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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.

Acta Ortopedica Brasileira

|February 19, 2019

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Patients, orthopedists, and rheumatologists reported similar Time Trade-Off (TTO) values for rheumatoid arthritis treatments. However, weak correlations between patient and physician scores indicate that single evaluations cannot substitute for comprehensive assessments.

Area of Science:

Rheumatology
Orthopedics
Health Economics

Background:

Rheumatoid arthritis affects 0.5% to 1% of the population, requiring integrated orthopedic and rheumatologic care.
The Time Trade-Off (TTO) technique is increasingly used in clinical settings to assess treatment value.
Understanding patient and clinician perspectives on TTO is crucial for treatment planning.

Purpose of the Study:

To compare Time Trade-Off (TTO) evaluations between rheumatoid arthritis patients, orthopedists, and rheumatologists.
To correlate TTO responses with clinical outcomes using established measures like the Brief Michigan Hand Questionnaire and DAS-28.

Main Methods:

A prospective study involving 37 rheumatoid arthritis patients, orthopedists, and rheumatologists.
TTO questionnaires administered by an independent evaluator.

Keywords:

Arthritis Hand/surgery Quality of life Rheumatoid/surgery Surveys and Questionnaire

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Clinical assessments included the DAS-28 and Brief Michigan Hand Questionnaire.

Main Results:

Descriptive analysis showed similar median TTO values across patients, orthopedists, and rheumatologists.
Weak correlations were observed between patient and rheumatologist TTO scores.
Limited correlation was found between patient scores and the Brief Michigan Hand Questionnaire, and between orthopedic surgeon scores and DAS-28.

Conclusions:

Median TTO values suggest agreement among patients and physicians regarding treatment value in rheumatoid arthritis.
Weak correlations between different assessment scores preclude the use of a single evaluation scale for substitution.
Further research is needed to reconcile patient-reported outcomes with clinical assessments in rheumatoid arthritis management.