Patient global assessment in measuring disease activity in rheumatoid arthritis: a review of the literature

Elena Nikiphorou (1) , Helga Radner (2) , Katerina Chatzidionysiou (3, 4) , Carole Desthieux (5, 4) , Codruta Zabalan (6) , Yvonne van Eijk-Hustings (5) , William G. Dixon (7) , Kimme L. Hyrich (8) , Johan Askling (4, 3) , Laure Gossec (4, 5)

1 Whittington Hospital NHS Trust
2 Medizinische Universität Wien = Medical University of Vienna
3 Karolinska Institutet, Department of Rheumatology
4 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
5 Academic Hospital Maastricht
6 Romanian league against rheumatism
7 University of Manchester [Manchester]
8 MAHSC - Manchester Academic Health Science Centre

Patient-reported outcomes (PROs) reflect the patient’s perspective and are used in rheumatoid arthritis (RA) routine clinical practice. Patient global assessment (PGA) is one of the most widely used PROs in RA practice and research and is included in several composite scores such as the 28-joint Disease Activity Score (DAS28). PGA is often assessed by a single question with a 0–10 or 0–100 response. The content can vary and relates either to global health (e.g., how is your health overall) or to disease activity (e.g., how active is your arthritis). The wordings used as anchors, i.e., for the score of 0, 10, or 100 according to the scale used, and the timing (i.e., this day or this week) also vary. The different possible ways of measuring PGA translate into variations in its interpretation and reporting and may impact on measures of disease activity and consequently achievement of treat-to-target goals. Furthermore, although PGA is associated with objective measures of disease activity, it is also associated with other aspects of health, such as psychological distress or comorbidities, which leads to situations of discordance between objective RA assessments and PGA. Focusing on the role of PGA, its use and interpretation in RA, this review explores its validity and correlations with other disease measures and its overall value for research and routine clinical practice.

Mots clés: Discordance; Rheumatoid arthritis; Patient global assessment

Domaines: Rhumatologie et système ostéo-articulaire

Elena Nikiphorou, Helga Radner, Katerina Chatzidionysiou, Carole Desthieux, Codruta Zabalan, et al.. Patient global assessment in measuring disease activity in rheumatoid arthritis: a review of the literature. Arthritis Research and Therapy, 2016, 18, pp.251. ⟨10.1186/s13075-016-1151-6⟩. ⟨hal-01404104⟩