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LIFE QUALITY EVALUATION USING "TIME TRADE OFF" METHOD FOR RHEUMATOID HANDS
Erick Yoshio Wataya1, Carlos Eduardo Azuma Lijo1, Mateus Saito1
1Hand and Microsurgery Group, Institute of Orthopedics and Traumatology Medical School, Universidade de Sao Paulo, Hospital das Clinicas HCFMUSP, Sao Paulo, SP, Brazil.
Objective:
Rheumatoid arthritis is a prevalent disease in the population (range 0.5% to 1%) and involves both orthopedic and rheumatologic treatment. The Time Trade-Off (TTO) technique, which determines the number of years the patient or the professional would be allowed before a successful procedure in terms of life expectancy and value of the procedure, has been gaining ground in clinical protocols. From this standpoint, we sought to compare evaluations provided by the patients, orthopedists, and rheumatologists in determining the TTO and to correlate their responses with the clinical repercussions using previously established scores such as the Brief Michigan Hand Questionnaire and the Disease Activity Score-28 (DAS-28).
Methods:
A prospective study was conducted that involved 37 patients with rheumatoid arthritis, orthopedists, and rheumatologists. The TTO questionnaire was administered by an independent evaluator for evaluation using the DAS-28 and the Brief Michigan Hand Questionnaire.
Results:
The descriptive analysis revealed similar medians between the orthopedists, rheumatologists, and patients for single assessments. However, there was a weak correlation between the results from the patient and rheumatologist, the patient and Brief Michigan Questionnaire, and those of the orthopedic surgeon and the DAS-28.
Conclusion:
Similar median values demonstrated equivalent TTO among the orthopedist, rheumatologist, and patient. However, given the weak correlations between the scores, it was not possible to substitute results using a single evaluation scale.
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