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Validation of the Sicca Symptoms Inventory for Clinical Studies of Sjögren's Syndrome
SIMON J. BOWMAN, DAVID A. BOOTH, ROSEMARY G. PLATTS, ANNE FIELD, JOCELYN ROSTRON, and the UK Sjögren's Interest Group
ABSTRACT. Objective. Oral, ocular, and other dryness are the hallmark features of Sjögren's syndrome (SS). We constructed a new measure of sicca symptoms, the Sicca Symptoms Inventory, for the evaluation of patients with primary SS. Methods. Female Caucasian groups of patients with primary SS, systemic lupus erythematosus, and rheumatoid arthritis and healthy controls were assessed for tear and saliva production and also completed a symptoms-profiling inventory construct-validated from primary SS patients' own vocabulary, augmented with sicca items from publications and participating clinicians. Multi-item facets of sicca and other discomfort were validated by factor analysis. Results. Primary SS and other "sicca" conditions were highly discriminated from other rheumatic disorders and healthy controls on each dryness-related facet of oral and ocular discomfort. Selected symptom scores were as sensitive and specific to primary SS as the scores for saliva and tears, respectively, although the severity scores of symptoms and signs were only moderately correlated. Conclusion. These multiple-question scales distinguish patients with primary SS from controls more precisely than previously used measures. Future studies will test if change in these symptom scores can serve as an outcome measure for clinical trials in SS. (J Rheumatol 2003;30:1259-66) Key Indexing Terms:
SJÖGREN'S SYNDROME
From the Rheumatology Department, Division of Immunity and Infection, The University of Birmingham; School of Psychology, The University of Birmingham, Birmingham; and the Department of Oral Medicine, Liverpool Dental Hospital, Liverpool, UK. Supported by the Arthritis Research Campaign (UK), University Hospitals Birmingham NHS Trust (in collaboration with Prof. R. Hobbs and R. Salter) and the British Sjögren's Syndrome Association. S.J. Bowman, PhD, FRCP, Rheumatology Department, Division of Immunity and Infection; D.A. Booth, PhD, DSc, CPsychol, FBPsS; R.G. Platts, BA, School of Psychology, University of Birmingham; A. Field, DDSci, FDSRCS; J. Rostron, BDS, FDSRCS, Department of Oral Medicine, Liverpool Dental Hospital. Address reprint requests to Dr. S.J. Bowman, Department of Rheumatology, Division of Immunity and Infection, School of Medicine and Dentistry, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. E-mail: S.J.Bowman@bham.ac.uk Submitted April 24, 2002; revision accepted November 27, 2002. |