Patient's global assessment of disease activity and patient's assessment of general health for rheumatoid arthritis activity assessment: are they equivalent?

Nasim Ahmed Khan; Horace Jack Spencer; Essam Ahmed Abda; Rieke Alten; Christof Pohl; Codrina Ancuta; Massimiliano Cazzato; Pál Géher; Laure Gossec; Dan Henrohn; Merete Lund Hetland; Nevsun Inanc; Johannes Wg Jacobs; Eduardo Kerzberg; Maria Majdan; Omondi Oyoo; Ruben A Peredo-Wende; Zahraa Ibrahim Selim; Fotini Nikolaos Skopouli; Alberto Sulli; Kim Hørslev-Petersen; Peter C Taylor; Tuulikki Sokka; QUEST-RA group

doi:10.1136/annrheumdis-2011-201142

Patient's global assessment of disease activity and patient's assessment of general health for rheumatoid arthritis activity assessment: are they equivalent?

Nasim Ahmed Khan, Horace Jack Spencer, Essam Ahmed Abda, Rieke Alten, Christof Pohl, Codrina Ancuta, Massimiliano Cazzato, Pál Géher, Laure Gossec, Dan Henrohn, Merete Lund Hetland, Nevsun Inanc, Johannes Wg Jacobs, Eduardo Kerzberg, Maria Majdan, Omondi Oyoo, Ruben A Peredo-Wende, Zahraa Ibrahim Selim, Fotini Nikolaos Skopouli, Alberto SulliKim Hørslev-Petersen, Peter C Taylor, Tuulikki Sokka, QUEST-RA group

Department of Clinical Medicine

43 Citations (Scopus)

Abstract

Objectives: To assess (A) determinants of patient's global assessment of disease activity (PTGL) and patient's assessment of general health (GH) scores of rheumatoid arthritis (RA) patients; (B) whether they are equivalent as individual variables; and (C) whether they may be used interchangeably in calculating common RA activity assessment composite indices. Methods: Data of 7023 patients from 30 countries in the Quantitative Standard Monitoring of Patients with RA (QUEST-RA) was analysed. PTGL and GH determinants were assessed by mixed-effects analyses of covariance models. PTGL and GH equivalence was determined by Bland-Altman 95% limits of agreement (BALOA) and Lin's coefficient of concordance (LCC). Concordance between PTGL and GH based Disease Activity Score 28(DAS28), Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) indices were calculated using LCC, and the level of agreement in classifying RA activity in four states (remission, low, moderate, high) using κ statistics. Results: Significant differences in relative and absolute contribution of RA and non-RA related variables in PTGL and GH ratings were noted. LCC of 0.64 and BALOA of -4.41 to 4.54 showed that PTGL and GH are not equivalent. There was excellent concordance (LCC 0.95-0.99) for PTGL and GH based DAS28, CDAI and RAPID3 indices, and >80% absolute agreement (κ statistics 0.75-0.84) in RA activity state classification for all three indices. Conclusions: PTGL and GH ratings differ in their determinants. Although they are individually not equivalent, they may be used interchangeably for calculating composite indices for RA activity assessment.

Original language	English
Journal	Annals of the Rheumatic Diseases
Volume	71
Issue number	12
Pages (from-to)	1942-9
Number of pages	8
ISSN	0003-4967
DOIs	https://doi.org/10.1136/annrheumdis-2011-201142
Publication status	Published - Dec 2012

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Khan, N. A., Spencer, H. J., Abda, E. A., Alten, R., Pohl, C., Ancuta, C., Cazzato, M., Géher, P., Gossec, L., Henrohn, D., Hetland, M. L., Inanc, N., Jacobs, J. W., Kerzberg, E., Majdan, M., Oyoo, O., Peredo-Wende, R. A., Selim, Z. I., Skopouli, F. N., ... QUEST-RA group (2012). Patient's global assessment of disease activity and patient's assessment of general health for rheumatoid arthritis activity assessment: are they equivalent? Annals of the Rheumatic Diseases, 71(12), 1942-9. https://doi.org/10.1136/annrheumdis-2011-201142

Patient's global assessment of disease activity and patient's assessment of general health for rheumatoid arthritis activity assessment : are they equivalent? / Khan, Nasim Ahmed; Spencer, Horace Jack; Abda, Essam Ahmed et al.

