Objective. The goal of this project was to develop a more comprehensive and sensitive version of the Arthritis Impact Measurement Scales (AIMS).Methods. AIMS scale items were revised, and 3 new scales were added to evaluate arm function, work, and social support. Sections were also added to assess satisfaction with function, attribution of problems to arthritis, and self-designation of priority areas for improvement. The new instrument was designated the -2.A pilot test of format and content and a performance test of reliability and validity were carried out.Results. Questionnaire completion times in a pilot study of 24 subjects averaged 23 minutes, and evaluations were positive regarding the instrument's length and ease of completion, and the subjects' willingness to complete serial forms and return them by mail. Mea- Submitted for publication February 20, 1991; accepted in revised form August 19, 1991. surement performance was tested in 408 subjects: 299 with rheumatoid arthritis (RA) and 109 with osteoarthritis (OA); 45 of these subjects completed a second AIMS2 within 3 weeks. Internal consistency coefficients for the 12 scales were 0.72-0.91 in the RA group and 0.74-0.96 in the OA group. Test-retest reliability was 0.78-0.94. All withm-scale factor analyses produced single factors, except for mobility level in OA. Validity analyses in both the RA and the OA groups showed that patient designation of an area as a problem or as a priority for improvement was significantly associated with a poorer AIMS2 scale score in that area. Reliability, factor analysis, and validity results were consistent in age, sex, and education subgroups. Satisfaction was moderately correlated with level of function in the same health status area, and the satisfaction items formed a reliable scale. Responses to the arthritis attribution items showed that most dysfunction in this sample was due to arthritis. Conclusion.The AIMS2 is a revised and expanded health status questionnaire with excellent measurement properties that should be useful in arthritis clinical trials and in outcomes research.
The Arthritis Impact Measurement Scales (AIMS) have been developed to assess the health status of arthritis patients. In this study, the self-administered AIMS questionnaire, which includes scales designed to measure the physical, psychologic, and social aspects of health status, was completed by 625 patients with various forms of arthritis. A comprehensive battery of analytic techniques was used to investigate the performance of these scales in this large sample. The results confirmed the reliability and validity of the AIMS instrument. They also showed that AIMS performs well ia at least 4 major types of arthritis, in a range of sociodemographic groups, and across time. These findings emphasize the strengths of the AIMS approach and suggest that the instrument will prove useful as a tool to assess arthritis outcome in a wide variety of clinical settings.The Arthritis Impact Measurement Scales (AIMS) are batteries of health status questions that are designed to assess the physical, emotional, and social well-being of individuals with rheumatic diseases. The self-administered AIMS instrument has been developed to improve the measurement of patient outcome in arthritis (1). Although the AIMS approach is based on previous work in health status measurement (2-6), the measurement properties of any new instrument must be documented before it is widely accepted and applied. Our preliminary findings on the AIMS instrument indicated acceptable levels of reliability and validity (7), but they were based on a relatively small sample size and were limited in analytic and clinical scope. This report reexamines the reliability and validity of the AIMS instrument through the use of a larger sample and a variety of additional analytic approaches. It presents new measures of test-retest reliability and estimates of construct validity, based on clinical data. This report also attempts to estimate the clinical applicability of the AIMS approach by providing the first descriptions of AIMS performance in the major rheumatic diseases, in various sociodemographic groups, and across time. MATERIALS AND METHODSInstrument description. The current AIMS instrument contains 45 health status questions, grouped into 9 component scales: Mobility, Physical Activity, Dexterity, Household Activities, Activities of Daily Living, Anxiety, Depression, Social Activity, and Pain. The scales contain 4-7 items, and each item, depending on the phrasing of the question, contains 2-6 possible responses. Item responses are summed by group to produce scale scores and then brought to a normal standard of 0-10 for further analysis. The instrument used was identical to that described in our original report, with 2 exceptions. First, the original Social Role scale has been renamed Household Activities to better reflect the contents of the scale. The items it contains are
A multidimensional index that measures the health status of individuals with arthritis has been developed. The Arthritis Impact Measurement Scales (AIMS) are a combination of previously studied and newly created health status scales which assess physical, emotional, and social well-being. The self-administered AIMS questionnaire has been pilot tested in a mixed arthritis population. Results indicate that the instrument is practical and that it generates scalable, reliable, and valid measures of both aggregated and disaggregated health status. The AIMS approach to health status measurement should prove useful for evaluating the outcomes of arthritis treatments and programs.The worth of a new medical practice or policy ultimately depends upon the effect it produces on health (1,2). Thus, the development of reliable, valid, and practical outcome measures is a priority area for health services research. Although the end results of health care can be assessed by measuring a variety of parameters such as satisfaction and cost, health status is the most important component of outcome (3,4).
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