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Research ArticleArticle

Measurement Properties of Outcome Instruments for Large-Vessel Vasculitis: A Systematic Literature Review

Gonçalo Boleto, Alvise Berti, Peter A. Merkel, Sibel Zehra Aydin, Haner Direskeneli, Christian Dejaco, Leslie C. Hassett, Loreto Carmona and Sofia Ramiro for the OMERACT Vasculitis Working Group
The Journal of Rheumatology November 2022, jrheum.220149; DOI: https://doi.org/10.3899/jrheum.220149
Gonçalo Boleto
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Alvise Berti
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Peter A. Merkel
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Sibel Zehra Aydin
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Haner Direskeneli
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Christian Dejaco
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Leslie C. Hassett
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Loreto Carmona
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Sofia Ramiro
G. Boleto, MD, Université de Paris, Hôpital Cochin, Department of Rheumatology, Paris, France; A. Berti, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Department of Rheumatology, Trento, Italy; P.A. Merkel, MD, PhD, Division of Rheumatology, and Department of Medicine, Division of Epidemiology, Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania, USA; S.Z. Aydin, MD, PhD, University of Ottawa Faculty of Medicine, Department of Rheumatology, Ottawa, Canada; H. Direskeneli, MD, PhD, Marmara University, Internal Medicine, Division of Rheumatology, Istanbul, Turkey; C. Dejaco, MD, PhD, Medical University of Graz, Department of Rheumatology, Graz, Austria; L.C. Hassett, Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota, USA; L. Carmona, Instituto de Salud Musculoesquelética (InMusc), Department of Rheumatology, Madrid, Spain; S. Ramiro, Leiden University Medical Center, Department of Rheumatology, Leiden, and Zuyderland Medical Center, Rheumatology, Heerlen, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G. Boleto, AP-HP, Department of Rheumatology, Paris Descartes University Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France. Email: goncalo.boleto@aphp.fr. Accepted for publication October 12, 2022.
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Abstract

Objective To systematically review the measurement properties of outcome instruments used in large-vessel vasculitis (LVV).

Methods MEDLINE, Embase, Cochrane, and Scopus databases were searched for studies published from inception to July 14, 2020, that addressed measurement properties of instruments used in giant cell arteritis (GCA) and Takayasu arteritis (TA). The measurement properties of the instruments identified were collected following the Outcome Measures in Rheumatology (OMERACT) and Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) frameworks. Instruments were grouped according to the following domains measured: disease activity/damage, organ function, and health-related quality of life (HRQOL)/health status.

Results From 3534 articles identified, 13 met the predefined criteria. These studies addressed 12 instruments: 4 specific to TA, 2 designed for all types of systemic vasculitis, and 6 non-disease-specific instruments. No instruments specific to GCA were identified. Regarding TA, the Indian Takayasu Clinical Activity Score (ITAS) showed very good consistency, adequate reliability, but doubtful validity for disease activity. The Disease Extent Index-Takayasu (DEI-Tak) showed adequate construct validity but doubtful discriminating validity for disease activity/damage. Instruments, including the Vasculitis Damage Index and the Birmingham Vasculitis Activity Score, were poorly assessed for disease activity/damage. In total, 6 non-vasculitis-specific patient-reported outcome (PRO) instruments showed inadequate validity in GCA/TA.

Conclusion The measurement properties of 12 outcome instruments for LVV covering the OMERACT domains of disease activity/damage, organ function, and HRQOL were assessed. The ITAS and the DEI-Tak were the instruments with the most adequate measurement properties for disease activity/damage in TA. Disease activity/damage instruments specific to GCA, as well as validated PROs for both GCA and TA, are lacking.

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Measurement Properties of Outcome Instruments for Large-Vessel Vasculitis: A Systematic Literature Review
Gonçalo Boleto, Alvise Berti, Peter A. Merkel, Sibel Zehra Aydin, Haner Direskeneli, Christian Dejaco, Leslie C. Hassett, Loreto Carmona, Sofia Ramiro
The Journal of Rheumatology Nov 2022, jrheum.220149; DOI: 10.3899/jrheum.220149

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Measurement Properties of Outcome Instruments for Large-Vessel Vasculitis: A Systematic Literature Review
Gonçalo Boleto, Alvise Berti, Peter A. Merkel, Sibel Zehra Aydin, Haner Direskeneli, Christian Dejaco, Leslie C. Hassett, Loreto Carmona, Sofia Ramiro
The Journal of Rheumatology Nov 2022, jrheum.220149; DOI: 10.3899/jrheum.220149
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