Patient_Reported_Outcome_Measures_in_Rheumatic_Diseases

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fering from infl ammatory arthritic conditions, a mutual index of several measures
has been recommended for assessment of disease activity and monitoring response
to therapy. The most widely used indices in RA are the ACR core dataset, disease
activity score (DAS-28), and clinical disease activity index (CDAI) [ 4 , 42 , 43 , 45 ,
46 ]. Specifi c multidimensional PROMs have been developed to capture those ele-
ments of health outcome measures of relevance to a specifi c patient group. Therefore,
it represents the best available tool offering a quantitative “gestalt” impression of
the outcome measures for a specifi c condition. Multidimensional PROMs question-
naire are already available for rheumatoid arthritis (examples are shown in Table 4.1
[ 12 , 13 , 18 , 62 , 63 , 66 – 69 ]). In all these conditions, PROMs has shown both a diag-
nostic value in helping to identify those who might be suffering from early infl am-
matory condition and a therapeutic impact as it helps to monitor response to therapy
over time [ 65 ].

Patient-Reported Outcome Measures Evolving from Static

to Dynamic

In acute diseases in hospital settings (the primary setting of most traditional medical
practice, education, training, and research) quantitative data regarding blood pres-
sure, temperature, and body weight come as a priority, whereas no data are collected
concer ning functional status or pain since success or failure of the treatment is obvi-
ous within a short period. However, in chronic diseases such as in the standard
rheumatology outpatient setting (the primary locale of almost all contemporary
rheumatologic care), such information is critical for the documentation of patient

Table 4.1 Patient-reported outcome measures for rheumatoid arthritis

Type Measure Score Generic Specifi c tools

Unidimensional Single

construct

Items

(questions)

are added to

yield overall

score

• EurQoL [ 62 ]


• Nottingham
  Health
  Profi le [ 63 ]
  
  
  • Pain questionnaire [ 12 ]
  
  
  • Bristol rheumatoid
    arthritis fatigue
    numerical rating scales
    (BRAF- NRS) [ 66 ]
  
  
  • Rheumatoid arthritis-
    specifi c work
    productivity survey
    (WPS-RA) [ 67 ]
    Multidimensional Health
    concepts of
    relevance to
    a wide range
    of patients
  
  
  
  

Specifi c

score for

each domain

• -SF-36 [ 13 ]


• 
  
  
  
  • MDHAQ
    [ 68 ]
    
    
    • MDPROMs-RA [ 18 ]
    
    
    • Bristol rheumatoid
      arthritis fatigue
      multidimensional
      questionnaire
      (BRAF-MDQ) [ 66 ]
    
    
    • Rheumatic arthritis
      impact of disease
      (RAID) [ 69 ]
    
    
    
    
  
  
  
  

Y. El Miedany