Sensitivity and specificity of assessment instruments of quality of life in rheumatoid arthritis

Abstract

ABSTRACT Objective: To check sensitivity and specificity of assessment instruments of QoL in patients with rheumatoid arthritis (RA). Methodology: Accuracy study in a sample consisting of patients with confirmed diagnosis of RA. QoL questionnaires QV SF-36 (Gold Standard), HAQ and NHP were applied. The Pearson correlation coefficient, ROC curve, AUC and Youden Index (J) were used to analyze the data. Results: This study enrolled 97 individuals with RA. The functional capacity estimated by SF-36 was correlated with the total score of HAQ (r = −0.666; p < 0.001; J = 0.579), while the emotional aspects of SF-36 were correlated with the emotional reactions domain of NHP (r = −0.316; p = 0.005; J = 0.341). The vitality domain of SF-36 was correlated with the level of energy of NHP (r = −0.362; p = 0.001; J = 0.302). For the evaluation of functional capacity (AUC = 0.839; p < 0.001) and physical aspect (AUC = 0.755; p < 0.001) the most accurate instrument was the HAQ. For evaluation of the impact of vitality, sleep (AUC = 0.679; p = 0.007), emotional reactions (AUC = 0.674; p = 0.009) and level of energy in QoL, the NHP (AUC = 0.633; p = 0.045) was the most specific and sensitive. In the evaluation of the emotional aspect domain, the most accurate instrument was the NHP in the “emotional reaction” score (AUC = 0.699; p = 0.003). The evaluation of pain was limited in the three instruments and SF-36 was the only one in assess of the domains of social aspects and general health status. Conclusion: For evaluation of the physical aspects in patients with RA, the HAQ is the most accurate. For evaluation of emotional aspects the NHP is the most indicated, although the SF-36 was the only one in the evaluation of general domains.

Keywords

• Rheumatoid arthritis
• Accuracy
• Questionnaires
• Quality of life
• Evaluation