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Subjective and Objective Measures of Dryness Symptoms in Primary Sjögren's Syndrome - Capturing the discrepancy

Bezzina, OM; Gallagher, P; Mitchell, S; Bowman, SJ; Griffiths, B; Hindmarsh, V; Hargreaves, B; ... Robinson, LJ; + view all (2017) Subjective and Objective Measures of Dryness Symptoms in Primary Sjögren's Syndrome - Capturing the discrepancy. Arthritis Care & Research , 69 (11) pp. 1714-1723. 10.1002/acr.23165. Green open access

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Abstract

BACKGROUND: There is a weak relationship between subjective symptoms and objective markers of disease activity in individuals with Primary Sjögren's Syndrome (PSS). This presents a significant barrier to developing treatments if modifying disease markers does not translate into reduced perception of symptoms. Little is known about the reasons for this discrepancy. OBJECTIVES: To develop a novel method for capturing the discrepancy between objective tests and subjective dryness symptoms (a 'Sensitivity' scale) and to explore predictors of dryness Sensitivity. METHODS: Archive data from the UK Primary Sjogren's Syndrome Registry (n=681) was used. Patients were classified on a scale from -5 (stoical) to +5 (sensitive) depending on the degree of discrepancy between their objective and subjective symptoms classes. Sensitivity scores were correlated with demographic variables, disease-related factors and symptoms of pain, fatigue, anxiety and depression. RESULTS: Patients were on average relatively stoical for both dryness symptoms (ocular mean±s.d. -0.42±2.2, oral mean±s.d. -1.24±1.6). Twenty-seven percent of patients were classified 'sensitive' to ocular dryness in contrast to 9% for oral dryness. Hierarchical regression analyses identified the strongest predictor of ocular dryness was self-reported pain and the strongest predictor of oral dryness was self-reported fatigue. CONCLUSIONS: Ocular and oral dryness sensitivity can be classified on a continuous scale. The two symptom types are predicted by different variables. A large number of factors remain to be explored that may impact on symptom-sensitivity in PSS and the proposed method could be used to identify relatively sensitive and stoical patients for future studies.

Type: Article
Title: Subjective and Objective Measures of Dryness Symptoms in Primary Sjögren's Syndrome - Capturing the discrepancy
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/acr.23165
Publisher version: http://dx.doi.org/10.1002/acr.23165
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Primary Sjögren's Syndrome, Schirmer's I Test, Unstimulated Salivary Flow, dryness symptoms, subjective objective discrepancy
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inflammation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > EDI MaxFac, Diagnostic, Med and Surg Sci
URI: https://discovery.ucl.ac.uk/id/eprint/1535648
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