Abstract
Objective
To compare 4 categories (high, moderate, and low severity, and near-remission) of RAPID3 (Routine Assessment of Patient Index Data 3), an index without formal joint counts, which is scored in < 10 seconds to 4 categories of the DiseaseActivity Score (DAS28) and Clinical Disease Activity Index (CDAI) in patients with rheumatoid arthritis (RA).
Methods
All patients complete a Multidimensional Health Assessment Questionnaire (MDHAQ) at each visit. A physician/assessor 28-joint count and erythrocyte sedimentation rate (ESR) were completed in 285 patients with RA in usual care by 3 rheumatologists to score DAS28, CDAI, and RAPID3. RAPID3 includes the 3 MDHAQ patient self-report RA Core Data Set measures for physical function, pain, and patient global estimate. Proposed RAPID3 (range 0–10) severity categories of high (> 4), moderate (2.01–4), low (1.01–2), and near-remission (≤ 1) were compared to DAS (0–10) activity categories of high (> 5.1), moderate (3.21–5.1), low (2.61–3.2), and remission (≤ 2.6), and CDAI (0–76) categories of > 22, 10.1–22.0, 2.9–10.0, and ≤ 2.8. Additional RAPID scores, which add to RAPID3 a physician/assessor or patient self-report joint count and/or assessor global estimate, were also analyzed. Statistical significance was analyzed using Spearman correlations, cross-tabulations, and kappa statistics.
Results
All RAPID scores were correlated significantly with DAS28 and CDAI (rho > 0.65, p < 0.001). Overall, 78%–84% of patients who met DAS28 or CDAI moderate/high activity criteria met similar RAPID severity criteria, and 68%–77% who met DAS28 or CDAI remission/low activity criteria also met similar RAPID criteria. RAPID3 was as informative as other indices.
Conclusion
RAPID3 provides a feasible, informative quantitative index for busy clinical settings.
Key Indexing Terms:Footnotes
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T. Pincus, MD, NYU Hospital for Joint Diseases; C.J. Swearingen, MS, Medical University of South Carolina; M. Bergman, MD, Taylor Hospital; Y. Yazici, MD, NYU Hospital for Joint Diseases.
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Supported in part by grants from Bristol-Myers Squibb, the Arthritis Foundation, and the Jack C. Massey Foundation.
- Accepted for publication May 26, 2008.
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