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Reliability and Validity

Reliability and Validity

Reliability and validity are two important considerations that must be made with any type of data collection. Reliability refers to the ability to consistently produce a given result. In the context of psychological research, this would mean that any instruments or tools used to collect data do so in consistent, reproducible ways.

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Measurement properties of the Polymyalgia Rheumatica Activity Score (PMR-AS): reliability, measurement error and

Noortje E S E P Kooijman^1,2, David F Ten Cate¹, Pauline M E T Bovens¹

¹Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands.

Rheumatology (Oxford, England)

|February 15, 2026

Summary

The Polymyalgia Rheumatica Activity Score (PMR-AS) shows excellent reliability between raters and good discriminative validity for assessing disease activity in Polymyalgia Rheumatica (PMR). However, its measurement error may affect interpretation of minor changes in individual patient scores.

Keywords:

PMR discriminative validity disease activity measurement error outcome measures reliability

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Area of Science:

Rheumatology
Clinical Measurement
Disease Activity Assessment

Background:

The Polymyalgia Rheumatica Activity Score (PMR-AS) is a validated tool for measuring disease activity in Polymyalgia Rheumatica (PMR).
Previous studies have not fully evaluated the reliability, measurement error, and discriminative validity of the PMR-AS.

Purpose of the Study:

To assess the inter-rater reliability, test-retest reliability, measurement error, and discriminative validity of the PMR-AS.
To determine the clinical utility of the PMR-AS in routine care and clinical trials for Polymyalgia Rheumatica.

Main Methods:

Cross-sectional cohort study of 124 PMR patients for inter-rater reliability and measurement error.
Analysis of data from 38 PMR patients in randomized trials for test-retest reliability and measurement error.
Statistical analyses included intraclass correlation coefficients (ICC), standard error of measurement (SEM), smallest detectable change (SDC), and ROC analyses.

Main Results:

Excellent inter-rater reliability (ICC 0.93) and good discriminative validity (AUC 0.93) were observed for the PMR-AS.
Test-retest reliability was moderate (ICC 0.66), with notable measurement error (inter-rater SDC 6.83; test-retest SDC 5.75).
Agreement between disease activity categories (PMR-AS <10 vs. ≥10) was substantial (Cohen's kappa 0.69).

Conclusions:

The PMR-AS demonstrates strong inter-rater reliability and discriminative validity, supporting its use in classifying Polymyalgia Rheumatica disease activity.
The identified measurement error suggests caution when interpreting small changes in individual patient scores over time.
Further validation is recommended to refine the clinical application of the PMR-AS in Polymyalgia Rheumatica management.