Appraisal of candidate instruments for assessment of the physical function domain in patients with psoriatic arthritis

Ying Ying Leung, Ana Maria Orbai, Alexis Ogdie, Pil Hojgaard, Richard Holland, Niti Goel, Jeffrey Chau, Laura C. Coates, Vibeke Strand, Dafna D. Gladman, Philip J. Mease, Robin Christensen, William Tillett

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Objective. Numerous patient-reported outcome measures (PROM) exist for the measurement of physical function for psoriatic arthritis (PsA), but only a few are validated comprehensively. The objective of this project was to prioritize PROM for measuring physical function for potential incorporation into a standardized outcome measurement set for PsA. Methods. A working group of 13 members including 2 patient research partners was formed. PROM measuring physical function in PsA were identified through a systematic literature review and recommendations by the working group. The rationale for inclusion and exclusion from the original list of existing PROM was thoroughly discussed and 2 rounds of Delphi exercises were conducted to achieve consensus. Results. Twelve PROM were reviewed and discussed. Six PROM were prioritized: Health Assessment Questionnaire (HAQ) and 4 modifications (HAQ-Disability Index, HAQ-Spondyloarthritis, modified HAQ, multidimensional HAQ), Medical Outcomes Study 36-item Short Form survey physical functioning domain, and the Patient-Reported Outcomes Measurement Information System (PROMIS) physical functioning module. Conclusion. Through discussion and Delphi exercises, we achieved consensus to prioritize 6 physical function PROM for PsA. These 6 PROM will undergo further appraisal using the Outcome Measures in Rheumatology (OMERACT) Filter 2.1.

Original languageEnglish
Pages (from-to)58-66
Number of pages9
JournalJournal of Rheumatology
Issue number1
Early online date1 Jan 2021
Publication statusPublished - 1 Jan 2021

Bibliographical note

Funding Information:
YYL is funded by the Clinician Scientist award of the National Medical Research Council, Singapore (NMRC/CSA-INV/0022/2017). The views expressed are those of the author(s) and not necessarily those of the NMRC. AMO is funded by the Jerome L. Greene Foundation Scholar Award, the Staurulakis Family Discovery Award, the Rheumatology Research Foundation, and the US National Institutes of Health (NIH) through the Rheumatic Diseases Resource-based Core Center (P30-AR053503 Cores A and D, and P30-AR070254, Cores A and B). All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of the NIH, the US National Institute of Arthritis Musculoskeletal and Skin Diseases (NIAMS), or the Rheumatology Research Foundation. PH and RC (The Parker Institute, Bispebjerg and Frederiksberg Hospital) are supported by a core grant from the Oak Foundation (OCAY-18-774-OFIL). LCC is funded by a UK National Institute for Health Research (NIHR) Clinician Scientist award. The research was supported by the NIHR Oxford Biomedical Research Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the UK National Health Service, the NIHR, or the UK Department of Health. AO is funded by the Rheumatology Research Foundation and NIH/NIAMS R01 AR072363. 1Y.Y. Leung, MB ChB, MD, Associate Professor, Duke-NUS Medical School, Department of Rheumatology and Immunology, Singapore General Hospital, Singapore; 2A.M. Orbai, MD, MHS, Assistant Professor of Medicine, Director Psoriatic Arthritis Program, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; 3A. Ogdie, MD, MSCE, Associate Professor of Medicine and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA; 4P. Hojgaard, MD, PhD, Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; 5R. Holland, MBBS, Concord Repatriation General Hospital, Sydney, Australia; 6N. Goel, MD, Patient Research Partner, Adjunct Assistant Professor, Duke University School of Medicine, Durham, North Carolina, USA; 7J. Chau, BBA, Patient Research Partner, Hong Kong Psoriatic Arthritis Association, Hong Kong, China; 8L.C. Coates, MB ChB, PhD, National Institute for Health Research Clinician Scientist, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; 9V. Strand, MD, Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, California, USA; 10D.D. Gladman, MD, FRCPC, Division of Rheumatology, University of Toronto, and Senior Scientist, Krembil Research Institute, and Director, Psoriatic Arthritis Program, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada; 11P.J. Mease, MD, Rheumatology Research, Swedish Medical Center and University of Washington School of Medicine, Seattle, Washington, USA; 12R. Christensen, BSc, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, Bispebjerg and Frederiksberg Hospital, and Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark; 13W. Tillett, BSc, MB ChB, PhD, MRCP, Consultant Rheumatologist, Senior Lecturer, Royal National Hospital for Rheumatic Diseases, University of Bath, Bath, UK. Address correspondence to Dr. Y.Y. Leung, Department of Rheumatology and Immunology, Singapore General Hospital, The Academia, Level 4, 20 College Road, Singapore 169856. Email: Accepted for publication January 17, 2020.

Publisher Copyright:
© 2021 Journal of Rheumatology. All rights reserved.

Copyright 2021 Elsevier B.V., All rights reserved.


  • Outcome measures
  • Physical function
  • Psoriasis
  • Psoriatic arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology


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