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A preliminary evaluation of the dimensionality and clinical importance of pain and disability in osteoarthritis of the hip and knee

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Summary

Current methods of clinical assessment in osteoarthritis show a high degree of variability. By contrast, patients with rheumatoid arthritis may be evaluated using a number of standardised and validated indices. One hundred patients with primary osteoarthritis of the hip and knee were interviewed in order to determine the dimensionality of their discomfort and disability and to define the clinical importance of each component item. The symptomatology of osteoarthritis was captured by five pain, one stiffness, twentytwo physical, eight social and eleven emotional items. In spite of a high degree of variability in the frequency of involvement of the individual items, their clinical importance was similar both within as well as across dimensions. Further studies are indicated to determine the reliability, validity and responsiveness of each of the items identified as a prelude to developing a standardized method of assessing patients with osteoarthritis of the hip and knee.

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References

  1. Baum, J. A review of the psychological aspects of rheumatic disease. Semin Arthritis Rheum. 1982, 11, 352–361.

    Article  PubMed  CAS  Google Scholar 

  2. Cumey, H.L.F. Osteoarthritis of the hip joint and sexual activity. Ann Rheum Dis. 1970, 29, 488–493.

    Article  PubMed  Google Scholar 

  3. Lunghi, M.E., Miller, P.M., McQuillan, W.M. Psychological factors in osteoarthrosis of the hip. J Psychosom Res, 1978, 22, 55–63.

    Article  Google Scholar 

  4. Bellamy, N., Buchanan, W.W. Outcome measurement in osteoarthritis clinical trials: The case for standardisation. Clin Rheumatol, 1984, 3, 293–303.

    Article  PubMed  CAS  Google Scholar 

  5. Convery, F.R., Minteer, M.A., Amiel, D., Connett, K.L. Polyarticular disability: A functional assessment. Arch Phys Med Rehabil, 1977, 58, 494–499.

    PubMed  CAS  Google Scholar 

  6. Deniston, O.L., Jette, A. A functional status assessment instrument: Validation in an elderly population. Health Serv Res. 1980, 15, 21–34.

    PubMed  CAS  Google Scholar 

  7. Doyle, D.V., Dieppe, P.A., Scott, J., Huskisson, E.C. An articular index for the assessment of osteoarthritis. Ann Rheum Dis. 1981, 40, 75–78.

    Article  PubMed  CAS  Google Scholar 

  8. Eberl, D.R., Fasching, V., Rahlafs, V., Schleyer, I., Wolfe, R. Repeatability and objectivity of various measurements in rheumatioid arthritis. Arthritis Rheum. 1976, 19, 1278–1286.

    Article  PubMed  CAS  Google Scholar 

  9. Empire Rheumatism Council. Multicentre controlled trial comparing cortisone acetate and acetyl salicylic acid in the long-term treatment of rheumatoid arthritis. Ann Rheum Dis. 1955, 14, 353–370.

    Article  Google Scholar 

  10. Fries, J.F., Spitz, P., Kraines, R.G., Homan, H.R. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980, 23, 137–145.

    Article  PubMed  CAS  Google Scholar 

  11. Jette, A.M. Functional capacity evaluation: An empirical approach. Arch Phys Med Rehabil. 1980, 61, 85–89.

    PubMed  CAS  Google Scholar 

  12. Jette, A.M. Functional status index: Reliability of a chronic disease evaluative instrument. Arch Phys Med Rehabil. 1980, 62, 395–401.

    Google Scholar 

  13. Jette, A.M., Deniston, O.L. Interobserver reliability of a functional status instrument. J Chronic Dis. 1978, 31, 573–580.

    Article  PubMed  CAS  Google Scholar 

  14. Katz, S., Akpom, C.A. A measure of primary sociobiological functions. Int J Health Serv. 1976, 6, 493–507.

    Article  PubMed  CAS  Google Scholar 

  15. Katz, S., Downs, T.D., Cash, H.R., Grotz, R.C. Progress in development of the index of ADL. Gerontologist. 1970, 1, 20–30.

    Google Scholar 

  16. Katz, S., Ford, A.B., Moskiwitz, R.W., Jackson, B.A., Jaff, M.W. Studies of illness in the aged. The index of ADL: A standardised measure of biological and psychosomal function. JAMA. 1963, 914–919.

  17. Keitel, W., Hoffman, H., Weber, G. Ermittlung der prozentualen Funktionsminderung der Gelenke durch einen Bewengungsfunkionstest in der Rheumatologie. Dtsch Gesundheitsw. 1971, 26, 1901–1903.

    PubMed  CAS  Google Scholar 

  18. Lansbury, J. A method for summation of the systemic indices of rheumatoid activity. Am J Med Sci. 1956, 232, 300.

    Article  PubMed  CAS  Google Scholar 

  19. Lansbury, J. Report of a three-year study on the systemic and articular indexes in rheumatoid arthritis — Theoretical and clinical considerations. Arthritis Rheum. 1958, 1, 505–522.

    Article  PubMed  CAS  Google Scholar 

  20. Lansbury, J., Baier, H.N., McCracken, S. Statistical study of variation in systemic and articular indices. Arthritis Rheum. 1962, 5, 445–456.

    Article  PubMed  CAS  Google Scholar 

  21. Lansbury, J., Mueller, E.E. A numerical method for summing up total deformity, Am J Med Sci. 1958, 235, 154.

    Article  PubMed  CAS  Google Scholar 

  22. Lee, P., Jasani, M.K. Dick, W.C., Buchanan, W.W. Evaluation of a functional index in rheumatoid arthritis. Scand J Rheumatol. 1973, 2, 71–77.

