TY - JOUR
T1 - Thresholds for unacceptable work state in radiographic axial Spondyloarthritis of four presenteeism and two clinical outcome measurement instruments
AU - Capelusnik, Dafne
AU - Ramiro, Sofia
AU - Nikiphorou, Elena
AU - Maksymowych, Walter P
AU - Magrey, Marina Nighat
AU - Marzo-Ortega, Helena
AU - Boonen, Annelies
PY - 2024/1/25
Y1 - 2024/1/25
N2 - OBJECTIVES: To a) identify threshold values of presenteeism measurement instruments that reflect unacceptable work state in employed r-axSpA patients; b) determine whether those thresholds accurately predict future adverse work outcomes (AWO) (sick leave or short/long-term disability); c) evaluate the performance of traditional health-outcomes for r-axSpA; d) explore whether thresholds are stable across contextual factors. METHODS: Data from the multinational AS-PROSE study was used. Thresholds to determine whether patients consider themselves in an 'unacceptable work state' were calculated at baseline for four instruments assessing presenteeism and two health-outcomes specific for r-axSpA. Different approaches derived from the receiver operating characteristic methodology were used. Validity of the optimal thresholds was tested across contextual factors and for predicting future AWO over 12?months. RESULTS: Of 366 working patients, 15% reported an unacceptable work state; 6% experienced at least one AWO in 12?months. Optimal thresholds were: WPAI-presenteeism =40 (AUC 0.85), QQ-method <97 (0.76), WALS =0.75 (AUC 0.87), WLQ-25?=?29 (AUC 0.85). BASDAI and BASFI performed similarly to the presenteeism instruments: =4.7 (AUC 0.82) and =3.5 (AUC 0.79), respectively. Thresholds for WALS and WLQ-25 were stable across contextual factors, while for all other instruments they overestimated unacceptable work state in lower educated persons. Proposed thresholds could also predict future AWO, although with lower performance, especially for QQ-method, BASDAI and BASFI. CONCLUSIONS: Thresholds of measurement instruments for presenteeism and health status to identify unacceptable work state have been established. These thresholds can help in daily clinical practice to provide work related support to r-axSpA patients at risk for AWO.
AB - OBJECTIVES: To a) identify threshold values of presenteeism measurement instruments that reflect unacceptable work state in employed r-axSpA patients; b) determine whether those thresholds accurately predict future adverse work outcomes (AWO) (sick leave or short/long-term disability); c) evaluate the performance of traditional health-outcomes for r-axSpA; d) explore whether thresholds are stable across contextual factors. METHODS: Data from the multinational AS-PROSE study was used. Thresholds to determine whether patients consider themselves in an 'unacceptable work state' were calculated at baseline for four instruments assessing presenteeism and two health-outcomes specific for r-axSpA. Different approaches derived from the receiver operating characteristic methodology were used. Validity of the optimal thresholds was tested across contextual factors and for predicting future AWO over 12?months. RESULTS: Of 366 working patients, 15% reported an unacceptable work state; 6% experienced at least one AWO in 12?months. Optimal thresholds were: WPAI-presenteeism =40 (AUC 0.85), QQ-method <97 (0.76), WALS =0.75 (AUC 0.87), WLQ-25?=?29 (AUC 0.85). BASDAI and BASFI performed similarly to the presenteeism instruments: =4.7 (AUC 0.82) and =3.5 (AUC 0.79), respectively. Thresholds for WALS and WLQ-25 were stable across contextual factors, while for all other instruments they overestimated unacceptable work state in lower educated persons. Proposed thresholds could also predict future AWO, although with lower performance, especially for QQ-method, BASDAI and BASFI. CONCLUSIONS: Thresholds of measurement instruments for presenteeism and health status to identify unacceptable work state have been established. These thresholds can help in daily clinical practice to provide work related support to r-axSpA patients at risk for AWO.
KW - presenteeism
KW - radiographic axial Spondyloarthritis
KW - work outcomes
KW - work satisfaction
U2 - 10.1093/rheumatology/keae033
DO - 10.1093/rheumatology/keae033
M3 - Article
SN - 1462-0324
JO - Rheumatology
JF - Rheumatology
M1 - keae033
ER -