title: Patient global assessment in psoriatic arthritis: a multicenter GRAPPA and OMERACT study.
abstract: OBJECTIVE
  During OMERACT 8, delegates selected patient global assessment (PGA) of disease as a domain to be evaluated in randomized controlled trials in psoriatic arthritis (PsA). This study assessed the reliability of the PGA, measured by means of 0-100 mm visual analog scale (VAS), and the additional utility of separate VAS scales for joints (PJA) and skin (PSA).
  
  
  METHODS
  In total, 319 consecutive patients with PsA (186 men, 133 women, mean age 51 ± 13 yrs) were enrolled. PGA, PJA, and PSA were administered at enrolment (W0) and after 1 week (W1). Detailed clinical data, including ACR joint count, Psoriasis Area and Severity Index (PASI), and Hospital Anxiety and Depression Scale, were recorded.
  
  
  RESULTS
  Comparison of W0 and W1 scores showed no significant variations (intraclass correlation coefficients for PGA 0.87, PJA 0.86, PSA 0.78), demonstrating the reliability of the instrument. PGA scores were not influenced by patient anxiety or depression, but were dependent on PJA and PSA (p = 0.00001). PJA was dependent on the number of swollen and tender joints (p < 0.00001). PSA scores were influenced by the extent of skin psoriasis and by hand skin involvement (p = 0.00001). Joint and skin disease were found not to correlate in terms of disease activity as evidenced by the swollen joint count compared to PASI (r = 0.11) and by the PJA compared to PSA (r = 0.38).
  
  
  CONCLUSIONS
  PGA assessed by means of VAS is a reliable tool related to joint and skin disease activity. Because joint and skin disease often diverge it is suggested that in some circumstances both PJA and PSA are also assessed.
authors.affiliation: Dipartimento di Scienze Mediche, Università di Cagliari, ss 554, Monserrato, Italy. cauli@medicina.unica.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Cauli
authors.forename: Dafna D
authors.initials: DD
authors.lastname: Gladman
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mathieu
authors.forename: Ignazio
authors.initials: I
authors.lastname: Olivieri
authors.forename: Giovanni
authors.initials: G
authors.lastname: Porru
authors.forename: Paul P
authors.initials: PP
authors.lastname: Tak
authors.forename: Claudia
authors.initials: C
authors.lastname: Sardu
authors.forename: Ilona
authors.initials: I
authors.lastname: Ujfalussy
authors.forename: Raffaele
authors.initials: R
authors.lastname: Scarpa
authors.forename: Antonio
authors.initials: A
authors.lastname: Marchesoni
authors.forename: William J
authors.initials: WJ
authors.lastname: Taylor
authors.forename: Antonio
authors.initials: A
authors.lastname: Spadaro
authors.forename: Jose L
authors.initials: JL
authors.lastname: Fernàndez-Sueiro
authors.forename: Carlo
authors.initials: C
authors.lastname: Salvarani
authors.forename: Joachim R
authors.initials: JR
authors.lastname: Kalden
authors.forename: Ennio
authors.initials: E
authors.lastname: Lubrano
authors.forename: Sueli
authors.initials: S
authors.lastname: Carneiro
authors.forename: Francesca
authors.initials: F
authors.lastname: Desiati
authors.forename: John A
authors.initials: JA
authors.lastname: Flynn
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Angelo
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vacca
authors.forename: Arno W R
authors.initials: AW
authors.lastname: VAN Kuijk
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Catanoso
authors.forename: Mathias
authors.initials: M
authors.lastname: Gruenke
authors.forename: Rosario
authors.initials: R
authors.lastname: Peluso
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Parsons
authors.forename: Nicola
authors.initials: N
authors.lastname: Ferrara
authors.forename: Paolo
authors.initials: P
authors.lastname: Contu
authors.forename: Philip S
authors.initials: PS
authors.lastname: Helliwell
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Mease
mesh_terms: D000328:Adult; D015535:Arthritis, Psoriatic / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012867:Skin / Q000503:physiopathology; D011795:Surveys and Questionnaires