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Rheumatology 2002; 41: 38-45
© 2002 British Society for Rheumatology
Original Papers |
Rheumatoid Arthritis Severity Scale: a brief, physician-completed scale not confounded by patient self-report of psychological functioning
1 Department of Psychiatry, University of California, San Diego,
2 California School of Professional Psychology, San Diego,
3 Department of Medicine, University of California, San Diego and
4 Department of Family and Community Medicine, University of California, San Diego, California, USA
Objective. The purpose of this study was to develop a brief measure of severity for rheumatoid arthritis (RA) that would not be seriously confounded by psychological functioning. The Rheumatoid Arthritis Severity Scale (RASS), designed for use by physicians on their own patients, consists of three visual analogue scales: Disease Activity, Functional Impairment and Physical Damage.
Methods. Ninety-four RA outpatients completed the Health Assessment Questionnaire (HAQ) Disability, Pain Severity, Health State subscales and the Symptom Checklist-90—Revised (SCL-90-R) Anxiety, Depression and Somatization subscales. Rheumatologists completed the RASS on their own patients.
Results. Results suggest that the RASS is internally consistent (
=0.85) and valid. RASS Disease Activity, Functional Impairment, Physical Damage correlated with HAQ Disability (r=0.40, 0.68, 0.61; P<0.01), Pain (r=0.37, 0.34, 0.34; P<0.01) and Health State (r=-0.27, -0.36, -0.27; P<0.01). RASS Physical Damage uniquely predicted longer illness duration (years with RA). In contrast to the HAQ, RASS subscales shared less variance with anxiety, somatization and depression scores.
Conclusions. Preliminary data suggest that the RASS may be a quick, reliable, valid physician-completed RA severity scale that compares favourably with the longer, patient-completed HAQ.
KEY WORDS: Rheumatoid arthritis, Disease severity, Health status.
Correspondence to: W. A. Bardwell, University of California, Department of Psychiatry (0804), 9500 Gilman Drive, La Jolla, CA 92093-0804, USA.
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