scholarly journals Measuring Outcomes in Psoriatic Arthritis: Comparing Routine Assessment of Patient Index Data and Psoriatic Arthritis Impact of Disease

2019 ◽  
Vol 47 (10) ◽  
pp. 1496-1505 ◽  
Author(s):  
Jessica A. Walsh ◽  
Marilyn T. Wan ◽  
Christine Willinger ◽  
M. Elaine Husni ◽  
Jose U. Scher ◽  
...  

ObjectiveTo examine the construct validity of Routine Assessment of Patient Index Data 3 (RAPID3) and Psoriatic Arthritis Impact of Disease (PsAID) in patients with psoriatic arthritis (PsA). In examining construct validity, we also addressed scores among subgroups with severe psoriasis, poly articular disease, enthesitis, and dactylitis, and evaluated influences of sociodemographic factors and comorbidities (contextual factors) on these patient-reported outcomes (PRO).MethodsPatients with PsA were enrolled in the Psoriatic Arthritis Research Consortium (PARC) between 2014 and 2016. PARC is a longitudinal observational cohort study conducted at 4 US institutions. In this cross-sectional study, construct validity was assessed by examining Spearman correlation coefficients for RAPID3 and PsAID with physician-reported disease activity measures and other PRO [e.g., Medical Outcomes Study Short Form-12 physical component summary/mental component summary (SF-12 PCS/MCS), Functional Assessment of Chronic Illness Therapy–Fatigue scale (FACIT-F)]. Contextual factors and disease subgroups were assessed in multivariable linear regression models with RAPID3 or PsAID12 as outcomes of interest and the hypothesized contextual factors as covariates.ResultsAmong 401 patients enrolled in PARC, 347 completed RAPID3 or PsAID12. Of these, most were white females with a mean age of 51.7 years (SD 14.02). RAPID3 and PsAID were highly correlated (r = 0.90). These measures were also correlated with the SF-12 PCS (r = −0.67) and FACIT-F (r = −0.77). Important contextual factors and disease subgroups included enthesitis, joint counts, education, insurance type, and depression.ConclusionRAPID3 and PsAID12 have excellent construct validity in PsA and are strongly correlated despite differing items. Contextual factors (i.e., the presence of depression and obesity) should be considered when interpreting raw scores of the RAPID3 and PsAID12.

2009 ◽  
Vol 36 (6) ◽  
pp. 1150-1157 ◽  
Author(s):  
SOGOL S. AMJADI ◽  
PAUL M. MARANIAN ◽  
HAROLD E. PAULUS ◽  
ROBERT M. KAPLAN ◽  
VEENA K. RANGANATH ◽  
...  

Objective.New methodologies allow the scores for the Health Assessment Questionnaire-Disability Index (HAQ-DI) to be translated into preferences/utility scores. We evaluated the construct validity of the HAQ-DI-derived Short Form-6D (SF-6D) score and assessed its responsiveness to change over 6- and 12-month followup periods in patients with early aggressive rheumatoid arthritis (RA).Methods.Patients (n = 277) participating in an RA observational study completed self-reported measures of symptoms and the HAQ-DI at baseline and at 6 and 12 months. Total Sharp scores, C-reactive protein, and erythrocyte sedimentation rate were assessed along with clinical data. Construct validity was assessed by examining the association between SF-6D score and patient-reported and clinical measures using Spearman correlation coefficients. The responsiveness of SF-6D to change was assessed using patient and physician assessments of the disease as clinical anchors. The magnitude of responsiveness was calculated using SF-6D effect size (ES).Result.Mean SF-6D scores were 0.690, 0.720, and 0.723 at baseline and 6 and 12-month followup, respectively. Baseline patient-reported measures had moderate to high correlations with baseline SF-6D (r = 0.43 to 0.52); whereas clinical measures had negligible to low correlations with SF-6D (r = 0.001 to 0.32). ES was moderate for the groups that were deemed to have improved (ES 0.63–0.75) but negligible to small for those that did not (ES 0.13–0.46).Conclusion.Our data support the validity and responsiveness of the HAQ-DI derived SF-6D score in an early RA cohort. These results support the use of the HAQ-DI derived SF-6D in RA cohorts and clinical trials lacking preference-based measures.


Author(s):  
Jing Zhang ◽  
Barry Dewitt ◽  
Evan Tang ◽  
Daniel Breitner ◽  
Mohammed Saqib ◽  
...  

