A simplified disease activity index for rheumatoid arthritis for use in clinical practice

Smolen, Josef S.; Breedveld, F. C.; Schiff, Michael; Kalden, Joachim R.; Emery, Paul; Eberl, Gérard; Riel, P.L.C.M. van; Tugwell, Peter

doi:10.1093/rheumatology/keg072

Cited by 865 publications

(601 citation statements)

References 25 publications

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“…Because the single items of both disease activity indices (SJC, TJC, ESR, CRP, VAS-GH, and VAS-PH) are part of the routine monitoring program for RA patients, both scores were calculated as described (1,5). For the calculation of the DAS28, an electronic device was used.…”

Section: Methodsmentioning

confidence: 99%

“…The value is the result of a complicated calculation (DAS28 ϭ 0.56 ϫ ͌[t28] ϩ 0.28 ϫ ͌[sw28] ϩ 0.70 ϫ Ln [ESR] ϩ 0.014 ϫ GH). The Simplified Disease Activity Index (SDAI), however, is derived by adding the following parameters: SJC and TJC of a 28-joint count, the C-reactive protein (CRP in mg/dl), the VAS-GH (scored 0 -10), and the VAS of physician's health assessment (VAS-PH scored 0 -10) (5). Both scores result in absolute numbers reflecting disease activity; however, by the way of calculation, different weightings of the single items are to be expected.…”

Section: Introductionmentioning

confidence: 99%

“…All parameters included in the SDAI and the DAS28 are of proven sensitivity to change and, moreover, the SDAI's sensitivity to change was demonstrated in the leflunomide study patient population (5). The SDAI and DAS28 values for the single patients were reported to be highly correlated and, therefore, the SDAI (because of its easy applicability) was proposed to provide advantages in daily practice compared with the DAS28 (5).…”

Section: Introductionmentioning

confidence: 99%

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Disease activity measurement of rheumatoid arthritis: Comparison of the simplified disease activity index (SDAI) and the disease activity score including 28 joints (DAS28) in daily routine

Leeb¹,

Andel²,

Sautner³

et al. 2005

Arthritis & Rheumatism

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Objective. To assess the reliability and congruency of the Simplified Disease Activity Index (SDAI) compared with the Disease Activity Score including 28 joints (DAS28) in daily practice. Methods. In 399 consecutive rheumatoid arthritis patients (307 women, 92 men), the SDAI and the DAS28 were calculated. Additionally, 115 of them were observed for 1 year and changes of both values were recorded. Joint assessments were performed by 4 experienced physicians. DAS28 and SDAI values and the respective changes were compared by correlation and regression analyses. Reliability assessment and factor analyses were performed. Disease activity categorizing was compared by the Wilcoxon's rank sum test. Results. The median ؎ SD scores were 3.42 ؎ 1.45 for the DAS28 and 11.50 ؎ 11.50 for the SDAI. Spearman's rho was 0.897 (P < 0.0001). Score changes were also significantly correlated. Reliability testing and factor analysis revealed that both scores can be regarded as monocomponent. Categorizing patients according to the European League Against Rheumatism response criteria (EULARC) or the SDAI revealed statistically significant differences between the 2 scales (P < 0.0001). Conclusion. SDAI values are considerably shifted to the left compared with DAS28 levels. Internal consistency and reliability of both scores are comparable. For the differences in disease activity categorizing due to the SDAI compared with the EULARC, a major limitation of the application of this newly developed disease activity score is given, unless these incongruencies can be cleared.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Disease activity measurement of rheumatoid arthritis: Comparison of the simplified disease activity index (SDAI) and the disease activity score including 28 joints (DAS28) in daily routine

Leeb¹,

Andel²,

Sautner³

et al. 2005

Arthritis & Rheumatism

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“…To investigate the validity of the 28-joint Disease Activity Score using ESR (DAS28-ESR) for evaluating the efficacy of TCZ as a treatment for RA, we compared the efficacy assessment in the SATORI study (a double-blind, comparative study of TCZ conducted in Japan) [4] using the DAS28-ESR [15] with the efficacy assessments using the clinical disease activity index (CDAI) [16], simplified disease activity index (SDAI) [17] and American College of Rheumatology (ACR) response [18]. …”

Section: Introductionmentioning

confidence: 99%

Assessment of the validity of the 28-joint disease activity score using erythrocyte sedimentation rate (DAS28-ESR) as a disease activity index of rheumatoid arthritis in the efficacy evaluation of 24-week treatment with tocilizumab: subanalysis of the SATORI study

