title: Determining minimally important changes in generic and disease-specific health-related quality of life questionnaires in clinical trials of rheumatoid arthritis.
abstract: OBJECTIVE
  To define clinically meaningful changes in 2 widely used health-related quality of life (HQL) instruments in studies of patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Patients with RA (n = 693) who were enrolled in 2 double-blind, placebo-controlled clinical trials completed the Short Form 36 (SF-36) modified health survey and the Health Assessment Questionnaire (HAQ) disability index at baseline and 6-week followup assessments. Data on 5 RA severity measures were also collected at baseline and at 6 weeks (patient and physician global assessments, joint swelling and tenderness counts, and global pain assessment). Comparison of changes in the SF-36 scales and HAQ scores was made between groups of patients known to differ in the level of change on each RA severity measure.
  
  
  RESULTS
  With few exceptions, changes in the SF-36 and HAQ scores were different between patients who differed in the level of change on each RA severity measure. Changes in the SF-36 and HAQ scores were more strongly related to changes in the patient and physician global assessments and patient pain assessment than to changes in the joint swelling and tenderness counts.
  
  
  CONCLUSIONS
  Based on these results, minimally important changes in the SF-36 scales and HAQ disability scores were determined, which will be useful in interpreting HQL results in clinical trials.
authors.affiliation: QualityMetric, Inc., Lincoln, Rhode Island, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kosinski
authors.forename: S Z
authors.initials: SZ
authors.lastname: Zhao
authors.forename: S
authors.initials: S
authors.lastname: Dedhiya
authors.forename: J T
authors.initials: JT
authors.lastname: Osterhaus
authors.forename: J E
authors.initials: JE
authors.lastname: Ware
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D000068579:Celecoxib; D004008:Diclofenac / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016595:Misoprostol / Q000627:therapeutic use*; D011720:Pyrazoles; D011788:Quality of Life; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013449:Sulfonamides / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D011720:Pyrazoles; D013449:Sulfonamides; D016595:Misoprostol; D004008:Diclofenac; D000068579:Celecoxib