Background and Objectives A preference-based health utility score (PROPr) can be calculated using Patient-Reported Outcomes Measurement Information System domain scores. We assessed the construct validity of PROPr among patients treated with kidney replacement therapy (hemodialysis or kidney transplant). Design, setting, participants and measurements Secondary analysis of data collected in multicenter, cross-sectional studies of adults treated with kidney replacement therapy, recruited between April 2016 to March 2020 in Toronto, Canada. All participants provided informed consent. The outcome was PROPr score. Co-administered outcome variables included the Short form 6-domain (SF-6D) and EuroQol 5-domain 5-level (EQ-5D-5L) scores. Socioeconomic and clinical variables included age, sex, diabetes, estimated Glomerular Filtration Rate (eGFR), serum albumin, hemoglobin, kidney replacement therapy and Charlson-comorbidity index. Construct validity was assessed through correlations between PROPr and SF-6D or EQ-5D-5L and associations between PROPr and other exposure variables. Health condition impact estimates (coefficients for health conditions compared to a referent category: e.g. dialysis vs kidney transplant) were calculated using multivariable linear regression. Results Mean (SD) age of the 524 participants was 57 (17) years, 58% were male and 45% white. Median (IQR) score was 0.39 (0.24-0.58) for PROPr, 0.69 (0.58-0.86) for SF-6D and 0.85 (0.70-0.91) for EQ-5D-5L. Large correlations were observed between PROPr vs SF-6D (0.79, 95%CI: 0.76 - 0.82) and EQ-5D-5L (0.71, 95%CI: 0.66 - 0.75). Both PROPr and the other utility indices demonstrated health condition impact in the expected direction. For example, the estimate for PROPr was -0.17 (95%CI: -0.13, -0.21) for dialysis (versus kidney transplant), -0.05 (95%CI: -0.11, 0.01, P=0.08) for kidney transplant recipients with eGFR <45 vs ≥45 ml/min/1.73m2 and -0.28 (95%CI: -0.22, -0.33) for moderate/severe versus no/mild depressive symptoms. Conclusions Our results support the validity of PROPr among patients treated with kidney replacement therapy.


Rheumatology ◽  
2017 ◽  
Vol 56 (suppl_2) ◽  
Author(s):  
William Tillett ◽  
Laura Coates ◽  
Gavin Shaddick ◽  
Neil McHugh ◽  
Theodore Pincus ◽  
...  

2011 ◽  
Vol 38 (12) ◽  
pp. 2619-2624 ◽  
Author(s):  
HEATHER MacKENZIE ◽  
ARANE THAVANESWARAN ◽  
VINOD CHANDRAN ◽  
DAFNA D. GLADMAN

Objective.Patients followed in observational cohorts often complete patient-reported outcomes on paper questionnaires. With advances in technology, Web-based (WB) formats have been developed. The aims of our study were to determine whether WB and paper-based questionnaires (PB) completed by patients followed in the psoriatic arthritis (PsA) clinic are comparable; whether there is a patient preference for one method or the other; and whether any preference is related to patient characteristics.Methods.Consecutive patients followed at the PsA clinic completed the Health Assessment Questionnaire, Medical Outcomes Study Short Form-36, fatigue scale, Dermatology Life Quality Index, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life Instrument, and EQ-5D both on paper (PB) and on computer by Internet (WB). Patients were also asked to complete questionnaires regarding their preference for one method or the other. Descriptive statistics and interclass correlation coefficients (ICC) were calculated.Results.Of 110 patients who agreed to participate, 67 (57.3%) successfully completed both PB and WB questionnaires. These patients did not differ from those who did not complete the questionnaires. WB and PB questionnaires took the same length of time to complete, with 20% of the patients complaining of more pain following completion of the questionnaires, more so with the PB. There was excellent agreement between the PB and WB (ICC 0.89–0.97) for all questionnaires.Conclusion.The PB and WB versions of 10 standardized self-administered questionnaires in patients with PsA were comparable. The WB format was well accepted by PsA outpatients. Patients may thus be offered a choice of format as well as the choice to complete the questionnaires either in the clinic or remotely by Internet.


