The arthritis impact measurement scales. further investigations of a health status measure

Self Cite

780

484

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.

Section: Discussionmentioning

confidence: 99%

AIMS2. The Content and Properties of a Revised and Expanded Arthritis Impact Measurement Scales Health Status Questionnaire

Meenan

Mason

Anderson

et al. 1992

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780

484

“…At each assessment, demographic variables were recorded, including sex, age, ethnic origin, education level, current marital status, medical history, and total family income. Disease status and activity variables collected included the Stanford Health Assessment Questionnaire (HAQ) functional disability index (19,20), pain, global disease severity, and fatigue as recorded on visual analog scales (VAS) (21), the Arthritis Impact Measurement Scales (AIMS) anxiety and depression scales (22,23), and the Rheumatoid Arthritis Disease Activity Index (RADAI) (24)(25)(26). Patients also completed the Medical Outcomes Study Short Form 36 (SF-36), from which the physical component score (PCS) and the mental component score were calculated (27,28).…”

Section: Methodsmentioning

confidence: 99%

Direct medical costs and their predictors in patients with rheumatoid arthritis

Michaud¹,

Messer²,

Choi³

et al. 2003

248

147

Objective. To estimate total direct medical costs in persons with rheumatoid arthritis (RA) and to characterize predictors of these costs.Methods. Patients (n ‫؍‬ 7,527) participating in a longitudinal study of outcome in RA completed 25,050 semiannual questionnaires from January 1999 through December 2001. From these we determined direct medical care costs converted to 2001 US dollars using the consumer price index. We used generalized estimating equations to examine potential predictors of the costs. Monte Carlo simulations and sensitivity analyses were performed to evaluate the varying prevalence and cost of biologic therapy.Results. The mean total annual direct medical care cost in 2001 for a patient with RA was $9,519. Drug costs were $6,324 (66% of the total), while hospitalization costs were only $1,573 (17%). Approximately 25% of patients received biologic therapy. The mean total annual direct cost for patients receiving biologic agents was $19,016 per year, while the cost for those not receiving biologic therapy was $6,164. RA patients who were in the worst quartile of functional status, as measured by the Health Assessment Questionnaire, experienced direct medical costs for the subsequent year that were $5,022 more than the costs incurred by those in the best quartile. Physical status as determined by the Short Form 36 physical component scale had a similar large effect on RA costs, as did comorbidity. Medical insurance type played a more limited role. However, those without insurance had substantially lower service utilization and costs, and health maintenance organization patients had lower drug costs and total medical costs. Increased years of education, increased income, and majority ethnic status were all associated with increased drug costs but not hospitalization costs. Costs in all categories decreased after age 65 years.Conclusion. Estimates of direct medical costs for patients with RA are substantially higher than cost estimates before the biologic therapy era, and costs are now driven predominantly by the cost of drugs, primarily biologic agents. RA patients with poor function continue to incur substantially higher costs, as do those with comorbid conditions, and sociodemographic characteristics also play an important role in determination of costs.

“…The AIMS is a multidimensional index designed to measure the physical, emotional, and social wellbeing of patients with arthritis (8,9). This index is reliable and valid for the assessment of a variety of arthritic conditions (8).…”

Section: Methodsmentioning

confidence: 99%

“…5 (May 1993) 160 individuals from multiplex families (i.e., families in which 2 2 first-degree relatives had the disease) (familial AS) and I6O age-and sex-matched controls who had AS but did not have another member asked whether they were currently working outside the home. The Arthritis Impact Measurement Scales (AIMS) overall impact, physical activity, social, pain, depression, and anxiety scores (8,9) and the Ankylosing Spondylitis Assessment Questionnaire (ASAQ) score (10) were calcuwith the disease (sporadic AS).…”

mentioning

confidence: 99%

Familial versus sporadic ankylosing spondylitis. two different diseases?

Calin

Kennedy

Edmunds

et al. 1993

Objective. To define potential differences and the possible contribution of susceptibility or severity genes in familial versus sporadic ankylosing spondylitis (AS).Methods. Three hundred twenty patients with AS were studied: 160 who had first-degree relatives with AS (familial) and 160 age-and sex-matched controls who had no first-degree relative with the disease (sporadic). Disease expression in the two groups was evaluated using an index of physical, psychological, and social functioning (the Arthritis Impact Measurement Scales [AIMS]) and an assessment of spinal mobility.Resubs. Familial disease was significantly milder than sporadic disease as assessed by all measures, e.g., Conclusion.The greater prevalence of AS in at-risk families may be explained by the occurrence of more AS "susceptibility" genes in those families, whereas the more severe disease, seen in patients with ~~ .____