Background A patient self-report joint count, rheumatoid arthritis disease activity index (RADAI),1 is correlated significantly with tender and swollen joint counts performed by a health professional in rheumatoid arthritis (RA) patients2. The RADAI is included on the multidimensional health assessment questionnaire (MDHAQ), which is completed in many rheumatology settings by all patients with all diagnoses, as the same questionnaire is (logistically) most feasible.
Objectives To analyze RADAI painful joint count scores in patients with diagnoses other than RA in usual care setting.
Methods Each patient seen at an academic rheumatology site completes an MDHAQ at each visit, while waiting to see the doctor in the infrastructure of clinical care. The RADAI on the MDHAQ includes 8 bilateral specific joint groups: fingers, wrist, elbow, shoulder, hip, knee, ankle and toes, each scored from 0 (“no pain”) to 3 (“severe pain”) (total 0-48). A random visit of 465 patients was analyzed including 75 with SLE, 50 with gout, 53 with PsA, 113 with OA, as well as 174 with RA. Mean RADAI and % of patients scoring each specific joint group as affected were computed for each diagnosis, and compared to the MDHAQ patient global estimate (PATGL) and physician global estimate (DOCGL) using Spearman correlations.
Results Patients were primarily women (68%), age 51±16 years;SLE patients were youngest (39.5±13.8) and OA patients oldest (62.8±12.5). An abnormal RADAI score >0 was reported by 99% of patients with OA, 87% of patients with RA, 83% with PsA, 60% with gout, and 59% with SLE. The joints reported as most affected were knees (58%) and fingers (52%) in all patients; in RA, fingers (52%), wrists (58%), and knees (58%); in SLE, fingers (37%) and shoulders (32%); in gout, toes (24%) and knees (22%); in PsA, knees (43%) and fingers (40%), and in OA, knees (68%) and fingers (42%) (Table). RADAI scores were correlated significantly with PATGL (rho =0.50–0.75, p<0.001), and moderately, though significantly, with DOCGL in all diagnoses except SLE (rho =0.40–0.54, p<0.001).
Conclusions A RADAI self-report joint count on an MDHAQ can be informative in patients with OA, gout, psoriatic arthritis and SLE, in addition to RA, with no additional work by the doctor, to assess clinical status in usual care.
Stucki G, Liang MH, Stucki S, Bruhlmann P, Michel BA. Arthritis Rheum 1995;38:795-8.
Barton JL, Criswell LA, Kaiser R, Chen YH, Schillinger D. J Rheumatol 2009;36:2635-41.
Disclosure of Interest None Declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.