Discrepancy between subjective symptoms, objective measures and disease activity indexes: the lesson of primary Sjögren's syndrome. 2018

Alessia Alunno, and Elena Bartoloni, and Valentina Valentini, and Giuliana Maria Concetta La Paglia, and Eleonora Valentini, and Maria Comasia Leone, and Elisa Marcucci, and Giacomo Cafaro, and Angelo Francesco Bonifacio, and Filippo Luccioli, and Roberto Gerli
Rheumatology Unit, Department of Medicine, University of Perugia, Italy.

Mucosal dryness is a key clinical feature in primary Sjögren's syndrome (pSS) and its assessment relies on both objective measurement of residual secretion and subjective symptoms reported by patients. However, while the objective assessment and grading of glandular dysfunction can be easily performed, the spectrum of clinical symptoms encompassed by the terms 'dry eye' and 'dry mouth' is wide and heterogeneous. Therefore, patient reported outcomes (PROs) for dryness in pSS poorly correlate with the amount of glandular secretion. In addition, subjective dryness is not correlated with the severity of systemic disease and severely affects the patient quality of life even in presence of active extraglandular manifestations. The purpose of this review article is to provide an overview of glandular dysfunction in pSS as well as the impact of discrepancy between objective assessment, subjective symptom and extraglandular disease activity on disease management.

UI MeSH Term Description Entries
D007765 Lacrimal Apparatus The tear-forming and tear-conducting system which includes the lacrimal glands, eyelid margins, conjunctival sac, and the tear drainage system. Lacrimal Gland,Nasolacrimal Apparatus,Conjunctival Sacs,Lacrimal Ducts,Lacrimal Punctum,Lateral Canthus,Medial Canthus,Apparatus, Lacrimal,Apparatus, Nasolacrimal,Canthus, Lateral,Canthus, Medial,Conjunctival Sac,Duct, Lacrimal,Gland, Lacrimal,Lacrimal Duct,Lacrimal Glands,Lacrimal Punctums,Punctum, Lacrimal,Sac, Conjunctival
D009626 Terminology as Topic Works about the terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area. Etymology,Nomenclature as Topic,Etymologies
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D003661 Decision Support Techniques Mathematical or statistical procedures used as aids in making a decision. They are frequently used in medical decision-making. Decision Analysis,Decision Modeling,Models, Decision Support,Analysis, Decision,Decision Aids,Decision Support Technics,Aid, Decision,Aids, Decision,Analyses, Decision,Decision Aid,Decision Analyses,Decision Support Model,Decision Support Models,Decision Support Technic,Decision Support Technique,Model, Decision Support,Modeling, Decision,Technic, Decision Support,Technics, Decision Support,Technique, Decision Support,Techniques, Decision Support
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000071066 Patient Reported Outcome Measures Assessment of the quality and effectiveness of health care as measured and directly reported by the patient. Patient Reported Outcome Measure,Patient-Reported Outcome,Patient-Reported Outcomes,Patient Reported Outcome,Patient Reported Outcomes,Outcome, Patient Reported,Outcome, Patient-Reported
D012469 Salivary Glands Glands that secrete SALIVA in the MOUTH. There are three pairs of salivary glands (PAROTID GLAND; SUBLINGUAL GLAND; SUBMANDIBULAR GLAND). Gland, Salivary,Glands, Salivary,Salivary Gland
D012472 Salivation The discharge of saliva from the SALIVARY GLANDS that keeps the mouth tissues moist and aids in digestion.

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