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A Web-Compatible Instrument for Measuring
Self-Reported Disease Activity in Arthritis
NINAD ATHALE, ANN STURLEY, STEVEN SKOCZEN, ARTHUR KAVANAUGH, and LESLIE LENERT
ABSTRACT.
Methods. Utilizing data from a study on RA, we compared results from 43 patients attending a university-based clinic who were each given a paper and a demonstration computer version of a patient self-assessment questionnaire including multiple-choice questions from a multi-dimensional Health Assessment Questionnaire (HAQ); visual analog scales (VAS) for pain, fatigue, and global disease severity; and a tender and swollen joint count reporting tool. Patients were given optional followup surveys to determine their opinion of the computer program. Results. High correlations (intraclass correlation coefficient > 0.9) were seen across methods for the 10-item HAQ and psychological distress scores and the VAS scores for pain and global disease severity. Moderate correlation was observed for the self-efficacy scores, the VAS scores for fatigue, and tender joint counts. The data also revealed a small shift in the mean scores for the HAQ and self-efficacy questions, with patients reporting slightly higher scores on the computer instrument. Overall, patient opinions of the uniquely designed joint count tool were good, with 71% of responding patients answering favorably. Conclusion. Web-based computer versions of patient self-assessment surveys in RA are comparable to paper versions, and their use in clinics or over the Internet could dramatically facilitate the ability of physicians to monitor patients' health. (J Rheumatol 2004;31:223-8) Key Indexing Terms:
HEALTH STATUS
From Health Services Research and Development, Veterans Affairs San Diego Healthcare System, Veterans Medical Research Foundation, University of California, San Diego (UCSD), California, USA. Supported by grant R01 AG17511 from the US National Institutes of Health. Infrastructure support was provided by a Research Enhancement Award from the Department of Veterans Affairs. N.R. Athale, BS, Research Coordinator, Veterans Medical Research Foundation; A.E. Sturley, DrPH, RN, Associate Manager, Research, San Diego Hospice; A. Kavanaugh, MD, Professor of Medicine, Division of Rheumatology, UCSD; S. Skoczen, Programmer, UCSD; L.A. Lenert, MD, MS, Associate Professor of Medicine, UCSD, Staff Physician and Researcher, Veterans Affairs Healthcare System, San Diego. Address reprint requests to Dr. L. Lenert, VA San Diego HCS, 3350 La Jolla Village Drive MC 111N-1, San Diego, CA 92161. E-mail: llenert@ucsd.edu Submitted March 20, 2003; revision accepted July 15, 2003. |