Pfizer Inc., 235 East 42nd Street, New York, NY 10017, USA.
J Med Econ. 2011;14(4):381-9. doi: 10.3111/13696998.2011.583703. Epub 2011 May 17.
To determine how patient-rated osteoarthritis (OA) severity correlates with other patient-reported and clinical outcomes in the European clinical setting.
We used the Adelphi Arthritis VII (2008) Disease Specific Program (DSP). OA severity was patient-rated using the question 'How bad would you say your arthritis is now?' with responses of 'mild,' 'moderate,' and 'severe.' Patient-reported outcomes included a 0-100 mm pain visual analogue scale (VAS); questions on daily functioning; Work Productivity and Activity Impairment (WPAI) scale; and EuroQoL (EQ-5D). Regression models and chi-square analyses evaluated relationships between self-rated OA severity and other outcomes.
Patient-reported data were available from 1739 individuals (63.1% female, mean age 64.4 [standard deviation 11.9] years) from France, Germany, Italy, Spain, and the UK. With increasing OA severity; mild (24.5%), moderate (56.3%), severe (19.2%), statistically significant differences (p<0.05) were observed with higher pain VAS scores (28.3, 49.9, 69.2, respectively), reduced function, and greater overall work impairment due to OA (24.3%, 38.5%, 68.6%, respectively). Significant associations of patient-reported OA severity with function and health status were indicated, including the EQ-5D health state index; 0.77 (mild), 0.62 (moderate), 0.30 (severe) (p<0.0001). Physicians tended to overestimate patients who rated their OA as mild, and underrate patients who rated their OA as severe.
In five European countries, patient-rated OA severity was associated with other patient-reported outcomes, and may be of benefit in the clinical setting when choosing treatment options aimed at improving pain, function and productivity, providing an accurate and tangible assessment of patient's perceptions of their disease.
确定在欧洲临床环境中，患者自评的骨关节炎（OA）严重程度与其他患者报告和临床结局的相关性。
我们使用了 Adelphi Arthritis VII（2008）疾病专项计划（DSP）。OA 严重程度由患者使用问题“您现在的关节炎有多严重？”进行自评，回答为“轻度”、“中度”和“重度”。患者报告的结果包括 0-100mm 疼痛视觉模拟量表（VAS）；日常功能问题；工作生产力和活动障碍（WPAI）量表；以及欧洲五维健康量表（EQ-5D）。回归模型和卡方分析评估了自评为 OA 严重程度与其他结果之间的关系。
来自法国、德国、意大利、西班牙和英国的 1739 名患者（63.1%为女性，平均年龄 64.4[标准差 11.9]岁）提供了患者报告数据。随着 OA 严重程度的增加，轻度（24.5%）、中度（56.3%）、重度（19.2%）患者的疼痛 VAS 评分分别为 28.3、49.9 和 69.2，差异具有统计学意义（p<0.05），功能下降，OA 导致的整体工作障碍更大（分别为 24.3%、38.5%和 68.6%）。患者自评的 OA 严重程度与功能和健康状况的显著相关性表明，包括 EQ-5D 健康状况指数；0.77（轻度）、0.62（中度）、0.30（重度）（p<0.0001）。医生往往高估自评 OA 为轻度的患者，低估自评 OA 为重度的患者。
在五个欧洲国家，患者自评的 OA 严重程度与其他患者报告的结果相关，在选择旨在改善疼痛、功能和生产力的治疗方案时，可能有益于临床环境，提供对患者对疾病感知的准确和切实的评估。
