TY - JOUR
T1 - The Patient Global Assessment of Disease Activity in Rheumatoid Arthritis
T2 - Identification of Underlying Latent Factors
AU - Challa, Divya N.V.
AU - Crowson, Cynthia S.
AU - Davis, John M.
N1 - Funding Information:
The Mayo Foundation Eaton Family Career Development Award in Innovative Rheumatoid Arthritis Research and the CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Science (NCATS) supported this study. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. No sponsorship was provided for the study and article processing charges.
Funding Information:
The Mayo Foundation Eaton Family Career Development Award in Innovative Rheumatoid Arthritis Research and the CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Science (NCATS) supported this study. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. No sponsorship was provided for the study and article processing charges. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval for the version to be published. Divya N. V. Challa, Cynthia S. Crowson, and John M. Davis III have nothing to disclose. The Mayo Clinic Institutional Review Board approved the study. All patients provided written informed consent. The datasets analyzed during the current study are available from the corresponding author on reasonable request. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Publisher Copyright:
© 2017, The Author(s).
PY - 2017/6
Y1 - 2017/6
N2 - Introduction: The patient global assessment of disease activity is a crucial component of various measures of disease activity in rheumatoid arthritis (RA). Our objective was to identify underlying latent traits driving the patient global assessment using a quantitative, multivariable data reduction approach. Methods: This was a prospective cross-sectional study of consecutive patients with RA. The patient sample was stratified to include 50 patients with patient-provider discordance (i.e., at least 25-mm absolute difference between the patient and provider global assessments) and 20 patients with patient-provider concordance (i.e., less than 25-mm absolute difference between the patient and provider global assessments). Data were collected from the most recent rheumatology visit, including patient characteristics, current RA medications, and comorbidities. Participants completed several validated patient-reported outcome measures. The data were evaluated using factor analysis, and then linear regression was used to determine the variability in the patient global assessment explained by the factor scores. Results: The study included 70 patients with mean age of 61 years, 73% female, and with mean disease duration of 8 years. The means (SD) for the patient and provider global assessments were 44.6 (22.7) and 20.1 (17.7), respectively. Factor analysis yielded eight factors that represented measurements of pain, fatigue, depression or anxiety symptoms, prior diagnosis of depression or anxiety, advanced age and degenerative arthritis, inability to participate, fibromyalgia (clinical diagnosis and Widespread Pain Index), and undetermined. Linear regression analysis showed that fibromyalgia explained the greatest proportion of the variance in the patient global assessment followed by the other factors. Conclusion: Latent factors underlying the patient global assessment include pain, depression and anxiety, inability to participate, fibromyalgia, advanced age, and degenerative arthritis.
AB - Introduction: The patient global assessment of disease activity is a crucial component of various measures of disease activity in rheumatoid arthritis (RA). Our objective was to identify underlying latent traits driving the patient global assessment using a quantitative, multivariable data reduction approach. Methods: This was a prospective cross-sectional study of consecutive patients with RA. The patient sample was stratified to include 50 patients with patient-provider discordance (i.e., at least 25-mm absolute difference between the patient and provider global assessments) and 20 patients with patient-provider concordance (i.e., less than 25-mm absolute difference between the patient and provider global assessments). Data were collected from the most recent rheumatology visit, including patient characteristics, current RA medications, and comorbidities. Participants completed several validated patient-reported outcome measures. The data were evaluated using factor analysis, and then linear regression was used to determine the variability in the patient global assessment explained by the factor scores. Results: The study included 70 patients with mean age of 61 years, 73% female, and with mean disease duration of 8 years. The means (SD) for the patient and provider global assessments were 44.6 (22.7) and 20.1 (17.7), respectively. Factor analysis yielded eight factors that represented measurements of pain, fatigue, depression or anxiety symptoms, prior diagnosis of depression or anxiety, advanced age and degenerative arthritis, inability to participate, fibromyalgia (clinical diagnosis and Widespread Pain Index), and undetermined. Linear regression analysis showed that fibromyalgia explained the greatest proportion of the variance in the patient global assessment followed by the other factors. Conclusion: Latent factors underlying the patient global assessment include pain, depression and anxiety, inability to participate, fibromyalgia, advanced age, and degenerative arthritis.
KW - Discordance
KW - Disease activity
KW - Rheumatoid arthritis
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U2 - 10.1007/s40744-017-0063-5
DO - 10.1007/s40744-017-0063-5
M3 - Article
AN - SCOPUS:85030449535
SN - 2198-6576
VL - 4
SP - 201
EP - 208
JO - Rheumatology and Therapy
JF - Rheumatology and Therapy
IS - 1
ER -