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Validation of a new glucocorticoid-specific Patient-Reported Outcome Questionnaire (the Steroid PRO)

Bridgewater, Susan; Ndosi, Mwidimi; Dawson, Jill; Richards, Pamela; Silverthorne, Christine; Dures, Emma; Goodman, Susan M.; Hill, Catherine; Mackie, Sarah L.; Robson, Joanna C.

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Dr Mwidimi Ndosi
Associate Professor in Nursing Rheumatology

Jill Dawson

Pamela Richards

Christine Silverthorne

Emma Dures
Professor in Rheumatology and Self-management

Susan M. Goodman

Catherine Hill

Sarah L. Mackie

Jo Robson
Consultant Associate Professor in Rheumatology


Objectives: Glucocorticoids used in the treatment of inflammatory rheumatic conditions can impact on health-related quality of life. An underpinning qualitative study developed a long-list of candidate items for a treatment-specific patient-reported outcome (PRO) measure. The objective of this paper is to determine scale structure and psychometric properties of the Steroid PRO. Methods: A cross-sectional survey of adults from the UK, USA, Australia and New Zealand, taking glucocorticoids for a rheumatic disease. Initial survey collected demographics, clinical information, 40 Steroid PRO candidate items and EuroQol-5 Dimensions- 5 levels (EQ-5D-5L). Follow-up, 3-5 days later, collected Steroid PRO candidate items and a condition-change ( € transition') question. Analysis included Rasch measurement model, exploratory factor analysis (EFA), and hypothesis testing for discriminative validity, convergence validity and test-retest reliability. Results: Total responses 946: UK n=743 (79%); USA n=139 (15%); Australia/New Zealand n=64 (7%); mean age 57.6 (SD=13.6); 833 (88%) women. Participants with inflammatory arthritis n=197 (21%), connective tissue disease and/or vasculitis n=402 (42%), giant cell arteritis and/or polymyalgia rheumatica n=347 (37%). Twenty-five items were removed due to lack of fit to Rasch model. Of the remaining items, EFA suggested four subscales: Social impact (4 items); Impact on appearance (3 items); Psychological impact (5 items); Treatment concerns (3 items). Rasch modelling supported a four-subscale structure and total score, confirming construct validity and reliability. Hypothesis testing confirmed discriminant and convergence validity. Intraclass correlation coefficient (total score) was 0.809 demonstrating excellent (test-retest) reliability. Conclusions: The Steroid PRO is a 15-item, valid and reliable scale for measuring the impact of glucocorticoid therapy in people with rheumatic diseases.


Bridgewater, S., Ndosi, M., Dawson, J., Richards, P., Silverthorne, C., Dures, E., …Robson, J. C. (2024). Validation of a new glucocorticoid-specific Patient-Reported Outcome Questionnaire (the Steroid PRO). Annals of the Rheumatic Diseases, 83(3), 394-400.

Journal Article Type Article
Acceptance Date Oct 24, 2023
Online Publication Date Nov 10, 2023
Publication Date Feb 15, 2024
Deposit Date Oct 24, 2023
Publicly Available Date Apr 11, 2024
Journal Annals of the Rheumatic Diseases
Print ISSN 0003-4967
Electronic ISSN 1468-2060
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 83
Issue 3
Pages 394-400
Keywords Systemic vasculitis, Connective Tissue Diseases, Arthritis, Rheumatoid, Glucocorticoids, Patient Reported Outcome Measures
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