Article Text
Abstract
Background Pn is a group of heterogeneous inflammatory diseases characterized by involvement of the subcutaneous fat (SF), locomotor system and viscera, and the number of panniculitis (Pn) cases is increasing in everyday practice of a rheumatologists.
There are no specific scales available to assess efficacy of Pn therapy. EQ-5D, RAPID-3 and HADS validity, sensitivity and specificity were proven for some rheumatic diseases. Thus, evaluation of EQ-5D, RAPID-3 and HADS psychometric properties in Pn patients has become the objective of this study.
Objectives Evaluate psychometric properties of questionnaires EQ-5D, RAPID-3 and HADS in Pn patients.
Methods The study group included 83 Pn pts (80 females, 3males) aged 43,4±13,9 years with median disease duration of 5 [2;24] months who were at the record of V. A. Nasonova Research Institute of Rheumatology during 2009–2015 yy. All patients filled in EQ-5D, RAPID-3 and HADS questionnaires during the first and the control visits at 12 months. Questionnaires' sensitivity was assessed by comparing patient's answers and objective response to therapy measured by achievement of complete regression of the nodules on the control visit. The construct validity was measured based on correlation with “external criteria”, including presence of arthritis and arthralgias, tenderness of nodules at palpation measured by VAS, ESR and CRP values.
Results Positive dynamics (nodule regression) correlated with improved EQ-5D (EQ-5D-scale - p=0,005, EQ-5D-VAS - p=0,004) and RAPID-3 (p=0,0011). Median Δ EQ-5D and HADS-depression after therapy were 0,27 [0,12; 0,45] (p=0,005), and 2 [1;5] (p=0,13) scores, respectively, while average decline in RAPID-3 and HADS-anxiety scores after therapy was 9,2±5,2 (p=0,0011) and 4±3 (p=0,15), respectively. EQ-5D showed the greatest power in Pn patients' quality of life assessment. EQ-5D-scale and VAS-“thermometer” showed moderate correlation with nodule tenderness at baseline (r= -0,23, p=0,036) & (r= -0,45, p=0,0003), and control visits (12 months) (r= -0,38, p=0,0002) & (r= -0,41, p=0,0002); EQ-5D-scale showed moderate correlation with ESR and CRP values at the control visit (r= -0,23, p=0,03) & (r= -0,25, p=0,005), and EQ-VAS – with CRP value at 12 months (r= -0,33, p=0,002), demonstrating clear correlation with patient's objective health status and lab parameters values. Moderate correlation between functional RAPID-3 values and nodule tenderness at baseline (r=0,34, p=0,0015) and after 12 months (r=0,5, p<0,0001) are also indicative of close links between the questionnaire data and pts' objective health status. As for the HADS scale, moderate correlation was found only between HADS-depression and nodule tenderness at baseline (r= -0,24, p=0,026) and 12 months (r=0,28, p=0,014) visits. There were no other significant correlations identified.
Conclusions EQ-5D and RAPID-3 questionnaires should be considered as valid and sensitive instruments for the assessment of the quality of life and efficacy of therapy in Pn pts.
Disclosure of Interest None declared