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Research ArticleArticle

Measurement Properties of the Polymyalgia Rheumatica Activity Score: A Systematic Literature Review

Thomas E. Bolhuis, Lizanne E.A. Nizet, Claire Owen, Alfons A. den Broeder, Cornelia H.M. van den Ende and Aatke van der Maas
The Journal of Rheumatology March 2022, jrheum.211292; DOI: https://doi.org/10.3899/jrheum.211292
Thomas E. Bolhuis
This is an investigator-initiated and -funded study. T.E. Bolhuis, MD, A.A. den Broeder, PhD, C.H.M. van den Ende, MSc, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; L.E.A. Nizet, A. van der Maas, MD, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, the Netherlands; C. Owen, MBBS, PhD, Department of Rheumatology, Austin Health, Melbourne, Australia. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. T.E. Bolhuis, Sint Maartenskliniek, Department of Rheumatology, PO Box 9011, 6500GM, Nijmegen, the Netherlands. Email: t.bolhuis{at}maartenskliniek.nl. Accepted for publication February 16, 2022.
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Lizanne E.A. Nizet
This is an investigator-initiated and -funded study. T.E. Bolhuis, MD, A.A. den Broeder, PhD, C.H.M. van den Ende, MSc, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; L.E.A. Nizet, A. van der Maas, MD, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, the Netherlands; C. Owen, MBBS, PhD, Department of Rheumatology, Austin Health, Melbourne, Australia. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. T.E. Bolhuis, Sint Maartenskliniek, Department of Rheumatology, PO Box 9011, 6500GM, Nijmegen, the Netherlands. Email: t.bolhuis{at}maartenskliniek.nl. Accepted for publication February 16, 2022.
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Claire Owen
This is an investigator-initiated and -funded study. T.E. Bolhuis, MD, A.A. den Broeder, PhD, C.H.M. van den Ende, MSc, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; L.E.A. Nizet, A. van der Maas, MD, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, the Netherlands; C. Owen, MBBS, PhD, Department of Rheumatology, Austin Health, Melbourne, Australia. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. T.E. Bolhuis, Sint Maartenskliniek, Department of Rheumatology, PO Box 9011, 6500GM, Nijmegen, the Netherlands. Email: t.bolhuis{at}maartenskliniek.nl. Accepted for publication February 16, 2022.
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Alfons A. den Broeder
This is an investigator-initiated and -funded study. T.E. Bolhuis, MD, A.A. den Broeder, PhD, C.H.M. van den Ende, MSc, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; L.E.A. Nizet, A. van der Maas, MD, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, the Netherlands; C. Owen, MBBS, PhD, Department of Rheumatology, Austin Health, Melbourne, Australia. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. T.E. Bolhuis, Sint Maartenskliniek, Department of Rheumatology, PO Box 9011, 6500GM, Nijmegen, the Netherlands. Email: t.bolhuis{at}maartenskliniek.nl. Accepted for publication February 16, 2022.
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Cornelia H.M. van den Ende
This is an investigator-initiated and -funded study. T.E. Bolhuis, MD, A.A. den Broeder, PhD, C.H.M. van den Ende, MSc, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; L.E.A. Nizet, A. van der Maas, MD, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, the Netherlands; C. Owen, MBBS, PhD, Department of Rheumatology, Austin Health, Melbourne, Australia. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. T.E. Bolhuis, Sint Maartenskliniek, Department of Rheumatology, PO Box 9011, 6500GM, Nijmegen, the Netherlands. Email: t.bolhuis{at}maartenskliniek.nl. Accepted for publication February 16, 2022.
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Aatke van der Maas
This is an investigator-initiated and -funded study. T.E. Bolhuis, MD, A.A. den Broeder, PhD, C.H.M. van den Ende, MSc, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; L.E.A. Nizet, A. van der Maas, MD, PhD, Department of Rheumatology, Sint Maartenskliniek, Ubbergen, the Netherlands; C. Owen, MBBS, PhD, Department of Rheumatology, Austin Health, Melbourne, Australia. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. T.E. Bolhuis, Sint Maartenskliniek, Department of Rheumatology, PO Box 9011, 6500GM, Nijmegen, the Netherlands. Email: t.bolhuis{at}maartenskliniek.nl. Accepted for publication February 16, 2022.
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Abstract

Objective To perform a COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)-based systematic literature review of measurement properties of the Polymyalgia Rheumatica Activity Score (PMR-AS).

Methods PubMed, EMBASE, and CINAHL were broadly searched. English full-text articles, with (quantitative) data on ≥ 5 patients with PMR using the PMR-AS were selected. Seven hypotheses for construct validity and 3 for responsiveness, concerning associations with erythrocyte sedimentation rate, physical function, quality of life, clinical disease states, ultrasound, and treatment response, were formulated. We assessed the structural validity, internal consistency, reliability, and measurement error, or the hypotheses on construct validity or responsiveness of the PMR-AS based on COSMIN criteria.

Results Out of the identified 26 articles that used the PMR-AS, we were able to use 12 articles. Structural validity, internal consistency, construct validity, and responsiveness were assessed in 1, 2, 8, and 3 articles, respectively. Insufficient evidence was found to confirm structural validity and internal consistency. No data were found on reliability or measurement error. Although 60% and 67% of hypotheses tested for construct validity and responsiveness, respectively, were confirmed, there was insufficient evidence to meet criteria for good measurement properties.

Conclusion While there is some promising evidence for construct validity and responsiveness of the PMR-AS, it is lacking for other properties and, overall, falls short of criteria for good measurement properties. Therefore, further research is needed to assess its role in clinical research and care.

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The Journal of Rheumatology: 53 (8)
The Journal of Rheumatology
Vol. 53, Issue 8
1 Aug 2026
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Measurement Properties of the Polymyalgia Rheumatica Activity Score: A Systematic Literature Review
Thomas E. Bolhuis, Lizanne E.A. Nizet, Claire Owen, Alfons A. den Broeder, Cornelia H.M. van den Ende, Aatke van der Maas
The Journal of Rheumatology Mar 2022, jrheum.211292; DOI: 10.3899/jrheum.211292

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Measurement Properties of the Polymyalgia Rheumatica Activity Score: A Systematic Literature Review
Thomas E. Bolhuis, Lizanne E.A. Nizet, Claire Owen, Alfons A. den Broeder, Cornelia H.M. van den Ende, Aatke van der Maas
The Journal of Rheumatology Mar 2022, jrheum.211292; DOI: 10.3899/jrheum.211292
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