title: The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The assessment of health-related quality-of-life (HRQoL) in rheumatoid arthritis (RA) is becoming increasingly common in both research and clinical practice. One of the most widely used tools for measuring HRQoL is the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). We conducted a systematic review examining the impact of RA on HRQoL, measured through the SF-36.
  
  
  METHODS
  MEDLINE and Embase were searched for observational studies reporting mean and standard deviation scores for each domain of the SF-36 in adult RA patients. Studies were reviewed in accordance with PRISMA guidelines, and a random-effects meta-analysis was performed.
  
  
  RESULTS
  In total, 31 studies were eligible for inclusion in the meta-analysis, including 22,335 patients. Meta-analyses found that pooled mean HRQoL score for the SF-36 physical component summary was 34.1 (95% CI: 22.0-46.1) and mental component summary was 45.6 (95% CI: 30.3-60.8). Increased age was associated with reduced physical function and physical component summary (PCS) scores but improved mental health and mental component summary (MCS) scores. Female gender was associated with improved scores on role physical, bodily pain and PCS but reduced mental health and MCS scores. Longer disease duration was associated with improved MCS. Patients with RA have a substantially reduced HRQoL in comparison to both other physical illnesses and in comparison to normative datasets from UK and USA populations.
  
  
  CONCLUSIONS
  RA has a substantial impact on HRQoL. This supports recent NICE guidelines stipulating that RA patients should be regularly assessed for the impact their disease has on HRQoL and appropriate management provided.
authors: Department of Psychological Medicine, Institute of Psychiatry, King׳s College London, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK. Electronic address: faith.matcham@kcl.ac.uk.
authors: Faith
authors: F
authors: Matcham
authors: Academic Department of Rheumatology, Centre for Molecular and Cellular Biology of Inflammation, King׳s College London, London, UK.
authors: Ian C
authors: IC
authors: Scott
authors: Department of Psychological Medicine, Institute of Psychiatry, King׳s College London, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK.
authors: Lauren
authors: L
authors: Rayner
authors: Department of Psychological Medicine, Institute of Psychiatry, King׳s College London, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ, UK.
authors: Matthew
authors: M
authors: Hotopf
authors: Department of Rheumatology, King׳s College London School of Medicine, King׳s College London, London, UK; Department of Rheumatology, University Hospital Lewisham, London, UK.
authors: Gabrielle H
authors: GH
authors: Kingsley
authors: Department of Psychology, King׳s College London, London, UK.
authors: Sam
authors: S
authors: Norton
authors: Department of Rheumatology, King׳s College Hospital, London, UK.
authors: David L
authors: DL
authors: Scott
authors: Department of Rheumatology, King׳s College Hospital, London, UK.
authors: Sophia
authors: S
authors: Steer
mesh_terms: D000367:Age Factors; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012680:Sensitivity and Specificity; D012737:Sex Factors
keywords: Health-related quality-of-life; Medical Outcomes Study 36-item Short-Form Health Survey; Meta-analysis; Rheumatoid arthritis; SF-36; Systematic review