Open AccessThe ability of the Cochin rheumatoid arthritis hand functional scale to detect change during the course of disease
Author(s) -
Poiraudeau Serge,
LefevreColau Marie Martine,
Fermanian Jacques,
Revel Michel
Publication year - 2000
Publication title -
arthritis care & research
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/1529-0131(200010)13:5<296::aid-anr9>3.0.co;2-f
Subject(s) - medicine , visual analogue scale , physical therapy , rheumatoid arthritis , rheumatism , confidence interval , rheumatology , spearman's rank correlation coefficient , correlation , arthritis , rank correlation , statistics , geometry , mathematics
Objective To assess changes measured with the Cochin rheumatoid arthritis (RA)hand functional disability scale during the course of the disease. Methods A cohort study evaluating outcome measure responsiveness in RA wasconducted in a referral center. Ambulatory or hospitalized patientswith RA according to the 1987 American College of Rheumatology(formerly the American Rheumatism Association) criteria were evaluatedtwice. Clinical measures included Cochin's scale, Revel's functionalindex, hand functional index, visual analog scale of patient‐perceivedhandicap, visual analog scale of pain in hands and wrists, total scoreof swelling, total score of tenderness, and morning stiffness duration.Responsiveness was assessed by the effect size (ES) and thestandardized response mean (SRM). The nonparametric Spearman rankcorrelation coefficient (r) was used to assess the correlation betweentwo quantitative variable changes. Results Fifty‐five patients (44 women) were evaluated twice at an interval of15.4 ± 1.4 months (mean ± SD) (range 13–18 months). TheCochin scale total score had worsened at the second visit (95%confidence interval for mean differences −5.16, 0.73). Its SRM and ESvalues were −0.20 and −0.15, respectively. Changes in the score hadthe highest correlation (r = 0.58) with changes in thepatient‐perceived handicap, while it had only fair or littlecorrelation with changes in the disease activity measures. The factor 2scale subscore significantly worsened and had the highest values of SRMand ES (SRM = −0.40 and ES = −0.31). Conclusion The Cochin scale can detect small but meaningful changes in RA handdisability.