In: Annals of the Rheumatic Diseases, Vol. 71, No. 12, 12.2012, p. 1942-9.

Research output: Contribution to journal › Journal article › Research › peer-review

Khan, NA, Spencer, HJ, Abda, EA, Alten, R, Pohl, C, Ancuta, C, Cazzato, M, Géher, P, Gossec, L, Henrohn, D, Hetland, ML, Inanc, N, Jacobs, JW, Kerzberg, E, Majdan, M, Oyoo, O, Peredo-Wende, RA, Selim, ZI, Skopouli, FN, Sulli, A, Hørslev-Petersen, K, Taylor, PC, Sokka, T & QUEST-RA group 2012, 'Patient's global assessment of disease activity and patient's assessment of general health for rheumatoid arthritis activity assessment: are they equivalent?', Annals of the Rheumatic Diseases, vol. 71, no. 12, pp. 1942-9. https://doi.org/10.1136/annrheumdis-2011-201142

@article{7d78ba53c5ee4e14ab7a0653fb7ce8bd,

title = "Patient's global assessment of disease activity and patient's assessment of general health for rheumatoid arthritis activity assessment: are they equivalent?",

abstract = "Objectives: To assess (A) determinants of patient's global assessment of disease activity (PTGL) and patient's assessment of general health (GH) scores of rheumatoid arthritis (RA) patients; (B) whether they are equivalent as individual variables; and (C) whether they may be used interchangeably in calculating common RA activity assessment composite indices. Methods: Data of 7023 patients from 30 countries in the Quantitative Standard Monitoring of Patients with RA (QUEST-RA) was analysed. PTGL and GH determinants were assessed by mixed-effects analyses of covariance models. PTGL and GH equivalence was determined by Bland-Altman 95% limits of agreement (BALOA) and Lin's coefficient of concordance (LCC). Concordance between PTGL and GH based Disease Activity Score 28(DAS28), Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) indices were calculated using LCC, and the level of agreement in classifying RA activity in four states (remission, low, moderate, high) using κ statistics. Results: Significant differences in relative and absolute contribution of RA and non-RA related variables in PTGL and GH ratings were noted. LCC of 0.64 and BALOA of -4.41 to 4.54 showed that PTGL and GH are not equivalent. There was excellent concordance (LCC 0.95-0.99) for PTGL and GH based DAS28, CDAI and RAPID3 indices, and >80% absolute agreement (κ statistics 0.75-0.84) in RA activity state classification for all three indices. Conclusions: PTGL and GH ratings differ in their determinants. Although they are individually not equivalent, they may be used interchangeably for calculating composite indices for RA activity assessment.",

author = "Khan, {Nasim Ahmed} and Spencer, {Horace Jack} and Abda, {Essam Ahmed} and Rieke Alten and Christof Pohl and Codrina Ancuta and Massimiliano Cazzato and P{\'a}l G{\'e}her and Laure Gossec and Dan Henrohn and Hetland, {Merete Lund} and Nevsun Inanc and Jacobs, {Johannes Wg} and Eduardo Kerzberg and Maria Majdan and Omondi Oyoo and Peredo-Wende, {Ruben A} and Selim, {Zahraa Ibrahim} and Skopouli, {Fotini Nikolaos} and Alberto Sulli and Kim H{\o}rslev-Petersen and Taylor, {Peter C} and Tuulikki Sokka and Hetland, {Merete Lund}",

year = "2012",

month = dec,

doi = "10.1136/annrheumdis-2011-201142",

language = "English",

volume = "71",

pages = "1942--9",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "B M J Group",

number = "12",

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TY - JOUR

T1 - Patient's global assessment of disease activity and patient's assessment of general health for rheumatoid arthritis activity assessment

T2 - are they equivalent?

