Patient-reported Outcome Measures for Rheumatoid Arthritis Symptom Severity: development of a computer adaptive test from an item bank using Rasch measurement theory (SOCRATES)

Pickles, Timothy ORCID: https://orcid.org/0000-0001-7743-0234 2024. Patient-reported Outcome Measures for Rheumatoid Arthritis Symptom Severity: development of a computer adaptive test from an item bank using Rasch measurement theory (SOCRATES). PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Disease activity (DA) monitoring is a standard of care in Rheumatoid Arthritis (RA). The current DA assessments require laboratory tests and/or health care professional input. Patient Reported Outcome Measures (PROMs) may therefore be preferable. However, there is no consensus on how to measure RA DA using a PROM. The aim was to assess the measurement properties of legacy RA DA PROMs and other relevant PROMs, and begin developing a new RA DA PROM. Multiple methods were employed including a systematic review following Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines, quantitative analyses of data on legacy PROMs collected in a cross-sectional study of people with RA (pwRA) across four South Wales University Health Boards, thematic and content analyses of cognitive interviews with pwRA and the development of a computer adaptive test. No legacy RA DA PROMs can be recommended for future use and no legacy PROMs could fully evidence fit to the Rasch measurement theory model. It was shown that the Patient global domain is two distinct domains of Disease activity and General health. 12 items across the domains of Pain, Disease activity, Tenderness and swelling, Physical functioning and Stiffness can be used to measure the construct of RA DA. Some initial evidence of content validity for these items was established. Lastly, it was determined that a computer adaptive test does not provide a major advantage for the purpose of administering the 12 items. The findings show that the construct of RA DA can be measured with just five items, with one from each of the Pain, Disease activity, Tenderness and swelling, Physical functioning and Stiffness domains. The next steps are to discover how best to design these five items and to test their measurement properties, before using them as part of a weekly DA monitoring tool.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Medicine
Date of First Compliant Deposit:	15 July 2024
Last Modified:	15 Jul 2024 08:24
URI:	https://orca.cardiff.ac.uk/id/eprint/170576

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