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To check sensitivity and specificity of assessment instruments of QoL in patients with rheumatoid arthritis (RA).
The
health-related aspects of quality of life in rheumatoid arthritis can be
studied efficiently via generic and specific instruments. According to this
study, three instruments most used in the evaluation of impact on QoL of the
morbidity of RA, validated and accessible in the Portuguese language of Brazil,
namely: SF-36, HAQ and NHP are beneficial and should be applied in clinical
studies and scientific researches.
To check
sensitivity and specificity of assessment instruments of QoL in patients with
rheumatoid arthritis (RA).
Accuracy study in
a sample consisting of patients with confirmed diagnosis of RA. QoL
questionnaires QV SF-36 (Gold Standard), HAQ and NHP were applied. The Pearson
correlation coefficient, ROC curve, AUC and Youden Index (J) were used to
analyze the data.
This study
enrolled 97 individuals with RA. The functional capacity estimated by SF-36 was
correlated with the total score of HAQ (r = −0.666; p < 0.001; J = 0.579),
while the emotional aspects of SF-36 were correlated with the emotional
reactions domain of NHP (r = −0.316; p = 0.005; J = 0.341). The vitality domain
of SF-36 was correlated with the level of energy of NHP (r = −0.362; p = 0.001;
J = 0.302). For the evaluation of functional capacity (AUC = 0.839; p <
0.001) and physical aspect (AUC = 0.755; p < 0.001) the most accurate
instrument was the HAQ. For evaluation of the impact of vitality, sleep (AUC =
0.679; p = 0.007), emotional reactions (AUC = 0.674; p = 0.009) and level of
energy in QoL, the NHP (AUC = 0.633; p = 0.045) was the most specific and
sensitive. In the evaluation of the emotional aspect domain, the most accurate
instrument was the NHP in the “emotional reaction” score (AUC = 0.699; p =
0.003). The evaluation of pain was limited in the three instruments and SF-36
was the only one in assess of the domains of social aspects and general health
status.
For evaluation of
the physical aspects in patients with RA, the HAQ is the most accurate. For
evaluation of emotional aspects, the NHP is the most indicated, although the
SF-36 was the only one in the evaluation of general domains.
Revista brasileira de reumatologia
Sensitivity and specificity of assessment instruments of quality of life in rheumatoid arthritis
Silvana Almeida Ribas et al.
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