Abstract
ObjectivesIn this study the concordance between the Routine Assessment of Patient Index Data 3 (RAPID3) and the Disease Activity Score 28-joint count (DAS28) was investigated in a clinical routine outpatient setting.Patients and methodsA sample of 150 adult patients with stable RA treated with biological DMARDs (bDMARDs) was asked to complete the RAPID3 (digital or on paper) just before their outpatient routine visit during which DAS28 assessment took place. The RAPID3 correlation with and the agreement in four DAS28 categories was studied using Spearman’s rank order and Cohen’s observed kappa statistics respectively. The positive (PPV) and negative (NPV) predictive values were calculated to test whether RAPID3 could make distinction in active disease (DAS28 >3.2) or not.ResultsA moderate correlation (ρ 0.576) and a poor kappa value of 0.13 were found in the whole study population. Patients reported a higher disease severity than was measured by DAS28. The PPV of RAPID3 for active disease by DAS28 was 0.59 (95 % CI 0.50–0.68) and the NPV was 0.91 (95 % CI 0.75–0.98) with a sensitivity and specificity of 96 and 40 % respectively.DiscussionWhile RAPID3 correlates to some extent with DAS28 at the group level, agreement between RAPID3 and DAS28 at the individual patient level is to poor to rely on RAPID3 results in monitoring patients with RA. RAPID3 tends to over-report disease activity as assessed by DAS28.
Highlights
Rheumatoid arthritis (RA) is a chronic inflammatory disease that may impair daily functioning and quality of life due to pain, swelling and stiffness
Between May 2013 and April 2014 a sample was taken of consecutive adult patients with RA according to the ACR 1987 criteria that were on stable treatment with a biological disease modifying anti-rheumatic drugs (DMARDs)
We have screened 1195 RA patients for the study and 293 patients met entry criteria since they were on treatment with biological DMARDs
Summary
Rheumatoid arthritis (RA) is a chronic inflammatory disease that may impair daily functioning and quality of life due to pain, swelling and stiffness. Treatment of RA mainly includes disease modifying anti-rheumatic drugs (DMARDs) including biologicals. (PROs) are well established by groups of experts from the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT)-working group (Felson et al 1993). Patient global health (pGH) a PRO element is included as a recommendation in the 2010 ACR-EULAR guideline that proposed tighter definitions for clinical remission in clinical trials, and is established for clinical practice (Smolen et al 2013). This implies that PROs have certain significance for routine clinical care
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