Rheumatoid Arthritis Disease Activity Measures: American College of Rheumatology Recommendations for Use in Clinical Practice

Arthritis Care & Research , 04/18/2012

Anderson J et al. – The authors recommend the Clinical Disease Activity Index, Disease Activity Score with 28–joint counts (erythrocyte sedimentation rate or C–reactive protein), Patient Activity Scale (PAS), PAS–II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings.

Methods

  • The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures.
  • Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created.
  • A survey was administered to rheumatologists soliciting input.
  • The Working Group (WG) used these survey results in conjunction with the psychometric analyses to derive final recommendations.

Results

  • Systematic review of the literature resulted in identification of 63 RA disease activity measures.
  • Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation.
  • Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible.
  • From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of American College of Rheumatology (ACR)–recommended RA disease activity measures.

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