POS0248 THE EVALUATION OF A NOVEL TRAINING INFOGRAPHIC FOR THE PHYSICIAN VISUAL ANALOGUE SCALE (VAS) IN PSORIATIC ARTHRITIS
Authors: S. Gunawardana, P. S. Helliwell, M. R. Kok, M. Vis, A. Allard, A. Akpabio, A. Alsaffar, J. Ellis, F. R. Kasiem, R. Macmillan, B. Mulhearn, A. Gorman, L. C. Coates, W. Tillett
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Psoriatic arthritis (PsA) is a heterogenous condition with musculoskeletal and skin manifestations. The physician visual analogue scale (VAS) is an important component of several composite scores used in clinical trials and routine clinical practice. To date, however, there are no training materials to standardise this assessment. <h3>Objectives:</h3> The aim of this study was to develop and validate a novel training infographic to standardise the physician global VAS in PsA assessment. <h3>Methods:</h3> A novel training infographic (Figure 1) was evaluated in a Latin square design in which 20 patients with PsA were assessed by 10 clinicians, consisting of rheumatology consultants, rheumatology trainees, rheumatology clinical fellows and a rheumatology specialist nurse. Patients were divided into two groups. For each group of 10 patients, five assessors conducted a 'traditional' assessment (consisting of 66/68 joint count, body surface area, Leeds enthesitis index, dactylitis and nail counts) and five assessors conducted a standardised, thorough general examination informed by the 'infographic'. Assessors completed the GRAPPA training modules for disease assessment and switched assessment type between both groups of patients. The physician global VAS informed by traditional and infographic methods were incorporated into the following composite measure scores: 3-item VAS (3VAS), 4-item VAS (4VAS), PASDAS and DAPSA scores. <h3>Results:</h3> There was strong agreement between traditional and infographic clinician VAS scores (intraclass correlation coefficient (ICC) 0.686, p = 0.008) (Figure 2a). This improved to very strong agreement when incorporated into the 3VAS (ICC 0.989, p &lt;0.001) and 4VAS (ICC 0.994, p &lt;0.001) (Figure 2b and 2c). The mean time taken to complete the physician global VAS was less for the infographic versus traditional groups (6.5 minutes versus 7.8 minutes, p&lt;0.001). There was strong agreement between the 3VAS and 4VAS composite scores informed by the infographic compared with PASDAS and DAPSA composite score (Rho 0.64-0.70, p &lt;0.05). There was moderately high agreement between the 3VAS and 4VAS categories of disease activity with the same categories defined by PASDAS and DAPSA (x<sup>2</sup> 17.0, p = 0.049). There was also strong agreement between infographic global VAS assessed by consultants compared with non-consultants (ICC 0.671, p = 0.01). <h3>Conclusion:</h3> This study has developed and evaluated the validity of a novel training infographic which informs a briefer assessment of the physician global VAS than by synthesising information from traditional individual domain assessments. This tool has potential applications in training and routine clinical practice. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> We would like to acknowledge the 20 patients who volunteered for this study with many thanks. <h3>Disclosure of Interests:</h3> <b>None declared.</b>