title: Patient-reported outcomes in Asia: evaluation of the properties of the Rheumatoid Arthritis Impact of Disease (RAID) score in multiethnic Asian patients with rheumatoid arthritis.
abstract: Patient-reported outcomes (PROs) such as the Europe-developed Rheumatoid Arthritis Impact of Disease (RAID) are important to assess patients' quality of life. Their interpretation may be culture-dependent. To evaluate the potential utility of RAID in multiethnic Asian rheumatoid arthritis (RA) patients. Cross-sectional study of English-speaking RA patients in a Singapore tertiary center. Validity of RAID (scored between 0 and 10 with higher score indicating worse status) was assessed by Spearman's correlation with patient global assessment (PGA), DAS28 and short form 12 (SF-12). Consistency was assessed by Cronbach's alpha and test-retest reliability by intra-class correlation coefficient (ICC) 7 days after (n = 20). Feasibility was assessed by % of missing data. Eighty-two patients were analyzed: median age 53 years (Q1:Q3 44.7; 60.7), disease duration 4.2 years (1.4; 8.8), 66 (81%) women and 54 (66%) Chinese. Although RA was moderately active (median DAS28, 3.2 (2.5; 4.3)), RAID score was very low (median, 1.9 (0.6; 3.7)) with 44 (53.7%) patients having RAID score between 0 and 2. RAID was strongly correlated with PGA (r = 0.75), and moderately with other outcomes (DAS28 r = 0.46, SF12 physical r = -0.45 and SF12 mental r = -0.52, p < 0.0001 for all). Consistency was high (Cronbach's alpha = 0.91). Test-retest reliability was excellent; ICC = 0.84 (95% confidence interval 0.74-0.90). Feasibility was good with only 2 patients with missing data. Despite considerable floor effects, the RAID appeared to be a valid and practical PRO to assess the impact of RA in Asia. Multiethnic Asian patients may underestimate the impact of their disease compared to European patients.
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. peter_cheung@nuhs.edu.sg.|Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore, Singapore. peter_cheung@nuhs.edu.sg.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Cheung
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.|Division of Rheumatology, University Medicine Cluster, National University Health System, Singapore, Singapore.
authors.forename: Manjari
authors.initials: M
authors.lastname: Lahiri
authors.affiliation: Institute of Bone and Joint Research, University of Sydney, Camperdown, Australia.
authors.forename: Lyn
authors.initials: L
authors.lastname: March
authors.affiliation: Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Universités, UPMC Univ Paris 06, GRC-08, Paris, France.|Rheumatology Department, AP-HP, Pitié Salpêtrière Hospital, Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D000071066:Patient Reported Outcome Measures; D011379:Prognosis; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Asia; Burden of disease; EULAR; Patient-reported outcome; Rheumatoid arthritis