The multi-faceted assessment of independence in patients with rheumatoid arthritis: preliminary validation from the ATTAIN study

Current Medical Research and Opinion
Afton L HassettM A Gignac

Abstract

To consider the feasibility of assessing multiple facets of independence in rheumatoid arthritis (RA) using a measure developed from existing items and examining its face validity, construct validity and responsiveness to change. The ATTAIN (Abatacept Trial in Treatment of Anti-tumor necrosis factor [TNF] Inadequate responders) database was used. Patients with RA were randomized 2:1, abatacept (n = 258) and placebo (n = 133). A multi-faceted scale to measure physical and psychosocial independence was constructed using items from the Health Assessment Questionnaire (HAQ) and Short Form 36 Health Survey (SF-36). Questions assessing activity limitations and need for outside caregiver help were also examined. Interviews with 20 RA patients assessed face validity. Item Response Theory analysis yielded two traits - 'Psychosocial Independence', derived from the number of days with activity limitations plus the Role Emotional, Social Functioning and Role Physical subscale items from the SF-36; and 'Physical Independence', derived from 15 HAQ items assessing need for help from another. The two traits showed no significant differential item functioning for age or gender and demonstrated good face validity. Changes over 169 days on Psycho...Continue Reading

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Citations

Dec 12, 2012·Best Practice & Research. Clinical Rheumatology·Wei ZhangAslam H Anis
Dec 17, 2014·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Becky Pennington, Sarah Davis

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