The authors note that the surprisingly low number of patients correctly classifying a remission model disease state has wide implications for clinical practice and research. “It also raises the possibility of misclassification of disease activity based on patient reported outcomes in vulnerable populations, and more broadly, of how disease activity is classified according to patient reported outcomes,” they write.
“Our data … are particularly valuable and add urgency to the growing sense that the PGA-VAS needs to be re-examined as a criterion of remission,” conclude the authors. “Finally, we believe that if the PGA-VAS is to be kept as a key component of all RA disease activity indices, it should be made less confusing in terms of its wording, clarification of its target dimensions, and reduction of its literacy and numeracy burdens.”
Hirsh J, Wood P, Keniston A, et al. Limited health literacy and patient confusion about rheumatoid arthritis patient global assessments and model disease states. Arthritis Care Res (Hoboken). 2019 May;71(5):611–619.