Health-related quality of life in systemic sclerosis: a systematic review.
OBJECTIVE
A number of studies (all n <200) have assessed health-related quality of life (HRQOL) in patients with systemic sclerosis (SSc), but no systematic review of the effect of SSc on HRQOL has been done. The objective of this study was to systematically review the literature on HRQOL in SSc measured using the Medical Outcomes Trust Short Form 36 (SF-36).


METHODS
A comprehensive search was conducted in August 2007 using Medline, CINAHL, and EMBase to identify original research studies reporting SF-36 scores of SSc patients. Selected studies were reviewed and characteristics of the study samples and SF-36 data were extracted. Bayesian meta-analysis and meta-regression were performed to obtain pooled estimates of SF-36 physical component summary (PCS) and mental component summary (MCS) scores for all patients as well as by limited and diffuse disease status.


RESULTS
Twelve data sets with a total of 1,127 SSc patients were included in the systematic review. HRQOL was impaired in patients with SSc, with pooled SF-36 PCS scores being more than 1 SD below the general population (38.3; 95% credible interval [95% CI] 35.2, 41.5) and pooled SF-36 MCS scores being approximately 0.5 SDs below the general population (46.6; 95% CI 44.2, 49.1). SF-36 PCS scores were 3.5 points (95% CI -1.0, 8.0) lower in patients with diffuse compared with limited disease.


CONCLUSIONS
This study provides robust evidence of the presence and magnitude of impairment in HRQOL in patients with SSc. Although the impairment appears greater in physical health, mental health impairment is also reported.
Hudson
Marie
M
SMBD-Jewish General Hospital and McGill University, Montreal, Quebec, Canada. marie.hudson@mcgill.ca
Thombs
Brett D
BD
Steele
Russell
R
Panopalis
Pantelis
P
Newton
Evan
E
Baron
Murray
M
D000203:Activities of Daily Living; D016206:Databases, Bibliographic; D006304:Health Status; D006801:Humans; D008603:Mental Health; D015201:Meta-Analysis as Topic; D011788:Quality of Life; D012595:Scleroderma, Systemic / Q000503:physiopathology* / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires