Prodinger Birgit, Coenen Michaela, Hammond Alison, Küçükdeveci Ayşe A, Tennant Alan
Technical University of Applied Sciences, Rosenheim, Germany, and Swiss Paraplegic Research and ICF Research Branch, Nottwil, Switzerland.
Institute for Medical Information Processing, Biometry, and Epidemiology, Public Health and Health Services Research, and Pettenkofer School of Public Health, Ludwig-Maximilians-Universität, Munich, Germany, and ICF Research Branch, Nottwil, Switzerland.
Arthritis Care Res (Hoboken). 2022 Apr;74(4):579-587. doi: 10.1002/acr.24503. Epub 2022 Feb 13.
Functioning is an important outcome for the management of rheumatoid arthritis (RA). Heterogeneity of respective patient-reported outcome measures (PROMs) challenges direct comparisons between their results. This study aimed to standardize reporting of such PROMs measuring functioning in RA to facilitate comparability.
Common-item nonequivalent group design with the Health Assessment Questionnaire (HAQ) as a common scale across data sets from various countries (including the UK, Turkey, and Germany) to establish a common metric was used. Other PROMs included are the physical function items of the Multidimensional HAQ (MDHAQ), the Disabilities of the Arm, Shoulder, and Hand questionnaire, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the World Health Organization Disability Assessment Schedule II (WHODAS II), the Medical Outcomes Study Short Form 36 (SF-36) health survey, and 4 short forms (20, 10, 6, and 4 physical function items) from the Patient-Reported Outcomes Measurement Information System. As the HAQ includes mobility, self-care, and domestic life items, this study focuses on these 3 domains. PROMs were described using standard error of measurement (SEM) and smallest detectable difference (SDD). A Rasch measurement model was used to create the common metric.
The range of the SEM was 0.2 (MDHAQ) to 7.4 (SF-36 health survey physical functioning domain). The SDD revealed a range from 9.7% (WOMAC rating scale) to 33.5% (WHODAS physical functioning domain). PROMs co-calibration revealed fit to the Rasch measurement model. A transformation table was developed to allow exchange between PROM scores.
Scores between the daily activity PROMs commonly used in RA can now be compared. Factors such as SEM and SDD help to determine the choice of a PROM in clinical practice and research.
功能状态是类风湿关节炎（RA）管理的一项重要结果。患者报告结局指标（PROMs）的异质性对其结果之间的直接比较构成挑战。本研究旨在规范此类用于测量RA功能状态的PROMs的报告，以促进可比性。
采用共同项目非等效组设计，将健康评估问卷（HAQ）作为来自不同国家（包括英国、土耳其和德国）数据集的共同量表来建立共同度量标准。纳入的其他PROMs包括多维HAQ（MDHAQ）的身体功能项目、手臂、肩部和手部残疾问卷、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）、世界卫生组织残疾评估量表第二版（WHODAS II）、医学结局研究简明健康调查36项量表（SF - 36）以及患者报告结局测量信息系统的4种简表（20项、10项、6项和4项身体功能项目）。由于HAQ包括活动能力、自我护理和家庭生活项目，本研究聚焦于这3个领域。使用测量标准误（SEM）和最小可检测差异（SDD）来描述PROMs。采用拉施测量模型来创建共同度量标准。
SEM范围为0.2（MDHAQ）至7.4（SF - 36健康调查身体功能领域）。SDD范围为9.7%（WOMAC评分量表）至33.5%（WHODAS身体功能领域）。PROMs共同校准显示符合拉施测量模型。制定了一个转换表，以便在PROM分数之间进行转换。
现在可以比较RA中常用的日常活动PROMs之间的分数。SEM和SDD等因素有助于在临床实践和研究中确定PROM的选择。
