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B, Panoramic view of the tumor showing a pediculated exophytic and endophytic lesion with a benign, well-delimited, round area at the base (hematoxylin-eosin, original magnification ×25). C, Detail of benign lesion formed by tubular structures partially colonized by atypical cells (arrow) (hematoxylin-eosin, original magnification ×100). D, Area of syringocystadenocarcinoma papilliferum with dermal invasion showing cells with squamous differentiation, mitosis, and pleomorphic nuclei (hematoxylin-eosin ×100).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.D. Agulló Pérez, B. Bonaut Iriarte, A. Córdoba Iturriagagoitia, A. Valcayo Peñalba" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A.D." "apellidos" => "Agulló Pérez" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Bonaut Iriarte" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Córdoba Iturriagagoitia" ] 3 => array:2 [ "nombre" => "A." 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Margarit, A. López-Ferrer, E. Vilarrasa, L. Puig" "autores" => array:4 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Margarit" "email" => array:1 [ 0 => "emargarit@santpau.cat" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "López-Ferrer" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "E." "apellidos" => "Vilarrasa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "L." "apellidos" => "Puig" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Facultad de Psicología, Universidad Autónoma de Barcelona (UAB), Bellaterra, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sesgo en el Cuestionario de productividad laboral y deterioro de las actividades: psoriasis (WPAI:PSO v2.0) en la población española" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The 6-item Work Productivity and Activity Impairment–Psoriasis questionnaire (the WPAI:PSO)<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> has been used in numerous clinical trials and other studies to evaluate the impact of psoriasis. It is supported by the WPAI validation study,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> version 2.0 of the Spanish language adaptation (the WPAI:PSO v.2.0),<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> and a validated adaptation to Spanish of the general health version of the questionnaire (the WPAI:GH).<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> This questionnaire, which measures effects on both work and other activities of daily living, includes items to be answered with <span class="elsevierStyleItalic">yes</span> or <span class="elsevierStyleItalic">no</span>, a time estimate in hours, or a choice on a 10-point scale. In our clinical practice in Spain we have detected that patients with psoriasis who are not employed by a company under a so-called indefinite contract—one that does not have a term limit—often do not respond as expected to the question on work status in the WPAI:PSO v.2.0.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We devised an observational, cross-sectional survey to assess the validity of information obtained from the Spanish questionnaire's first item, on work status: “<span class="elsevierStyleItalic">¿Está actualmente empleado (tiene un trabajo a sueldo)?</span>” Back-translated to English, this item would be “Are you currently employed? (Do you have a job with a salary?).” We enrolled 50 patients diagnosed with psoriasis in the dermatology department of Hospital de la Santa Creu i Sant Pau in March and April 2016. Participants had to be over the age of 18 years and give their written informed consent to inclusion before undergoing any part of the study. They then responded to the Spanish WPAI:PSO v.2.0 in a room in our outpatient clinic. After they had completed the questionnaire, we recorded age, sex, and work status. To give us this last information, the patients answered the Spanish question, “<span class="elsevierStyleItalic">¿Realiza actualmente algún tipo de trabajo remunerado?</span>” (“Are you currently doing some type of paid work?”) The respondent was then asked to give specifics about the work situation. Their answers are categorized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">All of the recruited patients agreed to participate. The mean (SD) age was 44.46 (13.69) years, and 60% were men. We detected no significant differences in responses according to sex or age. The correlation between our survey findings and the information from item 1 of the questionnaire was high (<span class="elsevierStyleItalic">α</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.81). All patients with employee status and who received a salary answered the WPAI:PSO question correctly. However, a comparison with the work situations recorded in our survey (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) revealed that 9 of the 10 working patients in the category “other” (18% of the total) responded incorrectly to item 1 of the Spanish WPAI:PSO v.2.0 (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The incorrectly responding patients were all freelancers, occasional-contract workers, or persons working without any contract whether legally or not. These 9 patients answered <span class="elsevierStyleItalic">no</span> to the Spanish item 1, which asked specifically if they had a “job with a salary.” We should point out that Spain had 1<span class="elsevierStyleHsp" style=""></span>974<span class="elsevierStyleHsp" style=""></span>881 persons registered as doing freelance work on September 30, 2016, namely 10% to 11% of the country's active population.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> In addition, a small portion of workers have no contract and are paid sums that are not legally declared. Statistics about such workers are not available, but most patients in this situation who come to our clinic will report that they do not work at all because they fear revealing that they work illegally.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Given the results of our study, we then examined the original English version of item 1 of the questionnaire, which asks, “Are you currently employed (working for pay)?” The definition of the word <span class="elsevierStyleItalic">pay</span> includes any type of monetary compensation. The Spanish version, on the other hand, specifies compensation received as a salary, which is a fixed regular payment made to a worker or professional within a company. This subtle difference presents us with a possible problem in the Spanish adaptation of the English questionnaire.