Ivette Essers1,2, Annelies Boonen3,2, Matthias Busch3, Désirée van der Heijde4, Andras P Keszei5, Robert Landewé6,7, Sofia Ramiro4, Astrid van Tubergen3,2. 1. Department of Rheumatology, Maastricht University Medical Center, Maastricht ivette.essers@maastrichtuniversity.nl. 2. School for Public Health and Primary Care, University of Maastricht, Maastricht. 3. Department of Rheumatology, Maastricht University Medical Center, Maastricht. 4. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. 5. Department of Medical Informatics, Uniklinik RWTH Aachen, Aachen, Germany. 6. Department of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, Amsterdam. 7. Department of Rheumatology, Atrium Medical Center, Heerlen, The Netherlands.
Abstract
OBJECTIVE: To evaluate in patients with AS (i) the fluctuation in self-reported disease activity (BASDAI), patient global well-being [visual analogue scale (VAS)-global] and spinal pain (VAS-pain) during 2 years of follow-up on a group level and (ii) the clinical relevance of these fluctuations on a patient level. METHODS: Dutch patients from the Outcome in AS International Study cohort completed patient-reported outcome measures every 2 months over 2 years. On the group level, mixed linear models were used to analyse whether the outcome measures were constant over time. On a patient level, relevant changes in scores were assessed by the frequency in which changes would exceed predefined cut-off values (>1.0 or >2.0 on a 0-10 scale) during the 2 years of follow-up using 2-, 4-, 6-, 12- or 24-month assessments. RESULTS: Ninety patients [median age 47.3 years (sd 11.4), 67.8% male, symptom duration 25.2 years (sd 11.3)] were included. On the group level, the outcome measures remained constant over time. However, large fluctuations were found on the patient level. For example, using 2 month intervals, 92% and 69% of the patients had at least one change of > 1.0 or > 2.0, respectively, in the BASDAI during the 2 year follow-up. When prolonging the interval, the proportion of changes exceeding the cut-off decreased, indicating that information is lost. Similar results were found for the VAS-global and VAS-pain. CONCLUSION: Substantial fluctuations in BASDAI, VAS-global and VAS-pain were found in individuals over time. With longer intervals, fewer fluctuations were observed, indicating that relevant changes might be missed.
OBJECTIVE: To evaluate in patients with AS (i) the fluctuation in self-reported disease activity (BASDAI), patient global well-being [visual analogue scale (VAS)-global] and spinal pain (VAS-pain) during 2 years of follow-up on a group level and (ii) the clinical relevance of these fluctuations on a patient level. METHODS: Dutch patients from the Outcome in AS International Study cohort completed patient-reported outcome measures every 2 months over 2 years. On the group level, mixed linear models were used to analyse whether the outcome measures were constant over time. On a patient level, relevant changes in scores were assessed by the frequency in which changes would exceed predefined cut-off values (>1.0 or >2.0 on a 0-10 scale) during the 2 years of follow-up using 2-, 4-, 6-, 12- or 24-month assessments. RESULTS: Ninety patients [median age 47.3 years (sd 11.4), 67.8% male, symptom duration 25.2 years (sd 11.3)] were included. On the group level, the outcome measures remained constant over time. However, large fluctuations were found on the patient level. For example, using 2 month intervals, 92% and 69% of the patients had at least one change of > 1.0 or > 2.0, respectively, in the BASDAI during the 2 year follow-up. When prolonging the interval, the proportion of changes exceeding the cut-off decreased, indicating that information is lost. Similar results were found for the VAS-global and VAS-pain. CONCLUSION: Substantial fluctuations in BASDAI, VAS-global and VAS-pain were found in individuals over time. With longer intervals, fewer fluctuations were observed, indicating that relevant changes might be missed.
Authors: Maike Imkamp; Valéria Lima Passos; Annelies Boonen; Suzanne Arends; Maxime Dougados; Robert Landewé; Sofia Ramiro; Filip Van den Bosch; Desirée van der Heijde; Freke R Wink; Anneke Spoorenberg; Astrid van Tubergen Journal: RMD Open Date: 2018-11-14
Authors: Esther Beckers; Annelies Boonen; Casper Webers; Peter Ten Klooster; Harald Vonkeman; Monique Efdé; Astrid van Tubergen Journal: Rheumatology (Oxford) Date: 2022-04-11 Impact factor: 7.580