一种用于监测犬特应性皮炎临床体征的新型在线工具的开发与验证

文献信息

中文摘要

目的： 本研究旨在开发一种简单、可靠且经过验证的患者报告结局工具，用于监测确诊或疑似特应性过敏并伴有复发性外耳炎的犬的临床体征严重程度。该工具称为犬导向特应性严重程度量表（DOSAS）。
材料与方法： 将人类患者导向湿疹测量量表（POEM）改编为与犬特应性皮炎（cAD）中主人可观察到的临床体征相关。通过与犬主人和兽医咨询进行改进，以确保适用性和易用性。评估了信度的相关特征（包括内部一致性、评分者内信度和重测信度）。随后由主人和临床医生对该工具进行测试，并与既有的临床体征评估方法比较其性能。
结果： DOSAS被证明既可靠又有效，其心理测量学特性高于此类工具开发的公认指南。文中给出了评分生成和评分分层以利于解读的指南。与犬特应性皮炎范围和严重程度指数第4版（CADESI-04）及瘙痒视觉评估量表（PVAS）的严重程度评估评分对变化的反应相比，DOSAS表现尤为突出，尽管与0-3外耳炎指数评分（OTIS-3）相比表现较差。
结论与临床意义： DOSAS作为一种补充工具，用于兽医实践和临床研究项目，与CADESI-04等现有临床测量方法并用，侧重于从犬及其主人角度所体验的疾病。与临床测量不同，DOSAS对犬主人而言易于获取和解读，这对于慢性瘙痒性疾病的管理很重要，并将使犬主人能够更积极地参与其犬的疾病管理。

英文摘要

OBJECTIVES: The aim of the study was to develop a simple, reliable and validated patient-reported outcome tool for use in monitoring the severity of clinical signs in dogs with confirmed or suspected atopic allergies and recurrent otitis externa. The tool is called the Dog-Orientated Severity of Atopy Scale (DOSAS).
MATERIALS AND METHODS: The human Patient-Oriented Eczema Measure (POEM) was adapted for relevance to the owner-observable clinical signs of canine atopic dermatitis (cAD). Refinements were made via consultation with dog owners and veterinary surgeons to ensure applicability and ease of use. Relevant features of reliability (including internal consistency, intrarater reliability and test-retest reliability) were evaluated. The tool was then tested by owners and clinicians for performance against established clinical sign assessment methods.
RESULTS: The DOSAS was shown to be both reliable and valid with psychometric properties above acceptable guidelines for the development of such tools. Guidelines are presented for score creation and stratification of the score to enable interpretation. When compared to how severity assessment scores from Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI-04) and pruritus Visual Assessment Scale (PVAS) responded to change, the DOSAS performed particularly strongly, although it performed less well when compared to the 0-3 Otitis Index Score (OTIS-3).
CONCLUSIONS AND CLINICAL RELEVANCE: The DOSAS is presented as a supplementary tool for use in veterinary practice and clinical research programmes alongside existing clinical measurements such as CADESI-04, providing a focus on the disease as it is experienced by the dog and their owner. Unlike clinical measurement, the DOSAS is accessible and interpretable for dog owners, which is important for the management of chronic pruritic conditions, and will enable dog owners to be more actively involved with their dog's disease management.