</p><p id="par0030" class="elsevierStylePara elsevierViewall">A new, validated adaptation to Spanish of the WPAI for use in Crohn disease (the WPAI:CD, v.2.1)<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">6,7</span></a> has rendered item 1 as follows: “<span class="elsevierStyleItalic">¿Está actualmente empleado (tiene un trabajo remunerado)?</span>” The back-translation of the parenthetical phrase would be, “Do you do paid work?” The use of <span class="elsevierStyleItalic">paid work</span> rather than <span class="elsevierStyleItalic">salary</span> widens the meaning of the concept of work considerably, so that respondents can more clearly see what information the questionnaire is attempting to elicit. In spite of the availability of this version for Crohn disease, most studies of Spanish patients with psoriasis use the WPAI:PSO v.2.0.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In summary, in order to obtain more reliable responses to the Spanish WPAI:PSO v.2.0, clinicians should explain item 1 to patients, saying it asks them to report any type of paid work, not just work done in a salaried position. Patients should also be reminded that the questionnaire they are filling out is not concerned with the legality of their work situation and that the information they provide will remain completely anonymous. It would be useful to make a new version 2.1 of the Spanish WPAI:PSO available in order to avoid bias in gathering information from our patients with psoriasis.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Please cite this article as: Margarit E, López-Ferrer A, Vilarrasa E, Puig L. Sesgo en el cuestionario de productividad laboral y deterioro de las actividades: psoriasis (WPAI:PSO v2.0) en la población española. Actas Dermosifiliogr. 2018;109:365–366.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Work Situation \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No. of Patients \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Employee (with an indefinite-term contract) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Unemployed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Retired \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Homemaker \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Student \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">On sick leave \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Other<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1737267.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Situations including freelance work, jobs done off the books (compensated with cash in hand that is not reported for tax purposes), internships or work done under a grant, or ownership of a business.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Categorized Responses to Our Survey Question About Work Status.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">ABBREVIATION: WPAI:PSO v.2.0, Work Productivity and Activity Impairment—Psoriasis, version 2.0 in Spanish.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No, Not Working (Our Survey) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Yes, Working (Our Survey) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">No, not working (WPAI:PSO v.2.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 (32%)<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 (18%)<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Yes, working (WPAI:PSO v.2.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0 (0%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25 (50%)<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1737268.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Patients who were officially unemployed, retired, homemakers, students, or on sick leave.</p>" ] 1 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">All 9 were in the category “Other” (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), which includes freelancers, those working off the books or receiving stipends from a grant, or business owners.</p>" ] 2 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Salaried workers plus others.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Contingency Table Showing Reported Work Status Distributed According to Responses to Item 1 of the Spanish WPAI:PSO v.2.0 Versus Our Survey Records.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0040" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "WPAI:PSO 2016 [cited 2016 Feb 19]. 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año/Mes | Html | Total | |
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2024 Noviembre | 9 | 9 | 18 |
2024 Octubre | 100 | 48 | 148 |
2024 Septiembre | 112 | 22 | 134 |
2024 Agosto | 147 | 51 | 198 |
2024 Julio | 86 | 31 | 117 |
2024 Junio | 90 | 35 | 125 |
2024 Mayo | 75 | 31 | 106 |
2024 Abril | 80 | 33 | 113 |
2024 Marzo | 70 | 29 | 99 |
2024 Febrero | 66 | 39 | 105 |
2024 Enero | 65 | 33 | 98 |
2023 Diciembre | 58 | 20 | 78 |
2023 Noviembre | 66 | 20 | 86 |
2023 Octubre | 67 | 25 | 92 |
2023 Septiembre | 69 | 33 | 102 |
2023 Agosto | 45 | 24 | 69 |
2023 Julio | 75 | 33 | 108 |
2023 Junio | 63 | 27 | 90 |
2023 Mayo | 62 | 23 | 85 |
2023 Abril | 55 | 20 | 75 |
2023 Marzo | 83 | 33 | 116 |
2023 Febrero | 65 | 25 | 90 |
2023 Enero | 49 | 35 | 84 |
2022 Diciembre | 98 | 38 | 136 |
2022 Noviembre | 56 | 38 | 94 |
2022 Octubre | 32 | 22 | 54 |
2022 Septiembre | 23 | 34 | 57 |
2022 Agosto | 22 | 35 | 57 |
2022 Julio | 24 | 35 | 59 |
2022 Junio | 21 | 19 | 40 |
2022 Mayo | 36 | 35 | 71 |
2022 Abril | 42 | 29 | 71 |
2022 Marzo | 36 | 37 | 73 |
2022 Febrero | 59 | 38 | 97 |
2022 Enero | 69 | 35 | 104 |
2021 Diciembre | 49 | 41 | 90 |
2021 Noviembre | 46 | 53 | 99 |
2021 Octubre | 66 | 50 | 116 |
2021 Septiembre | 56 | 41 | 97 |
2021 Agosto | 81 | 40 | 121 |
2021 Julio | 36 | 28 | 64 |
2021 Junio | 36 | 43 | 79 |
2021 Mayo | 40 | 41 | 81 |
2021 Abril | 72 | 100 | 172 |
2021 Marzo | 90 | 28 | 118 |
2021 Febrero | 62 | 36 | 98 |
2021 Enero | 43 | 26 | 69 |
2020 Diciembre | 47 | 28 | 75 |
2020 Noviembre | 36 | 29 | 65 |
2020 Octubre | 45 | 16 | 61 |
2020 Septiembre | 43 | 29 | 72 |
2020 Agosto | 42 | 25 | 67 |
2020 Julio | 41 | 32 | 73 |
2020 Junio | 41 | 31 | 72 |
2020 Mayo | 17 | 24 | 41 |
2020 Abril | 32 | 15 | 47 |
2020 Marzo | 27 | 14 | 41 |
2020 Febrero | 3 | 0 | 3 |
2020 Enero | 4 | 0 | 4 |
2019 Diciembre | 8 | 0 | 8 |
2019 Noviembre | 4 | 0 | 4 |
2019 Septiembre | 10 | 0 | 10 |
2019 Agosto | 4 | 0 | 4 |
2019 Julio | 4 | 0 | 4 |
2019 Junio | 4 | 0 | 4 |
2019 Mayo | 7 | 0 | 7 |
2019 Abril | 6 | 1 | 7 |
2019 Marzo | 2 | 0 | 2 |
2019 Febrero | 2 | 0 | 2 |
2018 Diciembre | 2 | 0 | 2 |
2018 Noviembre | 4 | 0 | 4 |
2018 Octubre | 1 | 0 | 1 |
2018 Septiembre | 2 | 0 | 2 |