Background Patient reported outcome (PRO) is an important measure to physician in management of patient with rheumatic diseases. Health assessment questionnaire disability index (HAQ-DI) is the most widely used PRO tool in rheumatoid arthritis (RA) clinical trials. Previous studies have shown that HAQ-DI correlates well with disease activity score of 28-joints (DAS28). However, routine assessment of patient index data 3 (RAPID3) is much simpler and faster questionnaire to score.
Objectives This study aims to evaluate the correlation between RAPID3 and DAS28 compared to HAQ-DI and DAS28 in our population.
Methods RA patients who received routine treatment in Hospital Tuanku Ja'afar from March to November 2016 were included in this study. Validated RAPID3 and HAQ-DI questionnaire were made available in other languages; Malay, Chinese and Tamil, for patients who were not English literate. Descriptive analysis were conducted. Pearson correlation was used to measure the correlation between these PRO tools while area under the curve of the receiver operating characteristic (ROC) curves evaluate the sensitivity to detect disease activity. DAS28-ESR and DAS28-CRP were used as the reference variable in ROC analysis to stratified the disease activity into two groups; low (remission and low) and high (moderate and high) disease activity.
Results A total of 400 patients completed PRO assessments were available for analysis. The median age of our cohort was 57 years old (range 22 to 88) and 87.5% were female. Ethnic distribution in this cohort were as follows; 38.5% Indian, 31.8% Malay and 27.8% Chinese. Both RAPID3 (r=0.74,p<0.001) and HAQ-DI (r=0.57,p<0.001) were correlated with DAS28-ESR. The area under the curve was significantly higher in RAPID3 (83%) compared to HAQ-DI (75%) which implied greater performance in discriminating low and high disease activity using DAS28-ESR as reference. We observed similar performance trend between RAPID3 (92%) and HAQ-DI (82%) compared to DAS28-CRP.
Conclusions In conclusion, RAPID3 is an effective quantitative measure of disease activity compared to HAQ-DI in our population. Furthermore, RAPID3 yield similar disease activity categories as DAS28 without the need of joint counts and laboratory tests. Hence is an informative assessment of disease activity in busy clinic settings.
Patient Reported Outcome in Rheumatoid Arthritis Clinical Trials. Ana-Maria Orbai, Clifton O. Bingham III. Current Rheumatology Reports. 2015 Apr;174(4):501.
RAPID3 (Routine Assessment of Patient Index Data) on an MDHAQ (Multidimensional Health Assessment Questionnaire): Agreement with DAS28 (Disease Activity Index) and CDAI (Clinical Disease Activity Index) Activities Categories, Scored in Five Versus More Than Ninety Seconds. T. Pincus, C.J. Sweringen, M.J. Bergman, C.L. Colglazier, A.T. Kaell, A.M. Kunath, E.L. Siegel, Y, Yazici. Arthritis Care Res 2010;62:181.
Disclosure of Interest None declared