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Identification of cutpoints for acceptable health status and important improvement in patient-reported outcomes, in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.

https://arctichealth.org/en/permalink/ahliterature98675
Source
J Rheumatol. 2010 Jan;37(1):26-31
Publication Type
Article
Date
Jan-2010
Author
Maria Knoph Kvamme
Ivar Sønbø Kristiansen
Elisabeth Lie
Tore Kristian Kvien
Author Affiliation
Department of Rheumatology, Diakonhjemmet Hospital, Institute of Health Management and Health Economics, University of Oslo, Norway. m.k.kvamme@medisin.uio.no
Source
J Rheumatol. 2010 Jan;37(1):26-31
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Antirheumatic Agents - therapeutic use
Arthritis, Psoriatic - drug therapy - pathology - physiopathology
Arthritis, Rheumatoid - drug therapy - pathology - physiopathology
Female
Health status
Humans
Middle Aged
Norway
Outcome Assessment (Health Care)
Patient satisfaction
Questionnaires
ROC Curve
Spondylitis, Ankylosing - drug therapy - pathology - physiopathology
Treatment Outcome
Abstract
OBJECTIVE: To identify cutpoints reflecting Patient Acceptable Symptom State (PASS) and Minimal Clinically Important Improvement (MCII) in patient-reported multi-attribute health status classification systems and health status measurements among patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA). METHODS: We identified patients with RA, AS, and PsA from the Norwegian disease-modifying antirheumatic drug (DMARD) register (NOR-DMARD). The patients (n = 4225) had started with DMARD and responded to the PASS and MCII anchoring questions at the 3-month followup examination. Receiver operating characteristics (ROC) curves with 80% specificity and the 75th percentile approach were used to identify PASS and MCII cutpoints in the EuroQol-5 Dimensions (EQ-5D) and the Short-Form-6 Dimensions (SF-6D) indexes, but also in other patient-reported outcomes (joint pain and patient global visual analog scale and Modified Health Assessment Questionnaire). RESULTS: The PASS cutpoints estimated with 80% specificity were around 0.70 in EQ-5D in all diseases and around 0.65 in SF-6D. The cutpoints were around 0.65 and 0.60, respectively, when the 75th percentile approach was used. The MCII cutpoints assessed by 80% specificity varied from 0.10 to 0.19 in EQ-5D and from 0.07 to 0.10 in SF-6D. CONCLUSION: The cutpoints for PASS in EQ-5D and SF-6D indicate that PASS corresponds to a health-related quality of life that is far from perfect health. Somewhat different cutpoints were identified for both PASS and MCII with 80% specificity versus the 75th percentile method.
PubMed ID
19955045 View in PubMed
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