Arthritis has become
the most common and principal reason of pain and disability, especially among
the elderly population around the world.
While some women with confirmed arthritis did
not have recent musculoskeletal signs or symptoms, others with the signs and
symptoms did not report diagnosed arthritis.
Arthritis has become the most common and principal reason of pain and disability, especially among the elderly population around the world. Government has to dedicate a considerable amount of healthcare resources for the arthritis management. The occurrence of arthritis is continuously increasing and has affected nearly 50 million people in the USA. Although it may occur in anyone, women are at greater risk. One of the most common form of arthritis is osteoarthritis, which is known to affect women more adversely and at multiple sites when compared men of their age. Thus, the rate of joint replacements is also much higher in women than men. The management of arthritis has become a real challenge for the healthcare systems with the limited resources. The major source of information for epidemiological studies and other health research is self-reported heath survey data. The reported health data is feasible because the data is routinely collected by government and/or agencies and is easily available to the common audience. Although it has been argued that self-reported diagnosis of chronic conditions may suffer from recall-bias, leading to underreporting of conditions and underestimation of incidence, some investigators have confirmed the use of self-reported arthritis as it has good agreement with medical records, and an adequate level of sensitivity and specificity in previous validation studies Previous validation studies of self-reported arthritis have mostly been based on a non-gender specific sample. Since women are most at risk of arthritis, a study with a focus on women represents an important milestone to the better understanding of the validity of self-reported arthritis and its application in large epidemiological studies.
Rationale behind the research:
Objective:
The objectives of this study were to:
1) Examine the agreement between self-report diagnosed arthritis and musculoskeletal signs and symptoms in community-living older women;
2) Estimate the sensitivity, specificity, and predictive values of self-reported arthritis; and
3) Assess the factors associated with the disagreement.
Study outcomes
Self-reported diagnosed arthritis: In the questionnaire based survey, participants were asked: “In the past 3 years, have you been diagnosed or treated for (a list of conditions)?” The list of condiitions (forms of arthritis) included osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, and/or other form of arthritis. Self-reported diagnosed arthritis in the present study was defined as an answer“Yes” to any form of these forms of arthritis. Agreement between self-reported arthritis and musculoskeletal signs symptoms was measured by Cohen’s kappa. Sensitivity, specificity, and predictive values of self-reported arthritis were estimated using musculoskeletal signs and symptoms as the reference standard. Factors associated with disagreement between self-reported arthritis and the reference standard were examined using multiple logistic regression.
Outcomes:
This study compared the self-reported diagnosed arthritis and musculoskeletal signs and symptoms, suggesting arthritis in a sample of geographically diverse older Australian women. Prevalence estimates based on the two case-definitions of arthritis were not significantly different, but Cohen’s kappa indicated that their agreement was only moderate. While two-fifths (91/223) of the self-reported arthritis cases did not have musculoskeletal signs and symptoms, two-thirds (132/198) of cases identified by signs and symptoms also reported diagnosed arthritis.
The results of study also indicate that
self-reported diagnosed arthritis has moderate sensitivity and specificity when
using musculoskeletal signs and symptoms as the reference standard. These
results are somewhat different from previous studies that included both women
and men. One of the USA study involving an older sample from Georgia and using
rheumatologists’ summary assessment as the reference standard, found that
selfreported arthritis had substantial agreement with the reference standard. This
study provides important information about the accuracy of selfreported
diagnosed arthritis in a population most affected by arthritis (i.e. older
women). Concurrently, the sample represents a strength of this study because:
a) survey participants were randomly drawn from an ALSWH cohort which is
geographically diverse and b) the response rate in this study was very high.
These factors contribute positively to both the external and internal validity
of the findings.
This study showed that the estimated prevalence of arthritis in older
community-living women based on self-reported diagnosed arthritis and cases
identified by musculoskeletal signs and symptoms were not statistically
significant.
Lo et al. BMC Musculoskeletal Disorders (2016) 17:494
Discordance between self-reported arthritis and musculoskeletal signs and symptoms in older women
TKT Lo et al.
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