TY - JOUR T1 - MBDA: A Valuable Tool for Medical Decision Making JF - The Journal of Rheumatology JO - J Rheumatol SP - 1642 LP - 1642 DO - 10.3899/jrheum.190553 VL - 46 IS - 12 AU - LEONARD H. CALABRESE Y1 - 2019/12/01 UR - http://www.jrheum.org/content/46/12/1642.1.abstract N2 - I read with interest the editorial by Dr. Roy Fleischmann on the limitations of the multibiomarker disease activity test (MBDA) in the management of rheumatoid arthritis (RA)1. He provides a comprehensive review of some of the key studies of MBDA in clinical trials and concludes that the “MBDA has not met the test of being a biomarker that can predict who will or will not respond to a specific therapy, who will or will not be able to taper or stop therapy or who will or will not have radiographic progression.” While overall I tend to agree with him that this biomarker, along with ALL biomarkers, will fail to answer these questions in a binary fashion, I still disagree with his conclusions.Medicine in general and rheumatology in particular are professions immersed in diagnostic and therapeutic uncertainty. Rheumatologists share a ritual when confronting new patients with RA of appraising their disease activity and severity, … Address correspondence to Dr. L.H. Calabrese, Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University 9500 Euclid Ave., Desk A50, Cleveland, Ohio 44195, USA. E-mail: CALABRL{at}ccf.org ER -