BLISS index using WOMAC index detects between-group differences at low-intensity symptom states in osteoarthritis
Accepted 4 August 2009. published online 09 November 2009. Corrected Proof
Abstract
Objectives
The ability of the Bellamy et al. Low-Intensity Symptom State-attainment (BLISS) Index to differentiate between treatment groups (hylan G-F 20 vs. appropriate care) at low and very low levels of state attainment in patients with knee osteoarthritis was explored using the stiffness, function, and total index (TI) components of the WOMAC.
Study Design and Setting
Six different BLISS measures were analyzed using five WOMAC score thresholds: ≤5 normalized units (NUs): ≤10, ≤15, ≤20, and ≤25 (lower=better health).
Results
More patients in the hylan G-F 20 group achieved BLISS states in all three WOMAC subscales for all six BLISS analyses. These differences were statistically significant for the BLISS response at any time at all threshold levels except ≤5NU.
Conclusions
The six BLISS measures and threshold levels of stiffness, function, and TI score were able to statistically discriminate between treatment groups. BLISS-10 is a therapeutically attainable very low symptom state at which clinically important statistically significant between-group differences are detectable in pain, stiffness, function, and TI score and therefore may provide a benchmark against which therapeutic interventions can be assessed. However, the value to patients of these symptom states requires further elaboration.
aCentre of National Research on Disability and Rehabilitation Medicine (CONROD), The University of Queensland, Level 3, Mayne Medical School, Herston Road, Brisbane, QLD 4006, Australia
bRheumatology and Clinical Epidemiology, Sunnybrook & Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
cDepartment of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
ABSTRACT
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