Comparison between self-report measures & clinical observations of functional disability in ankylosing spondylitis, rheumatoid arthritis & fibromyalgia (FM)

OBJECTIVE. To study concordance between self-report measures

and clinical observations of functional disability in

ankylosing spondylitis (AS), rheumatoid arthritis (RA), and

fibromyalgia (FM).

METHODS. 35 patients with AS completed 9

selected items of the Functional Index questionnaire, whereas

12 patients with RA and 13 with FM completed 7 selected items

of the Arthritis Impact Measurement Scales. Five days later,

all 60 patients and 4 controls actually performed the selected

activities, which were recorded on video. The tapes were

assessed in random order by 12 observers (6 occupational

therapists and 6 physicians). Both patients and observers

indicated functional disability on a 10 cm visual analog scale


RESULTS. Interobserver agreement was high (Cronbach’s

alpha 0.98). All observers scored the 4 healthy controls as

having no disability at all. Mean discordance scores (VAS

patients minus VAS observers) for the selected items were

negligible in AS [-0.17 cm (p = 0.30)], moderate in RA [+1.10

cm (p = 0.06)] and high in FM [+2.44 cm (p < 0.01)].

CONCLUSION. Discordance between self-report

questionnaires and observed functional disability is a feature

most striking in FM. In validation of self-report

questionnaires of functional disability the appropriate

spectrum of rheumatological diagnoses should be considered.

Hidding A, van Santen M, De Klerk E, Gielen X, Boers M, Geenen R,

Vlaeyen J, Kester A, van der Linden S

1 Star2 Stars3 Stars4 Stars5 Stars (48 votes, average: 3.25 out of 5)

Leave a Reply