    Article  PubMed  CAS  Google Scholar 

  23. Lee, P., Webb, J., Anderson, J., Buchanan, W.W. Method of assessing therapeutic potential of antiinflammatory anti-rheumatic drugs in rheumatoid arthritis. Br Med J 1973, 2, 685–688.

    Article  PubMed  CAS  Google Scholar 

  24. Lequesne, M. European guidelines for clinical trials of new antirheumatic drugs. Eular Bulletin. 1980, 9 (Suppl 6), 171–175.

    Google Scholar 

  25. Meenan, R.F., Gertman, P.M., Mason, J.H. Measuring health status in arthritics. The arthritis impact measurement scales. Arthritis Rheum. 1980, 23, 146–152.

    Article  PubMed  CAS  Google Scholar 

  26. Ritchie, D.M., Boyle, J.A., McInnes, J.M., Jasani, M.K., Dalakos, T.G., Grieveson, P., Buchanan, W.W. Clinical studies with and articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. 1968, Q J Med. 147, 393–406.

    Google Scholar 

  27. Smythe, H.A., Helewa, A., Goldsmith, C.H. Independent assessor and pooled index as techniques for measuring treatment effects in rheumatoid arthritis. J Rheumatol, 1977, 4, 144–152.

    PubMed  CAS  Google Scholar 

  28. Steinbrocker, O., Traeger, C.H., Batterman, R.C. Therapeutic criteria in rheumatoid arthritis. JAMA, 1949, 140, 659–662.

    CAS  Google Scholar 

  29. Taylor D. A table for the degree of involvement in chronic arthritis. Can Med Assoc J. 1977, 36, 608–610.

    Google Scholar 

  30. The Co-operating Clinics Committee of the American Rheumatism Association. A seven-day variability study of 449 patients with peripheral rheumatoid arthritis. Arthritis Rheum. 1965, 8, 302–335.

    Article  Google Scholar 

  31. Tugwell, P.X., Bombardier, C., Chambers, L.W. MACTAR Functional assessment questionnaire. Monograph — McMaster University — Department of Clinical Epidemiology and Biostatistics, 1981.

  32. Chambers, L.W. McMaster Health Index Questionnaire (MHIQ). Monograph — McMaster University — Department of Clinical Epidemiology and Biostatistics. 1980.

  33. Moskowitz, R.W. Clinical and laboratory findings in osteoarthritis. In: Arthritis and Allied Conditions. Ed. McCarty, D.J. Philadelphia, Lea & Febiger, 1979, 1161–1180.

    Google Scholar 

  34. Melzack, R. Concepts of pain measurement. In: Pain Measurement and Assessment. Ed. Melzack, R. New York, Raven Press, 1985, 1–5.

    Google Scholar 

  35. International classification of impairments, disabilities and handicaps. Geneva, World Health Organization. 1980, 7–174.

  36. Kremer, E.F., Block, A., Atkinson, J.H. Assessment of pain behaviour, factors that distort self-report. In: Pain Measurement and Assessment. Ed. Melzack, R. New York, Raven Press, 1985, 165–171.

    Google Scholar 

  37. Davis, G.C., Buchsbaum, M.S., Burney, W.E. Naloxone decreases diurnal variations in pain sensitivity and somatosensory-evoked potentials. Life Sci. 1978, 23, 1449–1459.

    Article  PubMed  CAS  Google Scholar 

  38. Simpson, H.W., Bellamy, N., Bohlen, J., Halberg, F. Double-blind field trial of a potential chronobiotic (Quiadon). Int J Chronobiol. 1973, 1, 287–311.

    PubMed  CAS  Google Scholar 

  39. Bellamy, N. Between-subject variability in response to antirheumatic drugs: Implications for clinical trials. Agents Actions. 1985, (In Press).

  40. Melzack, R. The McGill pain questionnaire. In: Pain Measurement and Assessment. Ed. Melzack, R. New York, Raven Press, 1985, 41–48.

    Google Scholar 

  41. Brook, R.H., Ware, J.E., Davies-Avery, A., Stewart, A.L., Donald, C.A., Rogers, W.K., Williams, K.N., Johnston, S.A. Overview of adult health status measures fielded in Rand's health insurance study. Med Care, 1979, 17 (Suppl 7), 1–131.

    Google Scholar 

  42. Deyo, R.A. Measuring functional outcomes in therapeutic trials for chronic disease. Controlled Clinical Trials. 1984, 5, 223–240.

    Article  PubMed  CAS  Google Scholar 

  43. Bellamy, N. The clinical evaluation of osteoarthritis in the elderly. In: Clinics in Rheumatic Diseases. Ed. Kean, W.F. Eastbourne, W.B. Saunders. 1986, (In Press).

  44. Carmines, E.G., Zeller, R.A. Reliability and validity assessment. Beverley Hills, Sages Publications, 1979, 5–71.

    Google Scholar 

  45. Forman, M.D., Malamet, R., Kaplan, E. A survey of osteoarthritis of the knee in the elderly. J Rheumatol. 1983, 10, 282–287.

    PubMed  CAS  Google Scholar 

  46. Bellamy, N. Osteoarthritis — An evaluative index for clinical trials. M.Sc. Thesis, Hamilton, Canada, McMaster University. 100–104.

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Bellamy, N., Buchanan, W.W. A preliminary evaluation of the dimensionality and clinical importance of pain and disability in osteoarthritis of the hip and knee. Clin Rheumatol 5, 231–241 (1986). https://doi.org/10.1007/BF02032362

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