RT Journal Article
SR Electronic
T1 Patients with Rheumatoid Arthritis Acquire Sustainable Skills for Home Monitoring: A Prospective Dual-country Cohort Study (ELECTOR Clinical Trial I)
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.181362
DO 10.3899/jrheum.181362
A1 Marie Skougaard
A1 Henning Bliddal
A1 Robin Christensen
A1 Karen Ellegaard
A1 Sabrina M.  Nielsen
A1 Jakub Zavada
A1 Sabina Oreska
A1 Niels S.  Krogh
A1 Christian C.  Holm
A1 Merete L.  Hetland
A1 Jiri Vencovsky
A1 Henrik Røgind
A1 Peter C.  Taylor
A1 Henrik Gudbergsen
YR 2019
UL http://www.jrheum.org/content/early/2020/01/27/jrheum.181362.abstract
AB Objective In an eHealth setting, to investigate intra- and interrater reliability and agreement of joint assessments and Disease Activity Score using C-reactive protein (DAS28-CRP) in patients with rheumatoid arthritis (RA) and test the effect of repeated joint assessment training. Methods Patients with DAS28-CRP ≤ 5.1 were included in a prospective cohort study (clinicaltrials.gov: NCT02317939). Intrarater reliability and agreement of patient-performed joint counts were assessed through completion of 5 joint assessments over a 2-month period. All patients received training on joint assessment at baseline; only half of the patients received repeated training. A subset of patients was included in an appraisal of interrater reliability and agreement comparing joint assessments completed by patients, healthcare professionals (HCP), and ultrasonography. Cohen’s κ coefficients and intraclass correlation coefficients (ICC) were used for quantifying of reliability of joint assessments and DAS28-CRP. Agreement was assessed using Bland-Altman plots. Results Intrarater reliability was excellent with ICC of 0.87 (95% CI 0.83–0.90) and minimal detectable change of 1.13. ICC for interrater reliability ranged between 0.69 and 0.90 (good to excellent). Patients tended to rate DAS28-CRP slightly higher than HCP. In patients receiving repeated training, a mean difference in DAS28-CRP of –0.08 was observed (limits of agreements of –1.06 and 0.90). After 2 months, reliability between patients and HCP was similar between groups receiving single or repeated training. Conclusion Patient-performed assessments of joints and DAS28-CRP in an eHealth home-monitoring solution were reliable and comparable with HCP. Patients can acquire the necessary skills to conduct a correct joint assessment after initial and thorough training. [clinicaltrials.gov (NCT02317939)]