Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice
Objective Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Gr...
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| Published in | Arthritis care & research (2010) Vol. 64; no. 5; pp. 640 - 647 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hoboken, USA
John Wiley & Sons, Inc
01.05.2012
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Objective
Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice.
Methods
The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations.
Results
Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR‐recommended RA disease activity measures.
Conclusion
We recommend the Clinical Disease Activity Index, Disease Activity Score with 28‐joint counts (erythrocyte sedimentation rate or C‐reactive protein), Patient Activity Scale (PAS), PAS‐II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. |
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| AbstractList | Objective
Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice.
Methods
The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations.
Results
Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR‐recommended RA disease activity measures.
Conclusion
We recommend the Clinical Disease Activity Index, Disease Activity Score with 28‐joint counts (erythrocyte sedimentation rate or C‐reactive protein), Patient Activity Scale (PAS), PAS‐II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice. The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations. Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR-recommended RA disease activity measures. We recommend the Clinical Disease Activity Index, Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein), Patient Activity Scale (PAS), PAS-II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. OBJECTIVEAlthough the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice. METHODSThe Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations. RESULTSSystematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR-recommended RA disease activity measures. CONCLUSIONWe recommend the Clinical Disease Activity Index, Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein), Patient Activity Scale (PAS), PAS-II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings. |
| Author | Yazdany, Jinoos Kazi, Salahuddin Robbins, Mark L. O'dell, James R. Anderson, Jaclyn Caplan, Liron Michaud, Kaleb Saag, Kenneth G. Neogi, Tuhina |
| AuthorAffiliation | 8 Salahuddin Kazi, MD: Dallas VA Medical Center, Dallas, Texas 2 Liron Caplan, MD, PhD: Denver VAMC and University of Colorado School of Medicine, Denver 5 Tuhina Neogi, MD, PhD: Boston University Schools of Medicine and Public Health, Boston, Massachusetts 3 Jinoos Yazdany, MD, MPH: University of California, San Francisco 4 Mark L. Robbins, MD, MPH: Harvard Vanguard Medical Associates, Boston, Massachusetts 6 Kaleb Michaud, PhD: University of Nebraska Medical Center, Omaha, and National Data Bank for Rheumatic Diseases, Wichita, Kansas 7 Kenneth G. Saag, MD, MS: University of Alabama at Birmingham 1 Jaclyn Anderson, DO, MS (current address: Abbott Laboratories, Abbott Park, Illinois), James R. O’Dell, MD: University of Nebraska Medical Center, Omaha |
| AuthorAffiliation_xml | – name: 1 Jaclyn Anderson, DO, MS (current address: Abbott Laboratories, Abbott Park, Illinois), James R. O’Dell, MD: University of Nebraska Medical Center, Omaha – name: 6 Kaleb Michaud, PhD: University of Nebraska Medical Center, Omaha, and National Data Bank for Rheumatic Diseases, Wichita, Kansas – name: 7 Kenneth G. Saag, MD, MS: University of Alabama at Birmingham – name: 2 Liron Caplan, MD, PhD: Denver VAMC and University of Colorado School of Medicine, Denver – name: 3 Jinoos Yazdany, MD, MPH: University of California, San Francisco – name: 5 Tuhina Neogi, MD, PhD: Boston University Schools of Medicine and Public Health, Boston, Massachusetts – name: 8 Salahuddin Kazi, MD: Dallas VA Medical Center, Dallas, Texas – name: 4 Mark L. Robbins, MD, MPH: Harvard Vanguard Medical Associates, Boston, Massachusetts |
| Author_xml | – sequence: 1 givenname: Jaclyn surname: Anderson fullname: Anderson, Jaclyn – sequence: 2 givenname: Liron surname: Caplan fullname: Caplan, Liron – sequence: 3 givenname: Jinoos surname: Yazdany fullname: Yazdany, Jinoos – sequence: 4 givenname: Mark L. surname: Robbins fullname: Robbins, Mark L. – sequence: 5 givenname: Tuhina surname: Neogi fullname: Neogi, Tuhina – sequence: 6 givenname: Kaleb surname: Michaud fullname: Michaud, Kaleb – sequence: 7 givenname: Kenneth G. surname: Saag fullname: Saag, Kenneth G. – sequence: 8 givenname: James R. surname: O'dell fullname: O'dell, James R. – sequence: 9 givenname: Salahuddin surname: Kazi fullname: Kazi, Salahuddin email: salahuddin.kazi@va.gov |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22473918$$D View this record in MEDLINE/PubMed |
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| Copyright | Copyright © 2012 by the American College of Rheumatology Copyright © 2012 by the American College of Rheumatology. 2012, American College of Rheumatology 2012 |
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| Notes | Dr. Saag has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Amgen, AstraZeneca, Lilly, Genentech, Merck, Horizon, Sanofi‐Aventis, Novartis, and Pfizer. Dr. Michaud has received consultant fees, speaking fees, and/or honoraria (less than $10,000) from the Mayo Foundation. Dr. Anderson owns stock and/or stock options in Abbot Laboratories. Dr. Kazi has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Genentech and Centocor. SourceType-Scholarly Journals-1 ObjectType-Feature-4 ObjectType-Undefined-1 content type line 23 ObjectType-Review-2 ObjectType-Article-3 Dr. Anderson owns stock and/or stock options in Abbot Laboratories. Dr. Michaud has received consultant fees, speaking fees, and/or honoraria (less than $10,000) from the Mayo Foundation. Dr. Saag has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Amgen, AstraZeneca, Lilly, Genentech, Merck, Horizon, Sanofi-Aventis, Novartis, and Pfizer. Dr. Kazi has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Genentech and Centocor. |
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| PublicationTitle | Arthritis care & research (2010) |
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| Publisher | John Wiley & Sons, Inc |
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Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations... Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist... OBJECTIVEAlthough the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations... |
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| SubjectTerms | Antirheumatic Agents - therapeutic use Arthritis, Rheumatoid - pathology Arthritis, Rheumatoid - therapy Health Surveys - methods Humans Practice Guidelines as Topic - standards Rheumatology - methods Rheumatology - standards Severity of Illness Index Societies, Medical - standards United States |
| Title | Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice |
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