OBJECTIVE: To develop a consensus based set of core domains for outcome studies in psoriatic arthritis. METHODS: A list of 26 potential domains was prepared through literature review and email discussions amongst the GRAPPA steering committee members and scored by rheumatologists identified through membership of the CASPAR study and the steering committee. Each participant was emailed an up to date review of outcome measures in psoriatic arthritis and asked to distribute 100 points amongst each potential domain. In two subsequent rounds the group median, interquartile range, and earlier responses were emailed to each respondent to provide an opportunity to revise their scoring. RESULTS: Thirty two participants responded to the first round, of whom 30 responded to the third round. For DC-ART, the highest scoring domains were actively inflamed joint count, radiological damage score, patient global assessment, pain, physical function, acute phase response, and quality of life (scores 7 to 12). For SMARD, the highest scoring domains were pain, patient global assessment, physical function, quality of life, and active joint count (scores 10 to 18). For clinical record keeping, three domains scored highly at 10 (pain, patient global assessment, and active joint count). For rehabilitation, the highest scoring domains were physical function, quality of life, pain, patient global assessment, work limitations, and work incapacity (scores 10 to 15). CONCLUSION: Amongst rheumatologists with an interest in psoriatic arthritis, a reduced list of potential standard outcome domains have been defined by Delphi consensus methods. [References: 6]
AimThe objective of this study was to determine which domains rheumatologists felt were most relevant to the assessment of outcome studies of psoriatic arthritis using structured Delphi methodology.
ContributorsTaylor, W. J.
Disease Category: Rheumatology
Disease Name: Psoriatic arthritis
Age Range: Unknown
Sex: Either
Nature of Intervention: Not specified
- Clinical experts
- Members of a clinical trial network.
- Prioritising
- COS for clinical trials or clinical research
- COS for practice
- Delphi process
A search of the literature, formalised into a review paper concerning outcome assessments in psoriatic arthritis, was used to develop a list of 26 potential outcome domains. These were discussed and refined using electronic communication by the steering committee of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA). Four contexts of measurement were identified, based on the ASAS process (except that ‘‘physical therapy’’ was broadened to include other rehabilitation interventions and was relabelled ‘‘rehabilitation’’):
• disease controlling antirheumatic therapy (DC-ART)
• symptom modifying antirheumatic drugs (SMARDs)
• rehabilitation
• clinical record keeping.
Potential participants were selected on the basis of a major interest in psoriatic arthritis and included investigators from Australasia, Europe, and North America of the multinational ClASsification of Psoriatic ARthritis (CASPAR) study and other individual rheumatologists nominated by members of the steering committee. A total of 50 rheumatologists were invited to participate.
A Delphi process was developed whereby each participant was asked to determine the relative importance of each domain by distributing 100 points amongst the 26 domains. Respondents were free to assign points to as many or as few domains as they wished. The number of points assigned to any particular domain reflected its relative importance, with more points being assigned to more important domains. Each of the four measurement contexts was scored separately. In subsequent rounds, participants were given their own response and the group opinion for each domain (median and interquartile range) from the previous round. Respondents were able to submit new scores or leave their scores unchanged. Three rounds were conducted by electronic mail or facsimile. In addition, with the first round, participants were given the review of assessment methods in PsA.