TY - JOUR T1 - Do Recent Trends in RA Surgery Reflect Success in Disease Management? JF - The Journal of Rheumatology JO - J Rheumatol SP - 147 LP - 149 DO - 10.3899/jrheum.171056 VL - 45 IS - 2 AU - SUSAN M. GOODMAN Y1 - 2018/02/01 UR - http://www.jrheum.org/content/45/2/147.abstract N2 - Longterm outcomes are critically important for patients living with a chronic disease such as rheumatoid arthritis (RA). Because joints are replaced for endstage damage to the target organ in RA, studies that identify changes in the use of arthroplasty provide insight into changes in longterm RA outcomes. In this issue of The Journal, Young and colleagues1 studied arthroplasties to evaluate use trends for patients with RA.The investigators used data from the National Inpatient Sample (NIS), the largest US all-payer inpatient database, which contains a sample of over 1000 hospitals in the United States participating in the Healthcare Cost and Utilization Project. They assessed trends in the proportion of patients with RA among arthroplasty patients undergoing total shoulder (TSA), elbow (TEA), knee (TKA), hip (THA), and ankle (TAA) arthroplasty between 2002 and 2012. They determined the incidence of arthroplasties based on the US population, and compared the data from the first year of the study, 2002, to the final year, 2012. While studies using large databases such as the NIS have strengths and weaknesses, the large numbers contained in this database permit recognition of surgical trends and can be used to assess trends in less frequently performed procedures such as TAA or TEA. However, relevant data such as disease severity, presence of erosions, or medication use are not available, and coding errors or misclassification may occur. The investigators note, however, that because misclassification is unlikely to change over time, the effect on … Address correspondence to Dr. S.M. Goodman, 535 East 70th St., New York, New York 10021, USA. E-mail: Goodmans{at}hss.edu ER -