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

M. Mosca, M. Govoni, P. Tomietto, M. Aringer, D. Boumpas, R. Cervera, F. Conti, D. D'Cruz, A. Doria, D. De La Fuente, M. Galeazzi, F. Houssiau, Twj Huizinga, M. A. Khamashta, L. Ines, C. Duarte, M. Couto, P. Meroni, C. Montecucco, E. NorkuvieneG. Riemekasten, V. Rios, M. Schneider, Y. Shoenfeld, G. M. Steup-Beekman, M. Szmyrka-Kaczmarek, C. Tani, A. Tincani, A. G. Tzioufas, R. Voll, W. Bencivelli, F. Salaffi, S. Bombardieri

Research output: Contribution to journalArticlepeer-review

Abstract

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 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.

Original languageEnglish
Pages (from-to)485-492
Number of pages8
JournalLupus
Volume20
Issue number5
DOIs
Publication statusPublished - Apr 2011

Keywords

  • Clinical practice
  • neuropsychiatric lupus
  • questionnaire
  • screening
  • systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology

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