Session Information
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: NIH’s PROMIS (Patient-Reported Outcomes Measurement Information System) measures have the potential to improve and expand outcomes measurement in SLE, but have not been tested on a large scale in lupus.
Methods: Data were from the California Lupus Epidemiology Study (CLUES), a population-based, multi-ethnic SLE cohort. All subjects’ diagnoses were physician-confirmed. Subjects participated in a structured interview administered by a trained interviewer. Nine PROMIS short-forms (Table 1) were administered and scored to derive T-scores scaled to population means of 50 and SD of 10. Race and ethnicity were self-reported. Score distributions were examined. Deficits in function were defined as scores 1 SD “worse” than the population mean. Means (±SDs) were calculated for the total sample and by racial/ethnic group. Correlations with self-reported disease activity (Systemic Lupus Activity Questionnaire; SLAQ) and damage (Brief Index of Lupus Damage; BILD) were examined. We expected moderate to large correlations of current functioning with SLAQ, but small correlations with BILD. Differences in mean scores by race/ethnicity were tested by ANOVA and then in multivariable regression analyses controlling for age, sex, education, and poverty.
Results: To date, data from 197 individuals are available. The sample is 31% white, 22% Hispanic, 14% African American, and 33% Asian; 89% female; mean age 46 (±10) years; 13% with education ≤high school; 13% with poverty-level income; mean SLAQ score 8.2 (±7.3); and median BILD score 1 (IQR 0, 3). With the exception of Pain Intensity, mean scores were ±3 points of the population mean (Table 1). Correlations with disease activity (SLAQ) ranged from |0.47| — |0.73|. Correlations with disease damage (BILD) were lower, ranging from |0.1| — |0.3|, except for physical function (r=-0.38). Fewer than 5% of scores were at scale floors but relatively high proportions scored at the ceiling for 6 scales. Except for Pain Intensity, 17-30% had scores one SD worse than the population mean. In bivariate analyses, significant differences existed among racial/ethnic groups, but differences disappeared after adjusting for sociodemographic characteristics.
Conclusion: These 9 PROMIS short forms appear to function well in this multi-ethnic cohort of SLE patients. Few scores were at the scale floor, but relatively high portions were at the ceiling, suggesting potential weakness of the scales in measuring higher positive levels of function. Means were not substantially different than population means, but relatively large portions of the cohort exhibited deficits in physical and social functioning. Correlations with current disease activity were moderate to large, and correlations with disease damage were small, as expected. Differences in scores among racial/ethnic groups appear to be explained by differences in socioeconomic characteristics.
| Table 1 | |||||||||||
|
Mean ± SD T-score |
|
Correlation with: |
|
||||||||
| Scale |
Total (n=197) |
White (n=60) |
Hispanic (n=44) |
Black (n=28) |
Asian (n=65) |
p-value * |
SLAQ |
BILD |
% at “worst” score |
% at “best” score |
% with deficit † |
| PF |
47.4 ± 9.6 |
49.8 |
46.1 |
41.9 |
49.9 |
.004 |
-0.69 |
-0.38 |
1.0 |
21.3 |
28.0 |
| PIn |
42.1 ± 9.8 |
42.7 |
44.1 |
46.7 |
37.5 |
<.0001 |
0.66 |
0.10 |
0.5 |
33.0 |
4.1 |
| PIf |
52.6 ± 9.5 |
52.5 |
54.4 |
56.0 |
49.1 |
.003 |
0.65 |
0.18 |
2.0 |
36.6 |
20.3 |
| F |
52.6 ± 11.3 |
53.1 |
52.9 |
54.2 |
48.9 |
.08 |
0.73 |
0.12 |
4.1 |
16.8 |
26.4 |
| SD |
51.5 ± 9.3 |
51.1 |
52.4 |
52.6 |
49.9 |
.44 |
0.47 |
0.10 |
2.0 |
5.1 |
16.8 |
| SI |
52.5 ± 10.4 |
52.2 |
52.1 |
54.1 |
51.0 |
.61 |
0.63 |
0.09 |
0.5 |
5.1 |
22.5 |
| CA |
47.7 ± 8.1 |
50.1 |
46.9 |
45.1 |
48.6 |
.04 |
-0.48 |
-0.20 |
1.5 |
13.2 |
20.6 |
| SSR |
51.4 ± 11.1 |
51.6 |
50.6 |
48.8 |
53.6 |
.25 |
-0.61 |
-0.17 |
3.4 |
25.6 |
30.4 |
| PSR |
49.7 ± 9.5 |
50.7 |
49.7 |
46.2 |
52.2 |
.05 |
-0.64 |
-0.28 |
2.1 |
23.6 |
19.2 |
| Note: Only data from English-speaking participants is shown. PF = Physical Function PIn = Pain Intensity PIf = Pain Interference F = Fatigue SD = Sleep Disturbance SI = Sleep Impairment CA = Cognitive Ability SSR = Satisfaction with Social Roles PSF = Participation in Social Roles • p-value from comparison of racial/ethnic group means using ANOVA † Deficit defined as T-score 1 SD worse than population mean of 50. In a normal distribution, 16% of scores would be expected to fall in this range. Differences between racial/ethnic groups were not significant. | |||||||||||
To cite this abstract in AMA style:
Katz PP, Yazdany J, Trupin L, Rush S, Lanata C, Helmick CG, Criswell LA, Dall'Era M. Performance of Promis Measures in a Multi-Ethnic Population-Based Systemic Lupus Erythematosus (SLE) Cohort [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/performance-of-promis-measures-in-a-multi-ethnic-population-based-systemic-lupus-erythematosus-sle-cohort/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/performance-of-promis-measures-in-a-multi-ethnic-population-based-systemic-lupus-erythematosus-sle-cohort/