TY - JOUR T1 - Standardization of Joint Examination Technique Leads to a Significant Decrease in Variability Among Different Examiners JF - The Journal of Rheumatology JO - J Rheumatol SP - 860 LP - 864 DO - 10.3899/jrheum.090195 VL - 37 IS - 4 AU - MATHIAS GRUNKE AU - CHRISTIAN E. ANTONI AU - ARTHUR KAVANAUGH AU - VERENA HILDEBRAND AU - CLAUDIA DECHANT AU - GEORG SCHETT AU - BERNHARD MANGER AU - MONIKA RONNEBERGER Y1 - 2010/04/01 UR - http://www.jrheum.org/content/37/4/860.abstract N2 - Objective. To reduce the amount of variability among assessors, we conducted joint examination standardization seminars in conjunction with multicenter clinical trials for patients with rheumatoid arthritis (RA). The examination techniques used were based on the recommendations of the European League Against Rheumatism (EULAR). Methods. To evaluate the effect of standardization, participants at the seminars examined a given patient with RA before and after they were made familiar with the EULAR examination technique. The number of tender and swollen joints as well as the variance among the examiners before and after the training were compared. Joints were rated positive or negative for tenderness and swelling without grading. Results. Overall, 553 individuals from a variety of countries in Europe, North America, Asia, and Australia participated. Examiners included different kinds of health professionals, mainly physicians and nurses. We found a substantial variance among examiners before the training in the standardized method. This variance could be significantly reduced by the training. We also found that the number of joints considered active was markedly reduced after the training. Conclusion. Standardized joint examination training significantly reduces variability among different assessors. ER -