Background/Purpose:   PROMIS (Patient-Reported Outcomes Measurement Information System) is a self-reported and parent-reported measure of global, physical, mental, and social health for the general population and those living with chronic conditions. Recent studies have demonstrated preliminary evidence of reliability and construct validity of PROMIS to assess Rheumatoid arthritis (RA) symptoms, impact, and feasibility of use in clinical care. The performance of PROMIS domains in subgroups and relationship to other disease activity scores in RA however has not been established. The aim of our study was to compare Clinical Disease Activity Index (CDAI) scores with PROMIS scores overall as well as stratify for disease duration, age and gender in RA patients.

Methods:  This was a single center retrospective study. We analyzed the records of all RA patients seen over the last 6 months at the RA clinic in the University of Rochester. We compared the CDAI scores when available to the physical function (PF), pain interference (PI) and depression (Dep) PROMIS scores. We also calculated the effect of disease duration, age and gender on PROMIS PF, PI and Dep domains. Additionally, we compared the PROMIS scores of RA patients to a cohort of orthopedic patients with foot and ankle disease.

Results:  We identified a total of 144 patients with RA with a median age of 59 and median disease duration of 10 years. There were 108 females and 36 males. CDAI scores were available for 45 patients. The mean CDAI score was 8.2 (median 2.5). PF decreased while PI and depression worsened with increase in CDAI scores (see Table 1). Scores for Dep (52.1), PF (40.0) and PI (61.6) were also worse for those with disease duration of less than 1 year since diagnosis of RA (median 52.1 and 61.6) compared with those with 1-5 years, 6-10 years and more than 11 years with RA (see Table 2). No significant difference was noted in PROMIS scores based on gender. Similarly, no difference was noted in PROMIS scores for the different age groups: those less 40 years, 40-50, 51-60 and those over 60 years. Surprisingly, no difference was noted in the PROMIS scores between the RA cohort when compared to all rheumatology patients (n=370) and a cohort of patients with foot and ankle disease (n=25,690).

Conclusion:   Physical function, Pain Interference and depression PROMIS scores are associated with disease activity in RA patients as measured by CDAI. PROMIS scores are also affected by disease duration but not age or gender among RA patients. PROMIS is a valuable tool in the assessment of RA patients.

Table 1: relationship between CDAI and PROMIS scores

Table 2: Effect of disease duration on PROMIS score in RA patients

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-relationship-between-promis-and-cdai-scores-disease-duration-age-and-gender-in-patients-with-rheumatoid-arthritis/