Sensitivity and specificity of assessment instruments of quality of life in rheumatoid arthritis

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Sensitivity and specificity of assessment instruments of quality of life in rheumatoid arthritis
Key Take-Away: 

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).

ABSTRACT: 
Background: 

To check sensitivity and specificity of assessment instruments of QoL in patients with rheumatoid arthritis (RA).

Methods: 

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.

Results: 

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.

Conclusion: 

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.

Rev Bras Reumatol. 2016 Mar 24
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