Article

The McMaster-Toronto Arthritis Patient Preference Disability
Questionnaire (MACTAR) measurement of function may be more comprehensive and add
useful information about disability than traditional fixed-item questionnaires,
especially about issues that really matter to the patient, for developing
personalized medicine. OBJECTIVES: We aimed to assess priorities in disability
and restriction in participation in patients with disabling knee osteoarthritis
(OA) by the MACTAR and evaluate its validity and responsiveness.
METHODS: We evaluated 127 in- and outpatients with knee OA in two tertiary care teaching
hospitals between August 2010 and July 2012 by using the MACTAR, the Western
Ontario and McMaster Universities Osteoarthritis Index, Lequesne scale, Fear
Avoidance Beliefs Questionnaire, a life satisfaction score and pain, global
assessment of disease activity and functional impairment scores on a numerical
rating scale. Validity was assessed by Pearson correlation and responsiveness by
the standardized response mean (SRM) and effect size (ES). RESULTS: Patients
ranked 35 different activities by the MACTAR; the 3 domains of the International
Classification of Functioning, Disability and Health most often identified were
mobility (cited 233 times, 52.3%); community, social and civic life (cited 122
times, 27.4%); and domestic life (cited 64 times, 14.4%).
The MACTAR score was
best correlated with functional impairment (r=0.5). Convergent and divergent
validity was as expected. In all, 108 patients completed a 6-month follow-up
evaluation: 27 patients shifted their priorities at 6 months, for a decrease in
SRM and ES. The SRM (0.64) and ES (0.92) for the MACTAR without shifts in
priorities were the highest among the outcome measures tested; for patients
considering their condition improved, the values were 0.85 and 1.17,
respectively. CONCLUSIONS: For assessing priorities in disability and restriction
in participation among patients with knee OA, the MACTAR has acceptable validity
and responsiveness.
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Langue : ANGLAIS