Measures of rheumatoid arthritis disease activity: Patient (PtGA) and Provider (PrGA) Global Assessment of Disease Activity, Disease Activity Score (DAS) and Disease Activity Score With 28‐Joint Counts (DAS28), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), Patient Activity Score (PAS) and Patient Activity Score‐II (PASII), Routine Assessment of Patient Index Data (RAPID), Rheumatoid Arthritis Disease Activity Index (RADAI) and Rheumatoid Arthritis Disease Activity Index‐

Anderson, J.; Zimmerman, Lani; Caplan, Liron; Michaud, Kaleb

doi:10.1002/acr.20621

Cited by 221 publications

(112 citation statements)

References 85 publications

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“…Patients provided a global assessment of their disease during the telephone interview, answering the following question, “Considering all the ways that your arthritis affects you, rate how well you are doing on a scale from 0 to 100, where 0 is very well and 100 is very poor” (33). The Patient Health Questionnaire-9 (PHQ-9)(34, 35) was collected in the UCSF RA Cohort and the Geriatric Depression Scale short form (GDS)(36, 37) was obtained in the RA Panel to measure depressive symptoms.…”

Section: Methodsmentioning

confidence: 99%

English Language Proficiency, Health Literacy, and Trust in Physician Are Associated with Shared Decision Making in Rheumatoid Arthritis

Barton

Trupin²,

Tonner³

et al. 2014

J Rheumatol

101

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Objective Treat to Target guidelines promote shared decision-making (SDM) in rheumatoid arthritis (RA). Also, due to high cost and potential toxicity of therapies, SDM is central to patient safety. Our objective was to examine patterns of perceived communication around decision-making in two cohorts of adults with RA. Methods Data were derived from patients enrolled in one of two longitudinal, observational cohorts (UCSF RA Cohort and RA Panel). Subjects completed a telephone interview in their preferred language that included a measure of patient-provider communication, including items about decision-making. Measures of trust in physician, education, and language proficiency were also asked. Logistic regression was performed to identify correlates of suboptimal SDM communication. Analyses were performed on each sample separately. Results Of 509 patients across two cohorts, 30% and 32% reported suboptimal SDM communication. Low trust in physician was independently associated with suboptimal SDM communication in both cohorts. Older age and limited English proficiency were independently associated with suboptimal SDM in the UCSF RA Cohort, as was limited health literacy in the RA Panel. Conclusions This study of over 500 adults with RA from two demographically distinct cohorts found that nearly one-third of subjects report suboptimal SDM communication with their clinicians, regardless of cohort. Lower trust in physician was independently associated with suboptimal SDM communication in both cohorts, as was limited English language proficiency and older age in the UCSF RA Cohort and limited health literacy in the Panel. These findings underscore the need to examine the impact of SDM on health outcomes in RA.

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Section: Methodsmentioning

confidence: 99%

English Language Proficiency, Health Literacy, and Trust in Physician Are Associated with Shared Decision Making in Rheumatoid Arthritis

Barton

Trupin²,

Tonner³

et al. 2014

J Rheumatol

101

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“…Nowadays, efficient disease-modifying antirheumatic drugs (DMARDS), such as Methotrexate, as well as targeted immunomodulating agents, are available to relieve patients 1–4. In order to define treatment strategy and to evaluate response to therapy, disease activity may be measured via several scoring schemes, including the Disease Activity Score, involving 28 joint counts (DAS28), the Simplified Disease Activity Score (SDAI), and the Clinical Disease Activity Score (CDAI),5,6 among others. All these measures consist of a weighted sum of bioclinical features, or a transform (eg, logarithm) of these, such as the number of tender joints in the hands, the number of swollen joints in the hands, the erythrocyte sedimentation rate (ESR), the C-reactive protein (CRP) concentration, the patient global assessment, and the physician global assessment.…”

Section: Introductionmentioning

confidence: 99%

“…A lot of detail on RA scores can be found in two very helpful reviews from Anderson et al published in 2011 and 2012 5,6. Some of them have been compared several times 15,16.…”

