Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.

Assessing Health Status in Patients with Systemic Sclerosis: Construct Validity of the Karnofsky Performance Status Score.

Nguyen2,  Christelle, Berezne2,  Alice, Rannou3,  François, Mestre-Stanislas2,  Caroline, Morell-Dubois1,  Sandrine, Guillevin2,  Loïc, Poiraudeau3,  Serge

Universite Lille 2; Service de Medecine Interne; Centre de Reference Pour la Sclerodermie Systemique; Hopital Claude Huriez; Lille; France
Universite Paris Descartes; Faculte de Medecine Paris Descartes; Pole de Medecine Interne, Centre de Reference Pour les Vascularites Necrosantes et la Sclerodermie Systemique; Hopital Cochin; Assistance Publique-Hopitaux de Paris (
Universite Paris Descartes; Faculte de Medecine Paris Descartes; Service de Medecine Physique et Readaptation; Hopital Cochin AP-HP; Inserm, Institut Federatif de Recherche sur le Handicap, Paris


Systemic sclerosis (SSc) is a connective-tissue disease, responsible for skin, tendon, joint, and vessel damage, which can ultimately lead to disability, compromised health-related quality of life and poor health status. However, available instruments assessing global, patient's perceived and location-specific disabilities do not specifically survey patient global health status. An example of a score that surveys global health status is the Karnofsky Performance Status (KPS) score. Previous data support the use of the KPS score to predict outcome in SSc. Nevertheless, before considering the KPS score as a suitable outcome measure in SSc, its relevance should be definitely established. Therefore, we aimed to assess the construct validity of the KPS score in the assessment of health status in patients with SSc, by determining its convergent and divergent validity.


Three-hundred-and-sixty-two SSc patients fulfilling the American College of Rheumatology and/or the Leroy and Medsger criteria were assessed for visceral involvement, handicap and health-related quality of life (HRQoL). Global health status was evaluated by the KPS score. KPS score convergent and divergent validities were assessed using the Spearman's rank correlation coefficient.


Mean age and disease duration at the time of evaluation were 55.7 (13.3) and 9.6 (7.9) years, respectively. Thirty-three (9.3%) patients had limited SSc, 179 (50.7%) limited cutaneous SSc, and 141 (39.8%) diffuse cutaneous SSc. Mean total score of the KPS score was 77.6 (11.7). The KPS score had fair convergent validity with disease duration (r=-0.361), dyspnea (NYHA classification, r=-0.308), perceived handicap as assessed by McMaster-Toronto Arthritis Patient Preference Disability Questionnaire (r=-0.479) and global disability as assessed by the Health-Assessment Questionnaire (HAQ, r=-0.337), and no correlation with hand-located disability as assessed by the Cochin Hand Functional Scale (r=-0.278), mouth-located disability as assessed by the Mouth Handicap In Systemic Sclerosis Scale (r=-0.003), anxiety and depression symptoms as assessed by the Hospital Anxiety and Depression Scale (r=-0.053), aesthetic impairment assessed on an 11-point scale (r=-0.071), and HRQoL as assessed by SF-36 mental and physical component scores (r=0.064 and r=0.168, respectively).


For assessing global health status in patients with SSc, the KPS score has acceptable construct validity. The weak correlation between KPS score and previously validated outcome measures in SSc suggests that the KPS score adds useful information for assessing the global health status in patients with SSc and that it may be a suitable instrument for daily practice or clinical trials in SSc.

To cite this abstract, please use the following information:
Nguyen, Christelle, Berezne, Alice, Rannou, François, Mestre-Stanislas, Caroline, Morell-Dubois, Sandrine, Guillevin, Loïc, et al; Assessing Health Status in Patients with Systemic Sclerosis: Construct Validity of the Karnofsky Performance Status Score. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1204
DOI: 10.1002/art.28970

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