ABSTRAK
Latar Belakang: Skor Clinical Disease Activity Index CDAI , sebagai salah satu metode pengukur derajat aktivitas artritis reumatoid AR , dipandang memiliki kelebihan dibandingkan metode skor lain karena tidak memerlukan pemeriksaan laboratorium penunjang. Studi-studi yang dilakukan pada pasien AR di luar Indonesia mengungkap bahwa korelasi, validitas dan reliabilitas CDAI dinilai baik saat diuji dengan pembanding skor lain. Namun demikian studi-studi tersebut hanya mengikutsertakan subjek pasien AR murni tanpa komorbiditas. Pasien AR di Indonesia memiliki karakteristik klinis yang berbeda, terutama dalam aspek adanya kondisi komorbiditas, perbedaan predisposisi genetik dan perbedaan fenotipe penyakit. Tujuan: Menilai validasi skor CDAI pada profil pasien AR di Indonesia. Metode: studi potong lintang pada subjek pasien AR yang berobat di poliklinik Reumatologi RS Cipto Mangunkusumo bulan April s.d. Mei 2016. Setiap subjek dilakukan anamnesis, pemeriksaan fisik, pencatatan hasil pemeriksaan penunjang dan pencatatan data komorbiditas yang tertera di rekam medis. Dua pengukur melakukan penghitungan skor CDAI dan skor Disease Activity Score 28 DAS28-CRP sebagai baku emas pembanding pada tiap subjek. Luaran berupa data numerik. Penilaian model validasi data numerik dilakukan dengan analisis performa model prediktor menggunakan indeks R 2 . Hasil: Terdapat 119 subjek penelitian yang memenuhi kriteria inklusi. Seluruh subjek memiliki kondisi komorbiditas selain AR. Indeks R 2 =0,831 83,1 ;
ABSTRACT
Background Clinical Disease Activity Index CDAI stands out amongst other methods in measuring disease activity of rheumatoid arthritis RA patient. CDAI is considered to be more practical and cost effective in daily practice because it requires no laboratory examination. Previous studies conducted overseas revealed that CDAI has good correlation, validity, and reliability compared with other scoring methods. However, those studies included only pure RA subjects. Indonesian RA patients have distinct clinical profiles, in terms of comorbidity diseases, genetic predisposition, and fenotype of the disease. Objectives To analyze validation of CDAI in distinct clinical profiles of RA patients in Indonesia. Methods A cross sectional study in RA outpatients, who were visiting Rheumatology Clinic in RSCM on monthly basis from April to May 2016. Assesement of each patient include history taking and physical examination. All recent laboratory results and other data in medical record were documented in reseacher form. CDAI and Disease Activity Score 28 CRP DAS28 CRP , as gold standard, were measured by two observers. Outcomes were in numeric. Validation measurement were done in terms of validating a model prediction and quantifying how good the predictions from the model are. Overall perforomance were measured with R 2 index. Result A total of 119 subjects met the inclusion criteria. All subjects were RA patients with comorbidities and were representing quite numbers of Indonesian races characteristic profile. R 2 0,831 83,1 p |
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