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The Responsiveness of Generic Health Status Measures As Assessed in Patients with Rheumatoid Arthritis Receiving Infliximab
ANTHONY S. RUSSELL, BARBARA CONNER-SPADY, ALISA MINTZ, CATHERINE MALLON, and WALTER P. MAKSYMOWYCH
ABSTRACT.
Methods. Two groups of patients were studied. Group 1: 24 patients with stable RA tested on 2 occasions; Group 2: 60 patients receiving methotrexate tested before and 14 weeks after treatment with infliximab. Assessments were made with self-completed questionnaires: the modified Health Assessment Questionnaire, Medical Outcomes Study Short Form-36 [SF-36 (SF-6D)], EuroQol, and, in some, the standard gamble. Group 2 also had joint counts, and measures of erythrocyte sedimentation rate, C-reactive protein, and hemoglobin. Results. The limits-of-agreement (Bland-Altman) approach had greater confidence intervals (CI) than did CI based on ± 2 standard errors of the measurement. Improvement with infliximab could be determined with all measures, however, but the standard gamble seemed least responsive to change. Conclusion. The various measures had different degrees of responsiveness, but with all it was possible to show improvement in Group 2 compared to Group 1. There was a closer association of the patient centered measures of improvement with changes in pain score than with joint counts. (J Rheumatol 2003;30:941-7) Key Indexing Terms:
QUALITY OF LIFE
From the Rheumatic Disease Unit and Department of Psychology, University of Alberta, Edmonton, Alberta Canada. A.S. Russell, FRCPC, Professor of Medicine; B. Conner-Spady, PhD; A. Mintz, MSc, Department of Psychology; C. Mallon, RN; W.P. Maksymowych, FRCPC, Professor of Medicine. Address reprint requests to Dr. A.S. Russell, Room 562, Heritage Medical Research Centre, University of Alberta, Edmonton, Alberta, Canada T6G 2S2. Submitted June 17, 2002; revision accepted October 31, 2002. |