Methods: We enrolled RA patients at the Denver Health rheumatology clinic in our study. Subjects completed the traditional written PtGA and GH and one of the verbal assessments. Subjects provided a verbal numeric response after reading the question, having the question read to them in person, or hearing the question over the phone. Spearman correlations comparing written and verbal assessments were determined. Multivariate logistic regression was performed to explain any discrepancies.

Results: Our subjects (n=300) were predominantly female, unmarried and currently unemployed. This cohort was diverse, consisting of approximately half non-white and 58% Hispanic. Limited HL was a common finding as 28% of patients had either inadequate or marginal HL. The verbally administered instruments showed good, but not excellent, correlation with traditional written VAS forms (Spearman coefficients 0.59 to 0.74; p<0.001 for all correlations). Approximately one-third of patients provided verbal PtGA and GH responses that were discrepant by more than 2 standard deviations with their PtGA-VAS and GH-VAS, respectively. Twenty-three percent of subjects were unable to complete the one of the VAS assessments without assistance. HL predicted missing written data and discrepancies between verbal and written assessments (p<0.05 for all correlations, see Table). Conclusion: Verbally-administered PtGA and GH are appropriate for use in population based-studies and randomized control trials, where the results are important for the cohort as a whole. Providers should use verbal versions of PtGA and GH with caution while caring for individual patients unable to complete traditional written version. Limited HL is widely prevalent and a barrier to obtaining patient-oriented data.