Characteristics of Subjects Self-Reporting Arthritis in a Population Health Survey: Distinguishing between Types of Arthritis

By Gariepy, Genevieve; Rossignol, Michel et al. | Canadian Journal of Public Health, November/December 2009 | Go to article overview

Characteristics of Subjects Self-Reporting Arthritis in a Population Health Survey: Distinguishing between Types of Arthritis


Gariepy, Genevieve, Rossignol, Michel, Lippman, Abby, Canadian Journal of Public Health


ABSTRACT

Objectives: Arthritis is a broad term covering disparate diseases with varying prognoses. Epidemiological surveys are important tools for arthritis research, but they either fail to specify arthritis subtypes or they provide self-reported arthritis data that are potentially misclassified. This limits their use for research about arthritis subgroups. This study describes and compares characteristics of subjects self-reporting subtypes of arthritis in a Canadian epidemiological survey. We also consider the feasibility of developing methods for distinguishing subtypes of arthritis in such population surveys.

Methods: Using data from 119,904 adult participants in the Canadian Community Health Survey (CCHS) cycle 3.1, we identified those self-reporting one of four subtypes of arthritis and compared the four groups with regard to socio-demographic status, lifestyle and health characteristics, medication use, health care utilization and functional outcomes. Cross-tabulations of weighted prevalence were estimated and tested for statistical significance using the chi-square test.

Results: Descriptive results showed very few distinguishing characteristics across self-reported arthritis subtypes on 34 investigated variables. Participants with osteoarthritis were more likely to be older and female than other groups. Statistical testing showed no difference between rheumatoid arthritis, osteoarthritis and "other" type of arthritis for physical activity level, health conditions, medication use, health care utilization and functional limitations.

Discussion: Characteristics of subjects who self-report different types of arthritis in a typical population health survey (CCHS) are not sufficiently dissimilar to justify valid data analyses and interpretation by arthritis subgroup. Future studies might focus on identifying and implementing supplemental questionnaire items in epidemiological population surveys.

Key words: Arthritis; arthritis, rheumatoid; osteoarthritis; epidemiologic methods; cluster analysis; health surveys

La traduction du résumé se trouve à la fin de l'article. Can J Public Health 2009;100(6):467-71.

Mots clés : arthrite; arthrite rhumatoïde; arthrose; méthode épidémiologique; analyse en grappe

Arthritis is the blanket term for a range of illnesses with widely varying prognoses, osteoarthritis (OA) and rheumatoid arthritis (RA) being the most common.1 Arthritis is one of the most prevalent chronic health conditions in North America and a leading cause of morbidity, functional disability and health care utilization.2,3 According to the 2002-2003 Canadian Community Health Survey (CCHS), 17.6% of Canadians report having arthritis, and its projected prevalence for 2021 is expected to reach between 21% and 26%.2-4 There is an urgent need to qualify, quantify and clarify many facets of arthritis and its subtypes.

Researchers often use self-reported arthritis data from epidemiological surveys to address questions about the disease. However, not all surveys ask respondents to specify their type of arthritis.5 This is problematic, because arthritis subtypes have a distinct pathogenesis, as well as functional, health and economic impacts. For example, those with RA have been shown to have higher risks of major vascular events, to experience more daily pain and to be more likely to suffer from depression than those with OA.6-8 By bundling all joint problems under the same term, researchers risk misinterpretations of their findings that may induce public health decisions not applicable to all arthritis subgroups.

In some investigations, participants are asked to self-report the specific type of arthritis they have. In this research, misclassification is likely to exist. OA and RA are often considered by lay people to be synonymous with each other and with other types of joint diseases. Previous research has highlighted the low positive predictive value of self-reported RA and OA. …

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