title: Lupus Impact Tracker is responsive to physician and patient assessed changes in systemic lupus erythematosus.
abstract: OBJECTIVE
  To evaluate the responsiveness of Lupus Impact Tracker (LIT) to changes in physician and patient disease activity assessments over time.
  
  
  METHODS
  Available longitudinal data from routine patient care visits on LIT, physician assessed disease activity (physician global assessment (PGA), SELENA-SLEDAI score, SELENA Flare Index (SFI)), and patient-reported changes in systemic lupus erythematosus (SLE) health status were analyzed. Significant, clinically important change (worsening or improvement) in physician disease activity assessment or patient-reported SLE health status were judged using the following criteria: change of 0.3 on PGA, 4 on SELENA-SLEDAI, change in SFI status over time, and change of 2 in either direction in patient-reported SLE health status. Mixed model regression analysis was used to compare changes in LIT using the above criteria.
  
  
  RESULTS
  There were 1184 observations with significant changes in physician disease activity or patient-reported measure for 182 patients' data across 1364 visits. Patients' mean (SD) age and SELENA-SLEDAI were 43.5 (13.2) years and 6.4 (7.3) respectively. LIT mean scores decreased by more than 3 with improvement in PGA (standardized response mean -0.26, p < 0.05), while it increased by more than 5 with worsening in SELENA-SLEDAI (standardized response mean 0.42, p = 0.01). Mean change in LIT of greater than ±3 was noted with change in SFI status (p < 0.05). Mean LIT score decreased by greater than 4 and increased by greater than 2 with patient-reported improvement and worsening in SLE health status respectively (p < 0.05).
  
  
  CONCLUSIONS
  LIT is responsive to physician-assessed and patient-assessed changes in disease status. A mean LIT change of 2-4 may represent a significant clinical change in LIT. It is an effective tool that may be used by patients and physicians in tracking disease impact in SLE patients.
authors.affiliation: Division of Rheumatology, Rush University Medical Center, Chicago, USA.
authors.forename: D
authors.initials: D
authors.lastname: Giangreco
authors.affiliation: Department of Internal Medicine and Systemic Diseases, Centre Hospitalier Universitaire de Dijon, Dijon, France.
authors.forename: H
authors.initials: H
authors.lastname: Devilliers
authors.affiliation: Division of Rheumatology and Immunology, Vanderbilt University, Nashville, USA.
authors.forename: N
authors.initials: N
authors.lastname: Annapureddy
authors.affiliation: Division of Rheumatology, Rush University Medical Center, Chicago, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Block
authors.affiliation: Division of Rheumatology, Rush University Medical Center, Chicago, USA Meenakshi_Jolly@rush.edu.
authors.forename: M
authors.initials: M
authors.lastname: Jolly
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D010820:Physicians; D015203:Reproducibility of Results; D057566:Self Report; D012720:Severity of Illness Index; D012984:Software
keywords: Systemic lupus erythematosus; disease activity; outcomes research