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Is the patient-perceived impact of psoriatic arthritis a global concept? An international study in 13 Arab countries (TACTIC study)

  • Observational Research
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Abstract

The Psoriatic Arthritis Impact of Disease (PsAID-12) questionnaire, a recommended measure of patient-reported impact for psoriatic arthritis (PsA), was initially developed in Europe and may lack universal validity. Recognizing the need for a culturally appropriate tool for Arab patients, this study aimed to TranslAte, CulTurally adapt, and validate the PsAID in ArabIC (TACTIC). The PsAID-12 was translated into Arabic using a rigorous process of double translation, back-translation, and cognitive debriefing. The Arabic version was then validated through a study conducted in 13 Arab countries in 2022. Participants were consecutive literate adult patients diagnosed with PsA and fulfilling the CASPAR criteria. Collected data included PsAID-12, disease activity, and legacy patient-reported outcomes. Psychometric properties, such as internal consistency, construct validity, and test–retest reliability, were examined. Factors associated with high PsAID-12 total scores (> 4) were explored using multivariable binary logistic regression. A culturally adapted Arabic PsAID-12 questionnaire was achieved with minor rephrasing. The validation study included 554 patients from 13 countries (mean age 45 years, 59% females), with a mean PsAID score of 3.86 (SD 2.33). The Arabic PsAID-12 demonstrated excellent internal consistency (Cronbach’s α = 0.95), and correlations with other measures ranged from 0.63 to 0.78. Test–retest reliability (N = 138 patients) was substantial (intraclass correlation coefficient, ICC 0.90 [0.86–0.93]; Cohen’s kappa 0.80). Factors associated with a high PsAID score were disability (odds ratio, OR 3.15 [2.03–4.89]), depression (OR 1.56 [1.35–1.81]), widespread pain (OR 1.31 [1.12–1.53]), and disease activity (OR 1.29 [1.13–1.47]). Pain and fatigue were identified as the most impactful PsAID-12 domains for PsA patients. The Arabic PsAID is a valid and reliable measure that reflects the priorities of patients with PsA. PsAID scores correlated with disease activity and legacy outcome measures, as expected, indicating PsAID is a consistent measure of PsA impact across cultures. These findings highlight the potential of the Arabic PsAID in improving the care provided to Arabic-speaking patients worldwide.

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Data availability

Data supporting the findings of this study are available upon request from the corresponding author.

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Acknowledgements

Ms. Arlyn Lim Acenas (Philippines). Arab League of Associations for Rheumatology (ArLAR) Research Group (ARCH). This work was presented as a poster at the ArLAR and EULAR Congresses 2023. Ziade N, Abbas N, Hmamouchi I, et al. POS1542 THE PSORIATIC ARTHRITIS IMPACT OF DISEASE (PSAID-12) QUESTIONNAIRE IS VALID IN ARABIC AND STRONGLY LINKED TO DISEASE ACTIVITY AND PATIENT-REPORTED OUTCOMES IN ARAB-SPEAKING COUNTRIES: AN ARLAR INITIATIVE. Ann Rheum Dis 2023 May 30;82:1138-1139. https://doi.org/https://doi.org/10.1136/annrheumdis-2023-eular.3209.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Saint-Joseph University, Hotel-Dieu de France Hospital, Beirut, Lebanon

    Nelly Ziadé & Noura Abbas

  2. Laboratory of Clinical Research and Epidemiology, Faculty of Medicine, Mohammed V University, Rabat, Morocco

    Ihsane Hmamouchi

  3. Health Sciences College, International University of Rabat (UIR), Rabat, Morocco

    Ihsane Hmamouchi

  4. Division of Rheumatology, Department of Internal Medicine, Specialized Medical Centre, Riyadh, Saudi Arabia

    Lina El Kibbi

  5. University of Kurdistan-Hewler (UKH) School of Medicine; and Rizgary Hospital Erbil, Erbil, Iraq

    Avin Maroof

  6. Rheumatology Department, Cairo University, Giza, Egypt

    Bassel Elzorkany

  7. Rheumatology Unit, Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq

    Nizar Abdulateef & Faiq Isho Gorial

  8. Baghdad Teaching Hospital, Baghdad Medical City, Baghdad, Iraq

    Asal Adnan & Nabaa Ihsan Awadh

  9. Rheumatology Department, Ibn Al-Nafees Hospital, Damascus, Syria

    Nada Alchama

  10. Rheumatology Department, Djilali Bounaama University Hospital, Khemis Miliana, Douera, Algiers, Algeria

    Chafika Haouichat

  11. Faculty of Medicine El Mahdi Si Ahmed., Blida, Algeria

    Chafika Haouichat

  12. Division of Rheumatology, Department of Medicine, The University of Jordan, Amman, Jordan

    Fatima Alnaimat

  13. Rheumatology Department, Emirates Health Services, Ministry of Health and Prevention, Dubai, UAE

    Suad Hannawi

  14. Al-Ahli Hospital, Al-Quds University, Hebron, Palestine

    Saed Atawnah

  15. Section of Rheumatology, Department of Internal Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia

    Hussein Halabi

  16. Rheumatology Division of Internal Medicine, King Hussein Medical Centre, Royal Medical Services, Jordan Armed Forces, Amman, Jordan

    Manal Al Mashaleh

  17. Tripoli Central Hospital, Tripoli, Libya

    Laila Aljazwi

  18. Al-Azhar Faculty of Medicine, Dr Sulaiman Al Habib Hospital, Dubai, UAE

    Ahmed Abogamal

  19. Rheumatology Unit, Department of Internal Medicine, Tripoli Central Hospital, Tripoli, Libya

    Laila Ayoub

  20. Faculty of Medicine, University of Tripoli, Tripoli, Libya

    Laila Ayoub

  21. Farhat Hached Hospital of Sousse, Sousse, Tunisia

    Elyes Bouajina

  22. El Ayachi Hospital, Medical University Hospital, Rabat, Morocco

    Rachid Bahiri

  23. Assiut Medical School of Egypt, King Hamad University Hospital Bahrain, Al Sayh, Bahrain

    Sahar Saad

  24. King Hamad University Hospital, Al Sayh, Bahrain

    Maha Sabkar

  25. Saint George Hospital University Medical Centre, Saint George University of Beirut, Beirut, Lebanon

    Krystel Aouad

  26. INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Paris, France

    Laure Gossec

  27. Rheumatology Department, AP-HP, Pitié-Salpêtrière Hospital, Paris, France

    Laure Gossec

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  1. Nelly Ziadé
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  2. Noura Abbas
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Contributions

This study was started by NZ and NA with expertise from LG (initial developer of the PsAID and advisor on the present study); the protocol was written by NZ, NA, IH, and LG. The Pilot study committee comprised: NZ, NA, IH, LK, and AV. All authors included patients except for LG (France). Statistical analysis was performed by NZ. Then all authors participated in the analyses and the writing up.

Corresponding author

Correspondence to Nelly Ziadé.

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Conflict of interest

The authors declare that they have no competing interest to disclose in relation to this study.

Ethics

Informed consent was obtained from all participants. The study was approved by the Ethics Committee of Hotel-Dieu de France Hospital (Lebanon) and by the Institutional Review Boards of the participating countries, when necessary, according to local requirements.

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Appendices

Appendix 1: The English version and Arabic translation of the PsAID questionnaire. The changes are highlighted in yellow, and the explanations for each change are presented in the Arabic section (in italic). Male and female grammar formulation was applied where appropriate

figure a

Appendix 2: Overview of study findings

figure b

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Ziadé, N., Abbas, N., Hmamouchi, I. et al. Is the patient-perceived impact of psoriatic arthritis a global concept? An international study in 13 Arab countries (TACTIC study). Rheumatol Int 44, 885–899 (2024). https://doi.org/10.1007/s00296-024-05552-1

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