Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Approaching Psoriatic Arthritis - Comparing the Patients's Perspective to Physicians' Evaluations.
Englbrecht, Matthias, Dandorfer, Stefan W. H., Ronneberger, Monika R., Lang, Veronika, Schett, Georg
To date, we hardly now anything about the comparability of physician's to patient's evaluation of disease related-symptoms in psoriatic arthritis (PsA). To investigate the relation of physician's to patient's evaluation of symptoms in PsA.
We examined 55 outpatients by referring to the GRAPPA core set of disease related symptoms for PsA including visual analogue scales for general pain, global status, arthritis and psoriasis related symptoms (i.e. status of peripheral joints, spinal involvement, enthesitis, involvement of the skin and the nails) and other symptoms (fatigue & sleep disorders). The second part of the questionnaire consisted of symptom interrelations of arthritis and psoriasis according to the individually experienced magnitude and patients were asked to complete the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The corresponding physician evaluated the patient's condition by using VAS for global status, disease activity of arthritis and psoriasis, and additional comparative measures (i.e. TJC68/SJC66, the Psoriasis Area and Severity Index, the Nail Psoriasis Severity Index and the Maastricht Ankylosing Spondylitis Enthesitis Score with gradation for tendon specific pain). After transformation for better comparability of scores, these measures where compared to the corresponding VAS-ratings of the patient by calculating 95% confidence intervals of differences.
On average, when comparing the magnitude of interrelations, patients evaluated symptoms of arthritis [95%CI:4.29; 5.71] to be worse than symptoms of psoriasis [95%CI:1.58; 3.00] or additional symptoms such as fatigue or sleep disorders [95%CI:2.19; 3.20]. When looking at 95%CI of average differences of VAS evaluations between patients and physicians for global status, arthritis and psoriasis, appraisals differed considerably with patients stating higher ratings (indicated by 95%CI > 0; global status: [95%CI:0.66; 1.79], rheumatic disorders: [95%CI:0.30; 1.33], psoriatic disorders: [95%CI:0.54; 1.58]). These results where confirmed in corresponding 95%CIs and t-tests with respect to physician-patient comparisons when applying comparative measures (p <= 0.02, see Table 1).
In general, patients gave significantly higher ratings to some disease-related symptoms than physicians did. Hence, when investigating the perceived disease impact it seems necessary to take into account both sides of the cointhe patient's as well as the physician's perspective.
To cite this abstract, please use the following information:
Englbrecht, Matthias, Dandorfer, Stefan W. H., Ronneberger, Monika R., Lang, Veronika, Schett, Georg; Approaching Psoriatic Arthritis - Comparing the Patients's Perspective to Physicians' Evaluations. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :548