PROMIS29 could be used to help explain discordance between patient, physician pain scores

WASHINGTON — According to an abstract presented at the American College of Rheumatology Annual Meeting, the patient-reported outcomes measurement information system 29 could be utilized to predict discordance between the patient and physician pain scores for rheumatoid arthritis.

“It is not surprising to see the discrepancy in some of these measures, because each measure captures different aspects of rheumatoid arthritis,” Yong Gil Hwang, MD, assistant professor of medicine in the Department of Rheumatology & Clinical Immunology at the University of Pittsburgh, said in his presentation.

Hwang and colleagues performed a cross-sectional analysis of 363 patients with rheumatoid arthritis who were enrolled in the University of Pittsburgh Rheumatoid Arthritis Comparative Effectiveness Registry. The average patient age was 64.2 years, and the mean disease duration was 13.9 years. Researchers recorded patient-reported outcomes measurement information system (PROMIS29), clinical disease activity index (CDAI) and routine assessment of patient index 3 (RAPID3). They determined the association between CDAI and RAPID3. Using logistic regression, they found predictors for patients in remission or with low disease activity.

The researchers found CDAI correlated with RAPID3 (r = 0.6). Out of the three pain indices, RAPID3 had the strongest correlation with pain intensity (r= 0.89) and pain interference (r = 0.84). Overall, there was a 40% agreement in disease activity between CDAI and RAPID3.

In patients with low PROMIS29 disease activity, pain intensity and physical function predicted the discordance between CDAI and RAPID3. When pain intensity and physical function were taken away, pain interference and impaired social roles became the predictors of discordance.

The researchers concluded PROMIS29 can help explain the discordance between patient and physician assessments of disease activity.

“It helps to understand the different aspects of disease activity measures,” Hwang said. – by Will Offit

Reference:

Hwang YG, et al. Abstract #3083. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.

Disclosure: The researchers report no relevant financial disclosures.