Background We reported the impact of joint diseases on modified health assessment questionnaire (MHAQ) scores determined using 2011 data from NinJa (National Database of Rheumatic Diseases by iR-net in Japan). The MHAQ score was significantly associated with disease in almost all joints and physical ability tended to become aggravated. We also developed a joint-weighted scoring system from odds ratios. Respective integer scores assigned to disease in bilateral and unilateral joints comprised shoulder, 4 and 2; elbow, 3 and 2; wrist, 2 and 2; hip, 0 and 3; knee, 3 and 2; ankle, 2 and 2; finger, 1 and 1. Statistical analyses indicated a cut-off at 3 points using this system (Ono K, et al., Modern Rheumatology, 2016).
Objectives To validate the weighted scoring system using NinJa data from 2009 and 2014.
Methods We analyzed data from 7,189 and 13,459 patients listed in the NinJa database during 2009 and 2014. The presence or absence of disease in each joint (swelling and/or tenderness were considered to indicate active disease) and whether the disease was bilateral or unilateral were investigated. We calculated joint scores for each patient using a weighted scoring system and then created ROC curves for each patient based on total scores.
Results Patients in the 2009 and 2014 groups were aged 62.4±12.6 and 64.1±12.8 years, median DAS28 CRP values were 2.9 and 2.4, and total joint scores were 3.4 and 2.4 with a significant difference (p<0.05; Wilcoxon signed-rank test) between the two groups. Analyses of ROC curves generated from scores derived using the new system and MHAQ revealed a cut-off of 3 points (same as 2011); AUC, 0.72, 0.68 (Table 1).
Conclusions Disease activity changed from moderate to low in the NinJa cohorts and the scoring system was validated for the years 2009 and 2014. The weighted scoring system appears useful to predict functional disability in a simpler way by examining each joint rather than changes in disease activity among patients with RA.
Ono K, et al., The impact of joint disease on the Modified Health Assessment Questionnaire scores in rheumatoid arthritis patients: A cross-sectional study the National Database of Rheumatic Diseases by iR-Net in Japan. Modern Rheumatology, 2016(4): 529–533.
Disclosure of Interest None declared