Systemic lupus erythematosus in three ethnic groups. XI. Sources of discrepancy in perception of disease activity: a comparison of physician and patient visual analog scale scores.
OBJECTIVE
To compare patient's and physician's assessment of disease activity in a multiethnic (Hispanic, African American, and Caucasian) cohort of systemic lupus erythematosus (SLE) patients.


METHODS
Three hundred patients with SLE from the LUMINA (Lupus in Minority populations: Nature versus nurture) cohort were included. Disease activity was assessed with the Systemic Lupus Activity Measure (SLAM); patients and physicians assessed disease activity using a 10-cm anchored visual analog scale (VAS). The difference between VAS scores was termed discrepancy (>1 cm was considered a priori clinically relevant). Selected sociodemographic, clinical, behavioral, and psychological variables were examined in relation to discrepancy in univariable and multivariable models adjusting for the physician global VAS score in order to eliminate ceiling and floor effects.


RESULTS
A discrepancy was exhibited by 58% of the patients. Abnormal laboratory findings were negatively associated with discrepancy, and poor self-perceived functioning and joint involvement were positively associated with discrepancy. Ethnicity did not account for discrepant perception of disease activity.


CONCLUSIONS
Patients and physicians rate disease activity in SLE differently. Physicians appear to place more emphasis on laboratory features while patients place more emphasis on function.
Alarcón
Graciela S
GS
Schools of Medicine and Public Health, University of Alabama at Birmingham, 35294, USA. graciela.alarcon@ccc.uab.edu
McGwin
Gerald
G
Brooks
Kemi
K
Roseman
Jeffrey M
JM
Fessler
Barri J
BJ
Sanchez
Martha L
ML
Bastian
Holly M
HM
Friedman
Alan W
AW
Baethge
Bruce A
BA
Reveille
John D
JD
D000328:Adult; D000407:Alabama / Q000453:epidemiology; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D008297:Male; D017060:Patient Satisfaction / Q000208:ethnology*; D012720:Severity of Illness Index; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome