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Finalisation and validation of the rheumatoid arthritis impact of disease score, a patient-derived composite measure of impact of rheumatoid arthritis: a EULAR initiative
  1. L Gossec1,
  2. S Paternotte1,
  3. G J Aanerud2,
  4. A Balanescu3,
  5. D T Boumpas4,
  6. L Carmona5,
  7. M de Wit6,
  8. B A C Dijkmans7,
  9. M Dougados1,
  10. M Englbrecht8,
  11. F Gogus9,
  12. T Heiberg10,11,
  13. C Hernandez12,
  14. J R Kirwan13,
  15. E Martin Mola12,
  16. M Matucci Cerinic14,
  17. K Otsa15,
  18. G Schett8,
  19. M Scholte-Voshaar7,
  20. T Sokka16,
  21. G von Krause1,
  22. G A Wells17,
  23. T K Kvien2
  1. 1Paris Descartes University, Medicine Facility; APHP, Rheumatology B Department, Cochin Hospital, Paris, France
  2. 2Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  3. 3Research Center of Rheumatic Diseases, “Sf. Maria” Hospital, University of Medicine and Pharmacy “Carol Davila”, Bucharest Romania
  4. 4Rheumatology, Clinical Immunology and Allergy, University of Crete, Faculty of Medicine, Heraklion, Greece
  5. 5Research Unit, Spanish Foundation of Rheumatology, Madrid, Spain
  6. 6EULAR standing committee of People with Arthritis/Rheumatism in Europe (PARE), Zurich, Switzerland
  7. 7Rheumatology, VU University medical center and Jan van Breemen Institute, The Netherlands
  8. 8Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany
  9. 9University of Gazi, Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Ankara, Turkey
  10. 10Department for Research and Education, Oslo University Hospital, Oslo, Norway
  11. 11Lovisenberg Diakonal College, Oslo, Norway
  12. 12Rheumatology Department, Hospital Universitario La Paz, Madrid, Spain
  13. 13University of Bristol, Academic Rheumatology Unit, Bristol Royal Infirmary, Bristol, UK
  14. 14Department of Medicine, Division of Rheumatology AOUC, Denothe Centre, University of Florence, Firenze, Italy
  15. 15Rheumatology Department, Tallinn Central Hospital, Estonia
  16. 16Jyväskylä Central Hospital, Jyväskylä, Finland
  17. 17Department of Epidemiology and Community Medicine, University of Ottawa, and Cardiovascular Research Methods Centre University of Ottawa Heart Institute, Ottawa, Ontario, Canada
  1. Correspondence to Dr L Gossec, Service de Rhumatologie B, Hôpital Cochin, 27, rue du faubourg Saint-Jacques, 75014 Paris, France; laure.gossec{at}


Objective A patient-derived composite measure of the impact of rheumatoid arthritis (RA), the rheumatoid arthritis impact of disease (RAID) score, takes into account pain, functional capacity, fatigue, physical and emotional wellbeing, quality of sleep and coping. The objectives were to finalise the RAID and examine its psychometric properties.

Methods An international multicentre cross-sectional and longitudinal study of consecutive RA patients from 12 European countries was conducted to examine the psychometric properties of the different combinations of instruments that might be included within the RAID combinations scale (numeric rating scales (NRS) or various questionnaires). Construct validity was assessed cross-sectionally by Spearman correlation, reliability by intraclass correlation coefficient (ICC) in 50 stable patients, and sensitivity to change by standardised response means (SRM) in 88 patients whose treatment was intensified.

Results 570 patients (79% women, mean±SD age 56±13 years, disease duration 12.5±10.3 years, disease activity score (DAS28) 4.1±1.6) participated in the validation study. NRS questions performed as well as longer combinations of questionnaires: the final RAID score is composed of seven NRS questions. The final RAID correlated strongly with patient global (R=0.76) and significantly also with other outcomes (DAS28 R=0.69, short form 36 physical −0.59 and mental −0.55, p<0.0001 for all). Reliability was high (ICC 0.90; 95% CI 0.84 to 0.94) and sensitivity to change was good (SRM 0.98 (0.96 to 1.00) compared with DAS28 SRM 1.06 (1.01 to 1.11)).

Conclusion The RAID score is a patient-derived composite score assessing the seven most important domains of impact of RA. This score is now validated; sensitivity to change should be further examined in larger studies.

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  • See Editorial, p 884

  • Funding This project was supported financially by EULAR (grant CLI.013).

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with approval of the ethics committees in participating countries.

  • Provenance and peer review Not commissioned; externally peer reviewed.