title: Health-related quality of life and utility: comparison of ankylosing spondylitis, rheumatoid arthritis, and systemic lupus erythematosus patients in Taiwan.
abstract: The purpose of this study was to evaluate the health-related quality of life among patients with ankylosing spondylitis (AS), rheumatoid arthritis (RA), or systemic lupus erythematosus (SLE). This prospective, cross-sectional survey was conducted from September 1, 2008 to August 31, 2009. Patients answered questions with regard to demographics and disease characteristics and also completed generic (SF-36) and preference-based utility (SF-6D and EQ-5D) instruments. Multivariate analysis assessed the relationship of RA and SLE to AS with respect to the outcomes of the different health-related quality of life instruments. In general, baseline and disease characteristics differed across the three disease groups. Compared to SLE patients, RA patients scored worse on the higher-order summary scores of physical (PCS) and mental components (MCS) of SF-36 (P ≤ 0.002) and total SF-36 (P ≤ 0.005). RA also had worse PCS than AS (P ≤ 0.001). SLE patients scored higher on the utility score of SF-6D compared with RA patients and higher than both AS and RA patients for the utility score of EQ-5D. Multivariate analysis found that compared with AS patients, RA had significantly lower SF-36 total score and PCS, and SLE patients had greater PCS and a greater EQ-5D utility score. Multivariate analysis found no difference across the patient groups with respect to MCS or SF-6D utility score. These findings suggest that among the three rheumatic diseases studied, RA patients have the worse health-related quality of life, and AS patients have similar or poorer health-related quality of life as SLE patient.
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung, 40705, Taiwan. shc5555@hotmail.com.|Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan. shc5555@hotmail.com.|School of Medicine, National Yang-Ming University, Taipei, Taiwan. shc5555@hotmail.com.|Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. shc5555@hotmail.com.|School of Medicine, Chung-Shan Medical University, Taichung, Taiwan. shc5555@hotmail.com.|Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan. shc5555@hotmail.com.|Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan. shc5555@hotmail.com.
authors.forename: Hsin-Hua
authors.initials: HH
authors.lastname: Chen
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung, 40705, Taiwan.|Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.|School of Medicine, Chung-Shan Medical University, Taichung, Taiwan.|Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Der-Yuan
authors.initials: DY
authors.lastname: Chen
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Taichung, 40705, Taiwan.|Institute of Biomedical Science and Rong Hsing Research Center for Translational Medicine, Chung-Hsing University, Taichung, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Chen
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Kuo-Lung
authors.initials: KL
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011594:Psychometrics; D011788:Quality of Life; D012720:Severity of Illness Index; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires; D013624:Taiwan
keywords: Ankylosing spondylitis; Health-related quality of life; Rheumatoid arthritis; Systemic lupus erythematosus