Diagnostic error as a scientific and ethical challenge in establishing the activity of rheumatoid arthritis

Abstract

IntroductionThe articular examination is an essential part of the physical examination of the patient with rheumatoid arthritis, since it gives information about the disease status at a given time and allows monitoring of its evolution over time. Despite the importance of the physical examination of the joints, it is noteworthy that there is no standardized technique. MethodsThis paper aims to frame a discussion on whether standardization of the joint examination is justified, presenting arguments for and against. Results and discussionThe paper raises several arguments about diagnostic error as a scientific and ethical challenge in establishing the activity of rheumatoid arthritis. ConclusionIt is time to adopt a standardized physical joint examination technique that allows better assessment of the inflammatory activity status of the disease, avoids risks resultant from poor disease status classification, adheres to ethical principles and does not incur unnecessary expenses. Failure to do so would have scientific, economic, ethical, and public health implications.