RESEARCH - Self-reporting instruments to assess patients with RA

[Guest guest]

Arthritis Rheum. 2006 Sep 29;55(5):745-750 [Epub ahead of print]

Comment on the use of self-reporting instruments to assess patients with

rheumatoid arthritis: The longitudinal association between the DAS28 and the

VAS general health.

Kievit W, Welsing PM, Adang EM, Eijsbouts AM, Krabbe PF, van Riel PL.

Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.

OBJECTIVE: Recently, the use of patient self-reporting instruments instead

of clinical, objective measurements to assess rheumatoid arthritis (RA)

patients was proposed. This assumes a constant association between disease

activity and the self-reporting instruments. The objective was to explore

the association (in time) between disease activity and patient perception of

general health, disease activity, pain, and functional disability in

patients with RA. METHODS: Data of 624 newly diagnosed RA patients who

completed 3 years of followup were analyzed. Cross-sectional linear

regression models and longitudinal regression models were estimated, with a

visual analog scale (VAS) measuring general health (VAS-GH; 0 = best, 100 =

worst) as a dependent variable and the Disease Activity Score (DAS28)

without the VAS-GH as an independent variable. Other dependent variables

were VAS disease activity, pain, and the Health Assessment Questionnaire.

RESULTS: The DAS28 and VAS-GH were significantly associated in RA patients

(P < 0.001). However, the explained variance was low (6.7%). From diagnosis

to 3 years after the diagnosis, the intercept decreased given the same

regression coefficient. The longitudinal regression model showed that the

VAS-GH improved during disease course independent of a change in DAS28.

Analyses on the other outcome parameters showed similar results.

CONCLUSION: Patients' perception of health can be different with equal

disease activity, depending on the moment in the disease course.

Furthermore, our results indicate that self-reported measures on

functionality, disease activity, and general health cannot substitute for

objective measures of disease activity in RA in longitudinal studies;

subsequently, both need to be measured.

PMID: 17013821

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

7013821

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org