2021 ◽  
pp. jrheum.201362
Author(s):  
Andrea García-Valle ◽  
Jesús María Andrés-de Llano ◽  
Aarón Josué Fariña-González ◽  
Roberto Daniel González-Benítez ◽  
Rubén Queiro-Silva

Objective Although there are different tools to evaluate axial spondyloarthritis (axSpA), they are hardly used in clinical routine due to time constraints. The Routine Assessment of Patient Index Data 3 (RAPID3) is a composite measure feasible to be used as a sole metric in busy clinics. We aimed to test its measurement properties in patients with axial SpA in a real clinical setting. Methods Cross-sectional study that included 131 consecutive patients with axial SpA. The convergent (Spearman's rho) and discriminant (ROC curve analysis) validity of RAPID3 were tested against several axSpA-specific measures (BASDAI, ASDAS, BASFI, mSASSS). A multivariate model was built to detect disease factors associated with RAPID3 remission (values ≤3). Results The study included 82 men and 49 women, median age of 55 years (IQR: 46-61), and median disease duration of 11 years (IQR: 6-24). Mean RAPID3 was 9.45 ± 6.7. The BASDAI showed moderate correlation with ASDAS (rho: 0.66, p < 0.0001), but higher with BASFI (rho: 0.78, p < 0.0001) and RAPID3 (rho: 0.75, p < 0.0001). The ASDAS had moderate correlations with BASFI, BASDAI, and RAPID3 (ranges from 0.66 to 0.68, p < 0.0001). Higher correlations were found between BASFI and BASDAI (rho: 0.78, p < 0.0001) and BASFI-RAPID3 (rho: 0.73, p < 0.0001). The m-SASSS did not show any correlation with any of the afore-mentioned composite measures. Kappa agreement between RAPID3 remission and other SpA remission criteria was moderate (k: 0.46-0.56). The RAPID3 thresholds to define remission ranged from values ≤2 to ≤ 6 with areas under the ROC curves between 0.86 and 0.91. Female sex (OR 0.34, 95%CI: 0.12- 0.90, p= 0.031) and NSAIDs intake (OR 0.26, 95%CI: 0.10-0.66, p= 0.005) were independently associated with lower odds of achieving RAPID3 remission. Conclusion RAPID3 demonstrated construct validity in this cross-sectional study. This index can be useful for a more comprehensive assessment of axSpA in busy clinical settings.


2016 ◽  
Vol 77 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Brian K.C. Lo ◽  
Leia Minaker ◽  
Alicia N.T. Chan ◽  
Jessica Hrgetic ◽  
Catherine L. Mah

Purpose: To adapt and validate a survey instrument to assess the nutrition environment of grab-and-go establishments at a university campus. Methods: A version of the Nutrition Environment Measures Survey for grab-and-go establishments (NEMS-GG) was adapted from existing NEMS instruments and tested for reliability and validity through a cross-sectional assessment of the grab-and-go establishments at the University of Toronto. Product availability, price, and presence of nutrition information were evaluated. Cohen’s kappa coefficient and intra-class correlation coefficients (ICC) were assessed for inter-rater reliability, and construct validity was assessed using the known-groups comparison method (via store scores). Results: Fifteen grab-and-go establishments were assessed. Inter-rater reliability was high with an almost perfect agreement for availability (mean κ = 0.995) and store scores (ICC = 0.999). The tool demonstrated good face and construct validity. About half of the venues carried fruit and vegetables (46.7% and 53.3%, respectively). Regular and healthier entrée items were generally the same price. Healthier grains were cheaper than regular options. Six establishments displayed nutrition information. Establishments operated by the university’s Food Services consistently scored the highest across all food premise types for nutrition signage, availability, and cost of healthier options. Conclusions: Health promotion strategies are needed to address availability and variety of healthier grab-and-go options in university settings.


2017 ◽  
Vol 44 (9) ◽  
pp. 1369-1374 ◽  
Author(s):  
Ian T.Y. Wong ◽  
Vinod Chandran ◽  
Suzanne Li ◽  
Dafna D. Gladman

Objective.We aimed to determine the prevalence and quality of sleep in patients with psoriatic arthritis (PsA) and those with psoriasis without PsA (PsC) followed in the same center, to identify factors associated with sleep disturbance, and to compare findings to those of healthy controls (HC).Methods.The study included 113 PsA [ClASsification for Psoriatic ARthritis (CASPAR) criteria] and 62 PsC (PsA excluded by a rheumatologist) patients and 52 HC. Clinical variables were collected using a standard protocol. The sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Other patient-reported outcomes collected included the Health Assessment Questionnaire (HAQ), Dermatology Life Quality Index, EQ-5D, Medical Outcomes Study Short Form-36 survey, patient’s global assessment, and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-fatigue) scale. Statistical analyses included descriptive statistics, Wilcoxon rank-sum test, and linear regression.Results.The prevalence of poor sleep quality was 84%, 69%, and 50% in PsA, PsC, and HC, respectively. Total PSQI score was higher in both patients with PsA and patients with PsC compared with HC (p < 0.01) and higher in patients with PsA compared to patients with PsC (p < 0.0001). EQ-5D anxiety component, EQ-5D final, and FACIT-fatigue were independently associated with worse PSQI in patients with PsC and those with PsA (p < 0.05). Actively inflamed (tender or swollen) joints are independently associated with worse PSQI in patients with PsA (p < 0.01).Conclusion.Patients with psoriatic disease have poor sleep quality. Poor sleep is associated with fatigue, anxiety, and lower EQ-5D. In patients with PsA, poor sleep is associated with active joint inflammation.


