Measurement of Minimal Disease Activity in Psoriatic Arthritis Using the Patient‐Reported Outcomes Measurement Information System–Physical Function or the Health Assessment Questionnaire Disability Index

• Published in: Arthritis care & research (2010) Vol. 74; no. 1; pp. 151 - 160
• Main Authors: Chew, Erin, Perin, Jamie, Grader‐Beck, Thomas, Orbai, Ana‐Maria
• Format: Journal Article
• Language: English
• Published: Boston, USA Wiley Periodicals, Inc 01.01.2022; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Agreements; Arthritis; Arthritis, Psoriatic; Cross-Sectional Studies; Disability Evaluation; Female; Humans; Information systems; Longitudinal Studies; Male; Middle Aged; Patient Reported Outcome Measures; Psoriatic arthritis; Questionnaires; Severity of Illness Index; Surveys and Questionnaires
• ISSN: 2151-464X; 2151-4658; 2151-4658
• DOI: 10.1002/acr.24433

Objective To assess the interchangeability of the Health Assessment Questionnaire disability index (HAQ DI) with the Patient‐Reported Outcomes Measurement Information System–Physical Function (PROMIS‐PF) in the calculation of minimal disease activity (MDA) in psoriatic arthritis (PsA). Methods Comprehensive PsA disease activity was collected concomitantly with the HAQ DI and the PROMIS‐PF measures in a PsA cohort. The PROMIS‐PF–based MDA definitions were built using the existing cross‐walk between the scores: HAQ DI ≤0.5 equivalent to a PROMIS‐PF T score of ≥41.3. We assessed agreement between MDA (MDA HAQ DI) and the PROMIS‐PF MDA definitions (MDA PROMIS‐PF short form 4a and MDA PROMIS‐PF bank) at each visit and longitudinally (MDA state changes between consecutive visits) through the kappa statistic. The predictive value of the MDA PROMIS‐PF for the MDA HAQ DI was assessed using receiver operator characteristic (ROC) curve analysis. Results A total of 100 participants contributed 352 observations with up to 5 visits. The mean ± SD age was 52 ± 12 years, 60% were female, and 43% were in MDA at baseline. The kappa statistic for the PROMIS‐PF–based MDA reflected excellent agreement with the HAQ DI MDA: κ = 0.94 (95% confidence interval [95% CI] 0.90–0.97) for MDA PROMIS‐PF bank, and κ = 0.90 (95% CI 0.80–0.95) for MDA PROMIS‐PF4a. Higher longitudinal agreement was seen between the MDA HAQ DI and the MDA PROMIS‐PF bank versus the MDA PROMIS‐PF4a between consecutive visits: κ values ranged between 0.81 and 0.94 versus a range between 0.72 and 0.84, respectively. The area under the ROC curve for predicting the MDA HAQ DI was 0.97 for the MDA PROMIS‐PF bank and 0.95 for the MDA PROMIS‐PF4a. Conclusion Excellent agreement was seen between the HAQ DI and the PROMIS‐based MDA definitions both cross‐sectionally and longitudinally. The PROMIS‐PF bank and PROMIS‐PF4a are accurate replacements for the HAQ DI in calculating MDA state in PsA.