| Name of the Instrument/Tool | Methotrexate Intolerance Severity Score (MISS) |
| First Description |
Bulatović M, Heijstek MW, Verkaaik M,Dijkhuizen EHP, Armbrust W, Hoppenreijs EPA, Kamphuis S, Kuis W, Egberts TCG, Sinnema G et al. High prevalence of methotrexate intolerance in juvenile idiopathic arthritis: Development and validation of a methotrexate intolerance severity score. Arthritis Rheum. 2011;63:2007–2013. |
| Year | 2011 |
| Domains | |
| Concept of constructs | Treatment tolerability |
| Population/Disease | Disease specific |
| Originally developed for | Juvenile Idiopathic Arthritis (JIA) |
| Other rheumatic diseases where can be applied (only if validated) |
Rheumatoid Arthritis (RA) |
| Additional population with no rheumatic diseases |
No |
| Language: Originally published in | English |
| Available in Language | French, Portuguese, Arabic |
| REFERENCE IDENTIFICATION | |
| Author/s | Bulatović M, Heijstek MW, Verkaaik MVan Dijkhuizen EHP, Armbrust W, Hoppenreijs EPA, Kamphuis S, Kuis W, Egberts TCG, Sinnema G et al. |
| Title | High prevalence of methotrexate intolerance in juvenile idiopathic arthritis: Development and validation of a methotrexate intolerance severity score. |
| Journal | Arthritis Rheum. |
| Year | 2011 |
| Vol | 63 |
| Num | --- |
| Pages | 2007–2013 |
| Country | The Netherlands |
| Language | English |
| Other references of interest | |
| Link | https://pubmed.ncbi.nlm.nih.gov/32843102/ |
| Brief Description |
High frequency of methotrexate intolerance in longstanding rheumatoid arthritis: using the methotrexate intolerance severity score (MISS) |
| Link | https://pubmed.ncbi.nlm.nih.gov/27053094/ |
| Brief Description |
Frequency of methotrexate intolerance in rheumatoid arthritis patients using methotrexate intolerance severity score (MISS questionnaire) |
| Link | https://pubmed.ncbi.nlm.nih.gov/34218394/ |
| Brief Description |
Real-world data on MTX tolerance with regimens used in children versus adults |
| Instrument/Tool Translations References | |
| Link | https://pubmed.ncbi.nlm.nih.gov/28477218/ |
| Brief Description |
MISS questionnaire in French version: a good tool for children and parents to assess methotrexate intolerance |
| Link | https://pubmed.ncbi.nlm.nih.gov/31789997/ |
| Brief Description |
Cultural Adaptation and Validation of the Methotrexate Intolerance Severity Score in Brazilian Portuguese for Adults With Rheumatoid Arthritis |
| Link | https://pubmed.ncbi.nlm.nih.gov/31245906/ |
| Brief Description |
Prevalence of methotrexate intolerance among patients with rheumatoid arthritis using the Arabic version of the methotrexate intolerance severity score |
| DEVELOPER CONTACT INFORMATION | |
| Correspondence to | Maja Bulatovic |
| m.bulatovic@umcutrecht.nl | |
| Address | --- |
| Website | --- |
| Available | --- |
| Links | --- |
| DESCRIPTION OF THE INSTRUMENT | |
| Type Of Measure | Questionnaire |
| Brief Description |
The MISS questionnaire aims to discriminate between patients with and those without MTX intolerance. It consist of 4 domains: stomach ache, nausea, vomiting, and behavioral symptoms. The domains each consisted of 3 questions pertaining to the presence of a symptom upon, prior to (anticipatory), and when thinking of (associative) MTX intake. |
| Number of Items | 12 |
| Range | 0-36 |
| Responses options/scale |
Yes 0-3 |
| Developed for | --- |
| PRACTICAL APPLICATION | |
| Method of administration | Interviewer/assessor, Physician |
| Recommendations to score |
A patient can score 0 (no symptoms), 1 (mild symptoms), 2 (moderate symptoms) or 3 (severe symptoms) points on each of the 12 items. The sum of each independent score gives the final score. |
| Score Interpretation | Higher scores indicate higher intolerance. |
| Cut-off points | Cutoff scores of 5 and 6 showed the highest sum score of sensitivity (88%) and specificity (80%) |
| Cut-off points applied to | Routine care |
| Smallest detectable change if described | --- |
| Smallest detectable change applied to | --- |
| Completion time by the patient | - minutes |
| Scoring time by the assessor | - minutes |
| Training to score | Not necessary |
| Strengths | Easy to use, Useful in clinical practice & research |
| Limitations | --- |
| OTHER COMMENTS | |
| Other Comments | --- |