Nishimoto

Takagi²

2010

Mod Rheumatol

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As tocilizumab (TCZ) greatly inhibits inflammatory markers, methods of evaluating rheumatoid arthritis (RA) disease activity that include inflammatory markers may overestimate the effect of TCZ treatment. We have evaluated the impact of inflammatory markers on the efficacy of TCZ by comparing the efficacy indicated by the 28-joint disease activity score using erythrocyte sedimentation rate (DAS28-ESR) with that indicated by the clinical and simplified disease activity indexes (CDAI and SDAI, respectively) and the American College of Rheumatology (ACR) core set criteria in a double-blind study of TCZ—the SATORI study. The Spearman correlation coefficient between DAS28-ESR and CDAI was comparable between that at week 24 and that at baseline [correlation coefficient at baseline and week 24 was 0.823 (p < 0.0001) and 0.818 (p < 0.0001), respectively]. A large difference between the DAS28 remission rate and CDAI remission rate was observed at week 24. However, these results are comparable to those of a previous study conducted with non-TCZ-treated patients. Moreover, the same results were obtained in the comparison between the DAS28-ESR and SDAI, even though the SDAI includes an inflammatory parameter as a component. These results confirm that the DAS28-ESR has a validity comparable to that of other methods in terms of evaluating the RA treatment efficacy of TCZ, despite its strong inflammatory marker-inhibiting effects.

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“…Mean Ϯ SD scores were 24.1 Ϯ 20.4 (range 0 -108) for the modified BVAS/WG, 3.4 Ϯ 3.0 (range 0 -17) for the original BVAS/WG, and 2.7 Ϯ 2.0 (range 0 -12) for the unweighted BVAS/WG. For the 180 trial participants at baseline (study entry), the mean modified BVAS/WG, original BVAS/WG, and unweighted BVAS/WG scores were 49.6 Ϯ 19.1 (range 10 -108), 6.9 Ϯ 3.4 (range 2-17), and 5.0 Ϯ 2.1 (range [1][2][3][4][5][6][7][8][9][10][11][12], respectively. Table 4 shows the correlation coefficients of the PGA with these 3 scores for all 734 visits with active disease, …”

mentioning

confidence: 99%

Assessment of the item selection and weighting in the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis

Mahr

Neogi

LaValley

et al. 2008

Arthritis & Rheumatism

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Objective. To assess the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG) with respect to its selection and weighting of items.Methods. This study used the BVAS/WG data from the Wegener's Granulomatosis Etanercept Trial. The scoring frequencies of the 34 predefined items and any "other" items added by clinicians were calculated. Using linear regression with generalized estimating equations in which the physician global assessment (PGA) of disease activity was the dependent variable, we computed weights for all predefined items. We also created variables for clinical manifestations frequently added as other items, and computed weights for these as well. We searched for the model that included the items and their generated weights yielding an activity score with the highest R 2 to predict the PGA. Results. We analyzed 2,044 BVAS/WG assessments from 180 patients; 734 assessments were scored during active disease. The highest R 2 with the PGA was obtained by scoring WG activity based on the following items: the 25 predefined items rated on >5 visits, the 2 newly created fatigue and weight loss variables, the remaining minor other and major other items, and a variable that signified whether new or worse items were present at a specific visit. The weights assigned to the items ranged from 1 to 21. Compared with the original BVAS/WG, this modified score correlated significantly more strongly with the PGA. Conclusion. This study suggests possibilities to enhance the item selection and weighting of the BVAS/WG. These changes may increase this instrument's ability to capture the continuum of disease activity in WG.

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A simplified disease activity index for rheumatoid arthritis for use in clinical practice

Cited by 865 publications

References 25 publications

Disease activity measurement of rheumatoid arthritis: Comparison of the simplified disease activity index (SDAI) and the disease activity score including 28 joints (DAS28) in daily routine

Disease activity measurement of rheumatoid arthritis: Comparison of the simplified disease activity index (SDAI) and the disease activity score including 28 joints (DAS28) in daily routine

Assessment of the validity of the 28-joint disease activity score using erythrocyte sedimentation rate (DAS28-ESR) as a disease activity index of rheumatoid arthritis in the efficacy evaluation of 24-week treatment with tocilizumab: subanalysis of the SATORI study

Assessment of the item selection and weighting in the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis

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