Health-Related Quality of Life (HRQoL) in Idiopathic Inflammatory Myopathy: A Systematic Review

<div><p>Health-related quality of life (HRQoL) is a research priority in chronic diseases. We undertook a systematic review (registration #CRD42015024939) to identify, appraise and synthesize the evidence relating to HRQoL in idiopathic inflammatory myopathies (IIM). A comprehensive search was conducted in August 2015 using CINAHL, EMBase and Pubmed to identify studies reporting original data on HRQoL in IIM using generic HRQoL instruments. Characteristics of samples and results from selected studies were extracted and appraised using a standardized approach. Qualitative synthesis of the results was performed. Ten studies including a total of 654 IIM subjects were included in this systematic review. HRQoL was significantly impaired in all subsets of IIM compared with the general population. Disease activity, disease damage and chronic disease course were associated with poorer HRQoL. Insufficient or conflicting results were found in associations between clinical features, treatment, disease duration and mood or illness perception, and HRQoL in IIM. This study suggests that HRQoL is impaired in IIM. However, due to the paucity and heterogeneity of the evidence to date, robust estimates are lacking and significant knowledge gaps persist. There is a need for studies that systematically investigate the correlates and trajectory of HRQoL in IIM.</p></div

Description of the studies included in this review.

<p>Description of the studies included in this review.</p

Summary of HRQoL results using the SF-36.

<p>Summary of HRQoL results using the SF-36.</p

Comparison of HRQoL between IIM and other chronic conditions using the SF-36.

<p>Comparison of HRQoL between IIM and other chronic conditions using the SF-36.</p

Comparison of HRQoL between IIM and other neuromuscular diseases using the INQOL.

<p>Comparison of HRQoL between IIM and other neuromuscular diseases using the INQOL.</p

Comparison of HRQoL between IIM and other rheumatologic diseases using the NHP.

<p>Comparison of HRQoL between IIM and other rheumatologic diseases using the NHP.</p

Flow diagram of study selection.

<p>Flow diagram of study selection.</p

Factor loadings for the “Positive” and “Negative” latent factors of the CES-D and influence on the overall estimates of fatigue latent factor scores.

a<p>Not corrected for DIF.</p>b<p>^bCorrected for DIF for items 3, 10, and 11.</p><p>CI = Confidence Interval.</p

Comparison of FSFI domain scores between sexually active women with systemic sclerosis Patients and sexually active women from a UK general population sample; unadjusted and adjusted for total FSFI score.

<p>(CSRG Sample: N = 296; UK Sample: N = 956).</p

An Assessment of the Measurement Equivalence of English and French Versions of the Center for Epidemiologic Studies Depression (CES-D) Scale in Systemic Sclerosis

<div><p>Objectives</p><p>Center for Epidemiologic Studies Depression (CES-D) Scale scores in English- and French-speaking Canadian systemic sclerosis (SSc) patients are commonly pooled in analyses, but no studies have evaluated the metric equivalence of the English and French CES-D. The study objective was to examine the metric equivalence of the CES-D in English- and French-speaking SSc patients.</p><p>Methods</p><p>The CES-D was completed by 1007 English-speaking and 248 French-speaking patients from the Canadian Scleroderma Research Group Registry. Confirmatory factor analysis (CFA) was used to assess the factor structure in both samples. The Multiple-Indicator Multiple-Cause (MIMIC) model was utilized to assess differential item functioning (DIF).</p><p>Results</p><p>A two-factor model (Positive and Negative affect) showed excellent fit in both samples. Statistically significant, but small-magnitude, DIF was found for 3 of 20 CES-D items, including items 3 (<i>Blues</i>), 10 (<i>Fearful</i>), and 11 (<i>Sleep</i>). Prior to accounting for DIF, French-speaking patients had 0.08 of a standard deviation (SD) lower latent scores for the Positive factor (95% confidence interval [CI]−0.25 to 0.08) and 0.09 SD higher scores (95% CI−0.07 to 0.24) for the Negative factor than English-speaking patients. After DIF correction, there was no change on the Positive factor and a non-significant increase of 0.04 SD on the Negative factor for French-speaking patients (difference = 0.13 SD, 95% CI−0.03 to 0.28).</p><p>Conclusions</p><p>The English and French versions of the CES-D, despite minor DIF on several items, are substantively equivalent and can be used in studies that combine data from English- and French-speaking Canadian SSc patients.</p></div