2017 ◽  
Vol 2 (3) ◽  
pp. 188-195 ◽  
Author(s):  
Kathleen Morrisroe ◽  
Wendy Stevens ◽  
Molla Huq ◽  
Joanne Sahhar ◽  
Gene-Siew Ngian ◽  
...  

Background We aimed to evaluate the construct validity of the Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) in Australian systemic sclerosis (SSc) patients. Methods SSc patients, identified through the Australian Scleroderma Cohort Study database, completed two quality-of-life instruments concurrently, the PROMIS-29 and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). The construct validity of the PROMIS-29 was assessed by the correlations between the PROMIS-29 and the SF-36 and Health Assessment Questionnaire Disability Index (HAQ-DI). Cronbach's alpha was used to test the internal reliability of all instruments in Australian SSc patients and non-parametric correlation, including Spearman's correlation, was used to test the construct validity of PROMIS-29 against the SF-36 and HAQ-DI. Results A total of 477 completed questionnaires were returned, equating to a response rate of 59.6%. The mean (±SD) age of respondents at the time of the survey was 64.1 (±11.1) years. They were predominantly female (87.4%), with limited disease subtype (lcSSc) (77.8%) and long disease duration from onset of first non-Raynaud's phenomenon symptom at the time of survey (10.9 ± 11.1 years). For the correlation analysis between the PROMIS-29 and the legacy instruments, all Spearman correlation coefficients were in the logical direction and highly significant suggesting that the PROMIS-29 is a good alternative to other validated measures of disease burden. Conclusions Our study indicates that the PROMIS-29 questionnaire is a valid instrument for measuring health-related quality of life in Australian females with lcSSc of long duration.


RMD Open ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. e000806 ◽  
Author(s):  
Vibeke Strand ◽  
Kurt de Vlam ◽  
Jose A Covarrubias-Cobos ◽  
Philip J Mease ◽  
Dafna D Gladman ◽  
...  

ObjectivesTofacitinib is an oral Janus kinase inhibitor for treatment of psoriatic arthritis (PsA). We evaluated patient-reported outcomes (PROs) in patients with PsA refractory to ≥1 conventional synthetic disease-modifying antirheumatic drug (csDMARD-IR) and tumour necrosis factor inhibitor-naïve in a 12-month, phase III randomised controlled trial (OPAL Broaden [NCT01877668]).MethodsPatients (N=422) received tofacitinib 5 mg or 10 mg twice daily, adalimumab 40 mg subcutaneously every 2 weeks or placebo advancing to tofacitinib 5 mg or 10 mg twice daily at month 3. Least squares mean changes from baseline and percentages of patients reporting improvements ≥minimum clinically important differences (MCID); and scores ≥normative values in: Patient Global Assessment of disease activity (PtGA), Pain, Patient Global Joint and Skin Assessment (PGJS), Short Form-36 Health Survey version 2 (SF-36v2), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), EuroQol 5-Dimensions-3-level questionnaire (EQ-5D-3L) and Ankylosing Spondylitis Quality of Life (ASQoL) were determined. Nominal p values were cited without multiple comparison adjustments.ResultsAt month 3, PtGA, Pain, PGJS, FACIT-Fatigue, EQ-5D-3L, ASQoL and SF-36v2 Physical Component Summary (PCS), physical functioning (PF), bodily pain (BP) and vitality domain scores exceeded placebo with both tofacitinib doses (p≤0.05); SF-36v2 social functioning with 5 mg twice daily (p≤0.05). Percentages reporting improvements ≥MCID in PtGA, Pain, PGJS, FACIT-Fatigue, ASQoL and SF-36v2 PCS, PF, BP and general health scores exceeded placebo with both tofacitinib doses (p≤0.05) and were similar with adalimumab.ConclusioncsDMARD-IR patients with active PsA reported statistically and clinically meaningful improvements in PROs with tofacitinib compared with placebo at Month 3.


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