Minimally Important Difference of Health Assessment Questionnaire in Psoriatic Arthritis: Relating Thresholds of Improvement in Functional Ability to Patient-rated Importance and Satisfaction
| Autor: | PHILIP J. MEASE, J. MICHAEL WOOLLEY, BOJENA BITMAN, BRIAN C. WANG, DENISE R. GLOBE, AMITABH SINGH |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Activities of daily living Immunology Placebo Receptors Tumor Necrosis Factor Etanercept law.invention Disability Evaluation Psoriatic arthritis Patient satisfaction Double-Blind Method Rheumatology Quality of life Randomized controlled trial law Surveys and Questionnaires Activities of Daily Living Outcome Assessment Health Care medicine Humans Immunology and Allergy Functional ability business.industry Arthritis Psoriatic Middle Aged medicine.disease Self Concept Treatment Outcome Patient Satisfaction Antirheumatic Agents Immunoglobulin G Linear Models Quality of Life Physical therapy Female business medicine.drug |
| Zdroj: | The Journal of Rheumatology. 38:2461-2465 |
| ISSN: | 1499-2752 0315-162X |
| Popis: | Objective.To evaluate changes in function as measured by Health Assessment Questionnaire Disability Index (HAQ-DI) and the meaningfulness of the changes, in importance and satisfaction, in patients with psoriatic arthritis (PsA).Methods.HAQ-DI was assessed at baseline and at Weeks 4, 12, and 24 in a randomized double-blind study of 205 patients with active PsA receiving etanercept 25 mg twice weekly or placebo. Concurrently, patients rated the importance of and satisfaction with their change in function on a 7-point scale (1 = not at all important/satisfied; 7 = extremely important/satisfied). Mean HAQ-DI improvement corresponding to ratings of minimally (2–3) or very (6–7) important or satisfied was determined using a posthoc linear mixed-model analysis. Patient importance ratings were used as an anchor to estimate minimally important difference (MID) for HAQ-DI; distribution-based estimates were also calculated.Results.A total of 161 patients (69 placebo; 92 etanercept) had ≥ 1 HAQ-DI scores showing improvement from baseline and a corresponding importance or satisfaction rating. HAQ-DI improvements corresponding to importance scale ratings of 2 or 3 were 0.335 (95% CI 0.214, 0.455) and 0.360 (95% CI 0.263, 0.456), respectively, suggesting an MID of about 0.35. HAQ-DI improvements corresponding to satisfaction scale ratings of 2 and 3 were 0.293 (95% CI 0.230, 0.357) and 0.360 (95% CI 0.307, 0.413). For a given change in HAQ-DI, nearly two-thirds of patients indicated a lower rating for satisfaction than for importance. This trial was registered in the ClinicalTrials.gov registry (NCT00317499).Conclusion.Our study suggests the MID for HAQ-DI in PsA is about 0.35. The results may also provide insight into patient satisfaction with changes in function and expectations for therapy. |
| Databáze: | OpenAIRE |
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