title: 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.
abstract: 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.
authors.affiliation: Schools of Medicine and Public Health, University of Alabama at Birmingham, 35294, USA. graciela.alarcon@ccc.uab.edu
authors.forename: Graciela S
authors.initials: GS
authors.lastname: Alarcón
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Kemi
authors.initials: K
authors.lastname: Brooks
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Roseman
authors.forename: Barri J
authors.initials: BJ
authors.lastname: Fessler
authors.forename: Martha L
authors.initials: ML
authors.lastname: Sanchez
authors.forename: Holly M
authors.initials: HM
authors.lastname: Bastian
authors.forename: Alan W
authors.initials: AW
authors.lastname: Friedman
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Baethge
authors.forename: John D
authors.initials: JD
authors.lastname: Reveille
mesh_terms: 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