AU - Khan, Nasim Ahmed

AU - Spencer, Horace Jack

AU - Abda, Essam Ahmed

AU - Alten, Rieke

AU - Pohl, Christof

AU - Ancuta, Codrina

AU - Cazzato, Massimiliano

AU - Géher, Pál

AU - Gossec, Laure

AU - Henrohn, Dan

AU - Hetland, Merete Lund

AU - Inanc, Nevsun

AU - Jacobs, Johannes Wg

AU - Kerzberg, Eduardo

AU - Majdan, Maria

AU - Oyoo, Omondi

AU - Peredo-Wende, Ruben A

AU - Selim, Zahraa Ibrahim

AU - Skopouli, Fotini Nikolaos

AU - Sulli, Alberto

AU - Hørslev-Petersen, Kim

AU - Taylor, Peter C

AU - Sokka, Tuulikki

AU - QUEST-RA group

PY - 2012/12

Y1 - 2012/12

N2 - Objectives: To assess (A) determinants of patient's global assessment of disease activity (PTGL) and patient's assessment of general health (GH) scores of rheumatoid arthritis (RA) patients; (B) whether they are equivalent as individual variables; and (C) whether they may be used interchangeably in calculating common RA activity assessment composite indices. Methods: Data of 7023 patients from 30 countries in the Quantitative Standard Monitoring of Patients with RA (QUEST-RA) was analysed. PTGL and GH determinants were assessed by mixed-effects analyses of covariance models. PTGL and GH equivalence was determined by Bland-Altman 95% limits of agreement (BALOA) and Lin's coefficient of concordance (LCC). Concordance between PTGL and GH based Disease Activity Score 28(DAS28), Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) indices were calculated using LCC, and the level of agreement in classifying RA activity in four states (remission, low, moderate, high) using κ statistics. Results: Significant differences in relative and absolute contribution of RA and non-RA related variables in PTGL and GH ratings were noted. LCC of 0.64 and BALOA of -4.41 to 4.54 showed that PTGL and GH are not equivalent. There was excellent concordance (LCC 0.95-0.99) for PTGL and GH based DAS28, CDAI and RAPID3 indices, and >80% absolute agreement (κ statistics 0.75-0.84) in RA activity state classification for all three indices. Conclusions: PTGL and GH ratings differ in their determinants. Although they are individually not equivalent, they may be used interchangeably for calculating composite indices for RA activity assessment.

AB - Objectives: To assess (A) determinants of patient's global assessment of disease activity (PTGL) and patient's assessment of general health (GH) scores of rheumatoid arthritis (RA) patients; (B) whether they are equivalent as individual variables; and (C) whether they may be used interchangeably in calculating common RA activity assessment composite indices. Methods: Data of 7023 patients from 30 countries in the Quantitative Standard Monitoring of Patients with RA (QUEST-RA) was analysed. PTGL and GH determinants were assessed by mixed-effects analyses of covariance models. PTGL and GH equivalence was determined by Bland-Altman 95% limits of agreement (BALOA) and Lin's coefficient of concordance (LCC). Concordance between PTGL and GH based Disease Activity Score 28(DAS28), Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) indices were calculated using LCC, and the level of agreement in classifying RA activity in four states (remission, low, moderate, high) using κ statistics. Results: Significant differences in relative and absolute contribution of RA and non-RA related variables in PTGL and GH ratings were noted. LCC of 0.64 and BALOA of -4.41 to 4.54 showed that PTGL and GH are not equivalent. There was excellent concordance (LCC 0.95-0.99) for PTGL and GH based DAS28, CDAI and RAPID3 indices, and >80% absolute agreement (κ statistics 0.75-0.84) in RA activity state classification for all three indices. Conclusions: PTGL and GH ratings differ in their determinants. Although they are individually not equivalent, they may be used interchangeably for calculating composite indices for RA activity assessment.

U2 - 10.1136/annrheumdis-2011-201142

DO - 10.1136/annrheumdis-2011-201142

M3 - Journal article

C2 - 22532638

SN - 0003-4967

VL - 71

SP - 1942

EP - 1949

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

IS - 12

ER -

Patient's global assessment of disease activity and patient's assessment of general health for rheumatoid arthritis activity assessment: are they equivalent?

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