Does disease activity add to functional disability in estimation of utility for rheumatoid arthritis patients on biologic treatment?
| Autor: | G. Ardine de Wit, Jacob M. van Laar, Johannes W. J. Bijlsma, Floris P J G Lafeber, Paulina Sijtsma, AK Marijnissen, Sandhya C. Nair, Paco M J Welsing |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Multivariate analysis Severity of Illness Index Arthritis Rheumatoid Disability Evaluation QALY 0302 clinical medicine Surveys and Questionnaires Activities of Daily Living Pharmacology (medical) mapping skin and connective tissue diseases Non-U.S. Gov't 030503 health policy & services Research Support Non-U.S. Gov't Middle Aged Prognosis Explained variation Rheumatoid arthritis Female 0305 other medical science Cohort study musculoskeletal diseases medicine.medical_specialty Mean squared error Observational Study Motor Activity Research Support 03 medical and health sciences Rheumatology Internal medicine Severity of illness EQ5D medicine Journal Article Humans DAS28 biologics functional limitation 030203 arthritis & rheumatology Biological Products business.industry prediction HAQ medicine.disease utility Physical therapy Observational study business human activities Follow-Up Studies |
| Zdroj: | Rheumatology (Oxford, England), 55(1), 94. Oxford University Press |
| ISSN: | 1462-0324 |
| DOI: | 10.1093/rheumatology/kev291 |
| Popis: | Objective. Treatment in general is mostly directly aimed at disease activity, and measures such as the DAS28 might therefore present important additional information. Our aim was to develop and validate a model that uses a combination of disease activity (DAS28) and HAQs to estimate EuroQoL 5-dimension scale (EQ5D) utilities. Methods. Longitudinal data from a cohort study in RA patients from the Utrecht Rheumatoid Arthritis Cohort study Group (Stichting Reumaonderzoek Utrecht) who started treatment with a biologic drug were used for mapping and validation. All 702 observations, including DAS28, HAQ and EQ5D assessed at the same time points, were used. The observations were randomly divided into a subset for development of the model (n = 428 observations) and a subset for validation (n = 274). A stepwise multivariable regression analysis was used to test the association of DAS28 (components) and HAQ (domains) with EQ5D. Model performance was assessed using the explained variance (R2) and root mean square errors. Observed and predicted utility scores were compared to check for under- or overestimation of the scores. Finally, the performance of the model was compared with published mapping models. Results. Lower DAS28 score and HAQ items dressing and grooming, arising, eating, walking and activities were associated with higher EQ5D scores. The final model had an explained variance of 0.35 and a lower root mean square error as compared with other models tested. The agreement between predicted and observed scores was fair. Conclusion. HAQ components estimate EQ5D better than total HAQ. Adding DAS28 to HAQ components does not result in better utility estimations. |
| Databáze: | OpenAIRE |
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