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5. Vitamin D - A review Free full text

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De Bandt M et al. – As a conclusion, panelists suggested that in clinical practice there is no need to change DMARD treatment in RA patients

Methods

967 case scenarios with various levels for each component of DAS28 score (resulting in a DAS score between 2 and 3.2), presented to 44 panelists
For each scenario, panelists had to decide whether or not DMARD treatment (excluding steroids) could be maintained unchanged
Relationship between panelists' decision, DAS28 score, and components of score analysed by multiple logistic regression analysis
Each panelist analysed 160 randomized scenarios
Intra- and inter-rater reproducibility assessed

Results

44 panelists participated in study
Inter-panelists agreement good
Quasi-perfect agreement observed for DAS28 less than or equal to 2.4, less pronounced between 2.5 and 2.9 and almost no agreement for DAS28 > 3.0
For values below 2.5, panelists agreed to maintain unchanged DMARDs; for values above 2.5, discrepancies occurred more frequently as DAS28 value increased
Multivariate analysis confirmed relationship between panelists decision, DAS28 value and components of DAS28
Between DAS28 2.4 and 3.2, major determinant for panelists' decision swollen joint count (SJC)
Female and public practice physicians decided more often to maintain treatment unchanged