Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.

A Self-Report RADAI (Rheumatoid Arthritis Disease Activity Index) Count of Painful Joints Can Be Informative in Patients with Rheumatic Diseases Other Than Rheumatoid Arthritis.

Castrejon¹, Isabel, Yazici², Yusuf, Pincus¹, Theodore

NYU Hospital for Joint Diseases, New York, NY
Division of Rheumatology, New York University School of Medicine and NYU Hospital for Joint Diseases, New York, NY

Background/Purpose:

To analyze a self-report painful joint count based on the rheumatoid arthritis disease activity index (RADAI) [Stucki G, et al. Arthritis Rheum 1995;38:795–8], in patients with rheumatic diseases other than rheumatoid arthritis (RA), including systemic lupus erythematosus (SLE), gout, psoriatic arthritis (PsA) and osteoarthritis (OA), in comparison with RA patients, and with other measures of clinical status, in a usual care setting.

Methods:

A database has been maintained on all patients seen at an academic rheumatology clinical setting since 2005, which includes demographic, patient self-report MDHAQ (multidimensional health assessment questionnaire), medication, and laboratory data. Each patient completes a 2-sided, 1-page multidimensional health assessment questionnaire (MDHAQ) at each visit while waiting to see the rheumatologist in the infrastructure of clinical care. RAPID3, an index of the 3 patient self-report RA Core Data Set measures – physical function, pain, and patient global estimate (each scored 0–10; total 0–30) – is scored on the MDHAQ by the rheumatologist prior to seeing the patient. The MDHAQ also includes a self-report joint count based on the RADAI, with scores for pain ranging from 0 ("no pain") to 3 ("severe pain") bilaterally for 8 specific joint groups, for a total of 0–48. A physician global estimate of status (DOCGL) also was scored by the rheumatologist, and erythrocyte sedimentation rate (ESR) was obtained. A random visit of 465 patients was analyzed including 174 with RA, 75 with SLE, 50 with gout, 53 with PsA and 113 with OA. RADAI self-report painful joint counts were compared to other MDHAQ measures, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), in patients with RA, SLE, gout, PsA and OA according to Spearman rank-order correlations.

Results:

RADAI scores were correlated significantly with MDHAQ scores for function, pain, patient global estimate and RAPID3 in patients with each of the 5 different diagnoses (rho = 0.44–0.81, p <0.001; Table). RADAI was correlated significantly with DOCGL in patients with all diagnoses except SLE. RADAI was correlated with DOCGL at higher levels than with ESR and CRP in all diseases studied, including RA.

Table. Spearman correlations of RADAI self-report joint count with other MDHAQ scores and laboratory tests

	RADAI self-report painful joint score (range 0–48)
	Total (n=465)	RA (n=174)	SLE (n=75)	Gout (n=50)	PsA (n=53)	OA (n=113)
DOCGL (0–10)	0.48*	0.54*	0.25	0.54	0.48	0.40*
PATGL (0–10)	0.67*	0.75*	0.50*	0.60	0.71*	0.50
Function (HAQ) (0–10)	0.67*	0.69*	0.60*	0.66	0.70*	0.50*
Pain (0–10)	0.74*	0.77*	0.64*	0.77*	0.80*	0.48*
RAPID3 (0–30)	0.77*	0.81*	0.63*	0.72*	0.80*	0.56*
ESR	0.15	0.25*	0.13	0.46*	0.28	0.15
CRP	0.18	0.22	0.06	-0.07	0.22	0.014
* p<0.0001

Conclusion:

A self-report joint count derived from the RADAI can be informative in patients with many rheumatic diagnoses, including SLE, gout, psoriatic arthritis and OA, in addition to RA.

To cite this abstract, please use the following information:
Castrejon, Isabel, Yazici, Yusuf, Pincus, Theodore; A Self-Report RADAI (Rheumatoid Arthritis Disease Activity Index) Count of Painful Joints Can Be Informative in Patients with Rheumatic Diseases Other Than Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2053
DOI:

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