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Outcome Measures in Polymyalgia Rheumatica. A Systematic Review
Cátia Duarte1, Ricardo Jorge de Oliveira Ferreira2, Sarah Louise Mackie2
1From the Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra; Faculdade de Medicina, Universidade de Coimbra, Coimbra; and Health Sciences Research Unit: Nursing (UICISA:E), Coimbra, Portugal; Leeds Institute of Rheumatic and Musculoskeletal Medicine and NIHR-Leeds Musculoskeletal Biomedical Research Unit, University of Leeds, Leeds, UK; and Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol, UK.C. Duarte, MD, Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, EPE; and Faculdade de Medicina, Universidade de Coimbra; R.J.O. Ferreira, RN, MSc, Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, EPE; and Health Sciences Research Unit: Nursing (UICISA:E); S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine and NIHR-Leeds Musculoskeletal Biomedical Research Unit, University of Leeds; J.R. Kirwan, PhD, University of Bristol, Academic Rheumatology Unit, Bristol Royal Infirmary; J.A. Pereira da Silva, PhD, Rheumatology Department, Centro Hospitalar e Universitário de Coimbra, EPE; and Faculdade de Medicina, Universidade de Coimbra. catiacmduarte@gmail.com.
Objective:
To identify the instruments used to assess polymyalgia rheumatica (PMR) in published studies.
Methods:
A systematic literature review of clinical trials and longitudinal observational studies related to PMR, published from 1970 to 2014, was carried out. All outcome and assessment instruments were extracted and categorized according to core areas and domains, as defined by the OMERACT (Outcome Measures in Rheumatology) Filter 2.0.
Results:
Thirty-five articles (3221 patients) were included: 12 randomized controlled trials (RCT); 3 nonrandomized trials; and 20 observational studies. More than 20 domains were identified, measured by 29 different instruments. The most frequently used measures were pain, morning stiffness, patient global assessment and physician global assessment, erythrocyte sedimentation rate, and C-reactive protein. The definition of outcomes varied considerably between studies.
Conclusion:
The outcome measures and instruments used in PMR are numerous and diversely defined. The establishment of a core set of validated and standardized outcome measurements is needed.
Insights
This review found many different ways to measure polymyalgia rheumatica (PMR) outcomes in studies. A standardized set of validated outcome measures for PMR is needed.
Area of Science:
- Rheumatology
- Clinical Research Methodology
Background:
- Polymyalgia rheumatica (PMR) assessment lacks standardized outcome measures.
- Variability in outcome assessment hinders comparative analysis of PMR studies.
Purpose of the Study:
- To systematically identify and categorize instruments used to assess PMR in published literature.
- To inform the development of standardized outcome measures for PMR research.
Main Methods:
- Systematic literature review of PMR studies (1970-2014).
- Extraction and categorization of outcome and assessment instruments.
- Categorization based on OMERACT (Outcome Measures in Rheumatology) Filter 2.0 domains.
Main Results:
- 35 articles (3221 patients) were reviewed.
- 29 distinct instruments measured over 20 domains.
- Commonly used measures included pain, stiffness, global assessments, ESR, and CRP.
- Significant variation in outcome definitions was observed.
Conclusions:
- The current landscape of PMR outcome measures is diverse and inconsistently defined.
- There is a critical need for a core set of validated and standardized outcome measurements for PMR.
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