Disease ◽  
Sectional Study ◽  
Cross Sectional ◽  
Clinical Disease Activity ◽  
Activity Indices

Objective.To study the effect of the presence of fibromyalgia (FM) on common clinical disease activity indices in patients with psoriatic arthritis (PsA).Methods.Seventy-three consecutive outpatients with PsA (mean age 51.7 yrs; 42 females, 57.5%) were enrolled in a prospective cross-sectional study. FM was determined according to American College of Rheumatism criteria (2010 and 1990). All patients underwent clinical evaluation of disease activity and completed the Health Assessment Questionnaire (HAQ), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Dermatology Life Quality Index, and the Leeds Enthesitis Index (LEI). Disease activity was evaluated using the Composite Psoriatic Disease Activity Index (CPDAI), minimal disease activity (MDA), and the Disease Activity Index for Psoriatic Arthritis (DAPSA) scores.Results.The overall prevalence of FM was 17.8% (13 patients), and all but 1 were women (12 patients, 92.3%, p = 0.005). CPDAI and DAPSA scores were significantly higher in patients with coexisting PsA and FM (9.23 ± 1.92 and 27.53 ± 19.23, respectively) than in patients with PsA only (4.25 ± 3.14 and 12.82 ± 12.71, respectively; p < 0.001 and p = 0.003). None of the patients with FM + PsA met the criteria for MDA, whereas 26 PsA-only patients did (43.3%, p = 0.003). HAQ, BASDAI, and LEI scores were significantly worse in patients with PsA and associated FM.Conclusion.Coexisting FM is related to worse scores on all tested measures in patients with PsA. Its influence should be taken into consideration in the treatment algorithm to avoid unnecessary upgrading of treatment.

scholarly journals Very Low Disease Activity, DAPSA Remission, and Impact of Disease in a Spanish Population with Psoriatic Arthritis

2019 ◽  
Vol 46 (7) ◽  
pp. 710-715 ◽  
Author(s):  
Ruben Queiro ◽  
Juan D. Cañete ◽  
Carlos Montilla ◽  
Miguel Angel Abad ◽  
María Montoro ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Routine Clinical Practice ◽  
Cross Sectional ◽  
Low Disease Activity ◽  
Moderate Agreement ◽  
Minimal Disease

Objective.To examine the grade of agreement between very low disease activity (VLDA) and Disease Activity Index for Psoriatic Arthritis (DAPSA) remission, as well as their association with the effect of the disease as assessed by the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire in patients with psoriatic arthritis in routine clinical practice.Methods.Posthoc analysis of data from a cross-sectional multicenter study. Patients were included who fulfilled the Classification for Psoriatic Arthritis (CASPAR) criteria with at least 1 year of disease duration and were treated with biological and/or conventional synthetic disease-modifying antirheumatic drugs according to routine clinical practice in Spain. Patients were considered in VLDA if they met 7/7 of the minimal disease activity criteria. DAPSA and clinical (c)DAPSA score ≤ 4 identified remissions.Results.Of the 227 patients included in the original study, 26 (11.5%), 52 (22.9%), and 65 (28.6%) were in VLDA, DAPSA remission, and cDAPSA remission, respectively. There was a moderate agreement between VLDA and DAPSA remission (κ = 0.52) or cDAPSA remission (κ = 0.42). Patients with VLDA had less effect of the disease as measured by PsAID [mean total score (SD): VLDA 1.1 (1.2); DAPSA remission 1.3 (1.5); cDAPSA remission 1.7 (1.6)]. There was a moderate agreement between DAPSA remission or cDAPSA remission and PsAID < 4 (κ = 0.46 and κ = 0.58 respectively), while poor agreement (κ = 0.18) was found between VLDA and PsAID < 4.Conclusion.VLDA criteria seem to be more stringent for assessing a status of remission; however, DAPSA remission shows better correlation with a patient-acceptable symptoms state than VLDA does.

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