Section: Introductionmentioning

confidence: 99%

Methodological issues in the design of a rheumatoid arthritis activity score and its cut-offs

Collignon

2014

CLEP

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Activity of rheumatoid arthritis (RA) can be evaluated using several scoring scales based on clinical features. The most widely used one is the Disease Activity Score involving 28 joint counts (DAS28) for which cut-offs were proposed to help physicians classify patients. However, inaccurate scoring can lead to inappropriate medical decisions. In this article some methodological issues in the design of such a score and its cut-offs are highlighted in order to further propose a strategy to overcome them. As long as the issues reviewed in this article are not addressed, results of studies based on standard disease activity scores such as DAS28 should be considered with caution.

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“…In more recent times, more stringent consensus definitions of remission have been developed that are both index based (Simplified Disease Activity Index [SDAI] score ≤3.3 3, 13, 19) and Boolean based. The Boolean‐based definition 13 requires a score of ≤1 on each of the following items: tender joint count in 28 joints, swollen joint count in 28 joints, CRP level (in mg/dl), and patient global assessment (on a 0–10‐cm visual analog scale 13, 19).…”

Section: Introductionmentioning

confidence: 99%

“…The Boolean‐based definition 13 requires a score of ≤1 on each of the following items: tender joint count in 28 joints, swollen joint count in 28 joints, CRP level (in mg/dl), and patient global assessment (on a 0–10‐cm visual analog scale 13, 19). …”

Section: Introductionmentioning

confidence: 99%

Effects of Achieving Target Measures in Rheumatoid Arthritis on Functional Status, Quality of Life, and Resource Utilization: Analysis of Clinical Practice Data

Alemao

Joo

Kawabata

et al. 2016

Arthritis Care & Research

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ObjectiveTo evaluate associations between achieving guideline‐recommended targets of disease activity, defined by the Disease Activity Score in 28 joints using C‐reactive protein level (DAS28‐CRP) <2.6, the Simplified Disease Activity Index (SDAI) ≤3.3, or the Clinical Disease Activity Index (CDAI) ≤2.8, and other health outcomes in a longitudinal observational study.MethodsOther defined thresholds included low disease activity (LDA), moderate (MDA), or severe disease activity (SDA). To control for intraclass correlation and estimate effects of independent variables on outcomes of the modified Health Assessment Questionnaire (M‐HAQ), the EuroQol 5‐domain (EQ‐5D; a quality‐of‐life measure), hospitalization, and durable medical equipment (DME) use, we employed mixed models for continuous outcomes and generalized estimating equations for binary outcomes.ResultsAmong 1,297 subjects, achievement (versus nonachievement) of recommended disease targets was associated with enhanced physical functioning and lower health resource utilization. After controlling for baseline covariates, achievement of disease targets (versus LDA) was associated with significantly enhanced physical functioning based on SDAI ≤3.3 (ΔM‐HAQ −0.047; P = 0.0100) and CDAI ≤2.8 (−0.073; P = 0.0003) but not DAS28‐CRP <2.6 (−0.022; P = 0.1735). Target attainment was associated with significantly improved EQ‐5D (0.022–0.096; P < 0.0030 versus LDA, MDA, or SDA). Patients achieving guideline‐recommended disease targets were 36–45% less likely to be hospitalized (P < 0.0500) and 23–45% less likely to utilize DME (P < 0.0100).ConclusionAttaining recommended target disease‐activity measures was associated with enhanced physical functioning and health‐related quality of life. Some health outcomes were similar in subjects attaining guideline targets versus LDA. Achieving LDA is a worthy clinical objective in some patients.

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Cited by 221 publications

References 85 publications

English Language Proficiency, Health Literacy, and Trust in Physician Are Associated with Shared Decision Making in Rheumatoid Arthritis

English Language Proficiency, Health Literacy, and Trust in Physician Are Associated with Shared Decision Making in Rheumatoid Arthritis

Methodological issues in the design of a rheumatoid arthritis activity score and its cut-offs

Effects of Achieving Target Measures in Rheumatoid Arthritis on Functional Status, Quality of Life, and Resource Utilization: Analysis of Clinical Practice Data

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