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Rheumatology 2005 44(Supplement 3):iii6; doi:10.1093/rheumatology/keh738
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Supplement Article

OP13. EVALUATING OUTCOMES IN POLYMYALGIA RHEUMATICA: PATIENT-REPORTED, PHYSICIAN-REPORTED OR CLINICAL MEASURES?

A. Hutchings1,2, D. Lamping1, J. Hollywood2 and B. Dasgupta2

1 Health Services Research Unit, London School of Hygiene & Tropical Medicine, UK, 2 Rheumatology Department, Southend Hospital NHS Trust, UK

Background: Outcomes in rheumatological diseases have been evaluated using clinical, physician-reported and patient-reported measures. The few studies that have evaluated outcomes in PMR have focused on clinical outcomes or changes in steroid treatment, whereas no studies have examined quality of life (QOL) despite reports of a dramatic response to steroid treatment.

Methods: We recruited 129 patients with newly diagnosed PMR from 8 centres in England between July 2001 and May 2003. Patients were eligible if they met a modified version of the Jones and Hazleman criteria (duration of symptoms was excluded). We evaluated QOL before starting a standard schedule of steroid treatment and at 3 and 12 months using the Medical Outcomes Study 36-Item Short-Form (SF-36v2) as well as other patient-reported outcomes (Modified HAQ, duration of morning stiffness, VAS ratings of overall pain and impact of PMR), physician-reported outcomes (VAS rating of impact of PMR) and clinical measures (ESR, CRP). We examined correlations between patient-reported, physician-reported, and clinical measures.

Results: Before starting steroids correlations were poor between clinical measures and patient-reported (range r = –0.10 to 0.14) and physician-reported (0.09 to 0.19) measures and between patient- and physician-reported measures (0.01 to 0.37). At follow-up assessments, correlations remained poor between clinical measures and patient-reported (0.05 to 0.33) and physician-reported (0.06 to 0.25) measures, though correlations improved between patient- and physician-reported measures (0.29 to 0.73).

Conclusions: The poor correlations indicate that patient-reported, physician-reported and clinical measures assess different aspects of outcome in PMR. These findings highlight the importance of evaluating patient-reported outcomes in studies of treatment in PMR.


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