Chinese Patient Reported Index with Rheumatoid Arthritis (CPRI-RA): Reliability, Validity and Agreement with DAS28 and HAQ

Man Han¹, Xun Gong¹, Xiao-po Tang¹, Hong-xiao Liu², Jian Liu³, Xin-chang Wang⁴, Jun-li Zhang⁵, Shi Chen⁶, Qing-chun Huang⁷, Yong-fei Fang⁸, Qing-jun Wu⁹, Dong-yi He¹⁰, Zhen-bin Li¹¹, Yue Wang¹², Hong Jiang¹³, Ming-li Gao¹⁴, Wei Liu¹⁵, Ying Liu¹⁶, Ze-guang Li¹⁷, Zhong-wen Zhao¹⁸, Cheng-wu Wang¹⁹, Wei-chao Liu²⁰, Hai-dong Wang²¹, Yu-qian Lou²², Qing-liang Meng²³, Chong-jie Ruan²⁴, Yan-ming Xie²⁵ and Quan Jiang²⁶, ¹Rheumatology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China, ²Department of Rheumatology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China, ³The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Heifei, China, ⁴Rheumatology, The Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine, Hangzhou, China, ⁵Rheumatology, The Fifth Hospital of Xi’an City, Xi’an, China, ⁶Rheumatology, Peking University People's Hospital, Beijing, China, ⁷Rheumatology, Guangzhou Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China, ⁸Rheumatology, Southwest Hospital, Third Military Medical University, chongqing, China, ⁹Rheumatology, Peking Union Medical College Hospital, Beijing, China, ¹⁰Institute of Arthritis Research, Shanghai Academy of Chinese Medical Sciences, Guanghua Integrative Medicine Hospital, Shanghai, China, ¹¹Rheumatology, Bethune international peace hospital, Shi jiazhuang, China, ¹²Jiangsu Provincial Hospital of Traditional Chinese Medicine, Nanjing, China, ¹³Rheumatology, The Ninth People's Hospital of Chongqing City, Chongqing, China, ¹⁴Rheumatology, The First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, China, ¹⁵Department of Rheumatology and Immunology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China, ¹⁶Rheumatology, The Affiliated Hospital of Shangdong University of Traditional Chinese Medicine, Qingdao, China, ¹⁷Rheumatology, The First Affiliated Hospital of Hei Longjiang University of Traditional Chinese Medicine, Ha Erbin, China, ¹⁸Rheumatology, The Second People's Hospital of Fujian Province, Fujian, China, ¹⁹Rheumatology, The First Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, China, ²⁰Rheumatology, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China, ²¹Rheumatology, Gansu Provincial Hospital of Traditional Chinese Medicine, Shanxi, China, ²²Henan Rheumatism Hospital, Zhengzhou, China, ²³Rheumatology, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou, China, ²⁴Rheumatology and Pain Management Department, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China, ²⁵Clinical Evaluation Center, China Academy of Chinese Medical Sciences, Beijing, China, ²⁶Rheumatology Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Disease Activity, Health Assessment Questionnaire and patient outcomes

Session Information

Date: Monday, November 6, 2017

Title: Patient Outcomes, Preferences, and Attitudes Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The use of patient reported outcomes(PROs) has become increasingly popular in the chronic disease management, disease monitoring and the assessment of drug efficacy. However, very few studies on rheumatoid arthritis (RA) have come down to PROS in China. We initiated CPRI-RA based on Chinese RA population, which include not only arthritis symptoms, physical function but also fatigue, appetite, emotional wellness and self-efficacy. We aimed to measure the reliability and the validity of CPRI-RA and evaluate the correlation and agreement with DAS28 and HAQ.

Methods: Nationwide multicenter cross-sectional and longitudinal studies were designed to recruit RA patients who fulfilled 1987 ACR classification criteria. Demographics, clinical and laboratory data were collected and CPRI-RA, DAS-28 and HAQ were recorded. Intensive treated patients with moderately to severely active RA were followed up regularly for 12-week and 24-week periods to track the changes of CPRI-RA, DAS-28 and HAQ scores. The reliability was measured using the Cronbach α coefficient and the validity was analyzed by the construct validity using factor analysis method. Agreement between CPRI-RA and DAS28 was analyzed by the weighted kappa value. The correlation between CPRI-RA and DAS28, HAQ was analyzed by Pearson correlations. The linear mixed-effects model was adopted to analyze the dynamic correlation and consistency between the indices.

Results: A total of 1868 RA patients (83.08% women, mean±SD age 54.79±12.62 years, disease duration 6.18±7.68 years, DAS28 5.56±1.36) from 19 provinces and 23 hospitals completed the cross-sectional survey and 186 active RA patients(85.48% women, mean±SD age 48.18±10.61 years, disease duration 1.77±1.52 years, DAS28 5.71±1.06) participated in the longitudinal study. The overall Cronbach α value was 0.756 and the Guttman spit-half coefficient was 0.733, indicating CPRI-RA had good internal consistency and stability. Three factors extracted by factor analysis (cumulative 53.199%) reflected the physical status, social and psychological properties of RA patients, which provided evidence for good construct validity. HAQ versus CPRI-RA scores were significantly correlated (r=0.581, P<0.0001), and DAS28 versus CPRI-RA scores were significantly correlated at higher levels (r=0.640, P<0.0001). The weighted kappa value was 0.4215 (P <0.0001) for DAS28 versus CPRI-RA, indicating fair agreement of the indices. Dynamically, HAQ versus CPRI-RA scores and DAS28 versus CPRI-RA scores were both significantly correlated (r=0.4464, r=0.4622, P<0.0001). The dynamic trends of the three indices were highly consistent.

Conclusion: CPRI-RA, a reliable, feasible and valid PRO scale, can provide similar quantitative information to DAS28 and HAQ. The results support the incorporating of CPRI-RA into the routine assessment and dynamic monitoring of RA.

Disclosure: M. Han, None; X. Gong, None; X. P. Tang, None; H. X. Liu, None; J. Liu, None; X. C. Wang, None; J. L. Zhang, None; S. Chen, None; Q. C. Huang, None; Y. F. Fang, None; Q. J. Wu, None; D. Y. He, None; Z. B. Li, None; Y. Wang, None; H. Jiang, None; M. L. Gao, None; W. Liu, None; Y. Liu, None; Z. G. Li, None; Z. W. Zhao, None; C. W. Wang, None; W. C. Liu, None; H. D. Wang, None; Y. Q. Lou, None; Q. L. Meng, None; C. J. Ruan, None; Y. M. Xie, None; Q. Jiang, None.

To cite this abstract in AMA style:

Han M, Gong X, Tang XP, Liu HX, Liu J, Wang XC, Zhang JL, Chen S, Huang QC, Fang YF, Wu QJ, He DY, Li ZB, Wang Y, Jiang H, Gao ML, Liu W, Liu Y, Li ZG, Zhao ZW, Wang CW, Liu WC, Wang HD, Lou YQ, Meng QL, Ruan CJ, Xie YM, Jiang Q. Chinese Patient Reported Index with Rheumatoid Arthritis (CPRI-RA): Reliability, Validity and Agreement with DAS28 and HAQ [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/chinese-patient-reported-index-with-rheumatoid-arthritis-cpri-ra-reliability-validity-and-agreement-with-das28-and-haq/. Accessed .

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