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Cross-cultural validation and psychometric properties of the Brazilian Portuguese version of the Psoriasis Epidemiology Screening Tool (PEST-bp)

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Abstract

Although the Psoriasis Epidemiology Screening Tool (PEST) questionnaire is a useful tool for screening patients for psoriatic arthritis (PsA), it has not been validated in Portuguese. Our aim was to perform a cross-cultural validation of the PEST for Brazilian Portuguese, as well as to analyse its psychometric properties and to test the association of PEST scores with patient clinical characteristics. The first step was the translation and cross-cultural adaptation of the PEST questionnaire into Brazilian Portuguese, which included forward translation, synthesis, back translation, consolidation with an expert panel and cognitive debriefing with pilot testing. The second step was validation and psychometric testing, in which 124 dermatology patients with no previous PsA diagnosis completed the new adapted questionnaire (PEST-bp). Patients were initially assessed by a dermatologist for clinical characteristics, then they answered the Dermatology Life Quality Index (DLQI) and PEST-bp questionnaires. Afterwards, a rheumatologist, blind to former tests, evaluated the presence of PsA according to CASPAR criteria. The PEST-bp proved to be 0.81 accurate (95% CI: 0.73–0.88) in the ROC curve, indicating a cutoff score ≥ 3 as suggestive of PsA (sensitivity = 84.6%, specificity = 63.3%). The assessment of internal consistency, via the Cronbach test, presented a coefficient of 0.72 (acceptable). A higher PEST-bp score was positively associated with lower quality of life scores and with male patients. In conclusion, the PEST-bp questionnaire proved to be suitable as a screening tool for PsA in patients with psoriasis. Elevated PEST-bp scores are associated with decreased patient quality of life.

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Acknowledgements

The authors would like to acknowledge the contribution of Dr. Phillip S. Helliwell, who granted authorisation for the PEST validation into Portuguese, thus allowing this study to be accomplished.

Funding

This study did not receive any external forms of funding, and all the expenses were covered by the authors.

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Authors and Affiliations

  1. Department of Dermatology, School of Medicine, Dermatology Service At Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, Porto Alegre, RS, 2350, Brazil

    Nicolle Gollo Mazzotti & Tania Ferreira Cestari

  2. Rheumatology Service At Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil

    Penelope Esther Palominos & Charles Lubianca Kohem

  3. Rheumatology Service At Hospital Nossa Senhora da Conceição, Grupo Hospitalar Conceição, Porto Alegre, RS, Brazil

    Markus Bredemeier

Authors
  1. Nicolle Gollo Mazzotti
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  2. Penelope Esther Palominos
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  3. Markus Bredemeier
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  4. Charles Lubianca Kohem
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  5. Tania Ferreira Cestari
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Correspondence to Nicolle Gollo Mazzotti.

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Mazzotti, N.G., Palominos, P.E., Bredemeier, M. et al. Cross-cultural validation and psychometric properties of the Brazilian Portuguese version of the Psoriasis Epidemiology Screening Tool (PEST-bp). Arch Dermatol Res 312, 197–206 (2020). https://doi.org/10.1007/s00403-019-02013-9

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  • DOI: https://doi.org/10.1007/s00403-019-02013-9

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