Validation and clinical correlates of the Turkish version of the methotrexate intolerance and severity assessment (MISA) questionnaire in rheumatoid arthritis.

The ''Methotrexate Intolerance and Severity Assessment in Adults'' (MISA) questionnaire was developed in patients with rheumatoid arthritis (RA) to better define methotrexate (MTX)- related intolerance. This study aims to translate and validate the MISA questionnaire in Turkish. A total of 130 RA patients who used MTX for at least three months were included in the study. The Turkish version of the MISA was developed following the recommended guidelines for cross-cultural adaptation. The validity of the test was assessed using Cronbach's α agreement. Test-retest reliability was tested with a 2-way random effect intra-class correlation coefficient (ICC). Intolerance by physician's decision was accepted as the gold standard. The Kappa test analyzed the agreement between intolerance according to the physician and intolerance according to the MISA questionnaire. Of all patients, 105 (80.8%) were female, with a mean age of 55.8 ± 10.50 years. The Cronbach's α value of the MISA questionnaire was 0.831 and had a good internal consistency. The total score of the MISA questionnaire was 1.7 ± 3.39. Test-retest assessments were conducted with a group of 32 patients. The test-retest ICC value was excellent, with a value of 0.894. There were 38 (29.2%) patients with MTX intolerance, according to the physician, and 55 (42.3%) patients with intolerance, according to the MISA questionnaire. The kappa agreement between physician-identified intolerance and intolerance identified by the MISA questionnaire was 0.721, indicating significant agreement. The Turkish version of the MISA questionnaire has been found valid, reliable, reproducible, and easily applicable.