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Defining Minimum Clinically Important Changes for the Patient Activity Scale II.

Joshua F Baker¹, Patti Katz², Kaleb Michaud³

¹Philadelphia Veterans Affairs Medical Center and Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Arthritis Care & Research

|June 1, 2020

Summary

This summary is machine-generated.

The minimum clinically important improvement (MCII) and worsening (MCIW) for the Patient Activity Scale II (PAS-II) were defined. A change of approximately 0.5 on the PAS-II indicates a meaningful difference for rheumatoid arthritis patients.

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Area of Science:

Rheumatology
Clinical Outcomes Measurement
Patient-Reported Outcomes

Background:

The Patient Activity Scale II (PAS-II) is a key patient-reported outcome for assessing rheumatoid arthritis disease activity.
Defining minimum clinically important improvement (MCII) and worsening (MCIW) is crucial for interpreting PAS-II scores.

Purpose of the Study:

To establish the MCII and MCIW for the PAS-II.
To determine if these values differ based on baseline disease activity levels.

Main Methods:

Utilized data from the Forward, The National Databank for Rheumatic Diseases.
Employed both anchor-based (pain, general health) and distribution-based (0.5 and 0.35 SD) methods.
Stratified analyses by baseline PAS-II scores (above/below 3.7) and assessed construct validity.

Main Results:

Overall MCII was ~0.4-0.5 and MCIW was ~0.5-0.55 for pain and general health.
For moderate-to-high disease activity, MCII was 1.1; for low disease activity, MCIW was 1.1.
Anchor-based and distribution-based methods showed agreement; patients on new therapies had higher odds of achieving MCII.

Conclusions:

The minimum important change on the PAS-II is approximately 0.5.
MCII and MCIW values vary depending on baseline disease activity.
These findings aid in the clinical interpretation of PAS-II scores in rheumatoid arthritis management.