A NEW simulation study based on registry data has explored whether patient-reported outcome scores in spondyloarthritis can be interchanged when data is missing—and found that while fatigue scores show promise, pain and global assessment scores should be treated as distinct.
The study tested whether missing data for one score, such as pain, fatigue, or global disease impact, could be substituted with a related measure captured at the same timepoint. Researchers assessed performance across multiple imputation methods, looking at accuracy and reliability depending on sample size, data availability, and patterns of missingness.
While attempts to substitute patient pain scores with related items from the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) failed across all scenarios, fatigue scores proved more promising. Interchanging fatigue with the BASDAI fatigue question was acceptable when data was only partially missing (up to 50%). However, substituting between pain, fatigue, and global assessment scores produced inconsistent results and was not recommended.
These findings have practical implications for rheumatology researchers working with real-world registry data, where missing entries are common. The authors conclude that patient pain, fatigue, and global assessments should ideally be recorded independently, rather than relying on imputation from other domains.
As data completeness remains a challenge in spondyloarthritis research, the study highlights the importance of robust data collection while also pointing to limited opportunities for safe and accurate imputation in specific cases—such as fatigue scores.
Reference
Georgiadis et al. Interchangeability of patient pain, fatigue and global scores in patients with spondyloarthritis – a registry-based simulation study. BMC Rheumatol. 2025;DOI: 10.1186/s41927-025-00527-6.
