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

*Corresponding author for this work
14 Citations (Scopus)

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
JournalLupus
Volume20
Issue number5
Pages (from-to)485-492
Number of pages8
ISSN0961-2033
DOIs
Publication statusPublished - 04.2011

Research Areas and Centers

  • Academic Focus: Center for Infection and Inflammation Research (ZIEL)

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