Nasim A. Khan|Horace J. Spencer|Esam Abda|Amita Aggarwal|Rieke Alten|Codrina Ancu?a|Daina Andersone|Martin Bergman|Raili Müller|J. Detert|Lia Georgescu|Laure Gossec|Hisham Hamoud|Johannes W. G. Jacobs|Iêda Maria Magalhães Laurindo|Maria Majdan|Antonio Naranjo|Sapan Pandya|Christof Pohl|Georg Schett|Zahraa I. Selim|Sergio Toloza|Hisahi Yamanaka|Tuulikki Sokka
Determinants of discordance in patients' and physicians' rating of rheumatoid arthritis disease activity
University of Arkansas for Medical Sciences
abstract objective assess determinants patients ptgl physicians mdgl global assessment rheumatoid arthritis ra activity factors associated discordance among methods total 7028 patients quantitative standard monitoring patients ra study ptgl mdgl assessed clinic visit 010cm visual analog scale vas three patient groups defined concordant rating group ptgl mdgl within 2 cm higher patient rating group ptgl exceeding mdgl gt2 cm lower patient rating group ptgl less mdgl gt2 cm multivariable regression analysis used identify determinants ptgl mdgl discordance results mean sd vas scores ptgl mdgl 401 270 291 237 respectively pain overwhelmingly single important determinant ptgl followed fatigue contrast mdgl influenced swollen joint count sjc followed erythrocyte sedimentation rate esr tender joint count tjc total 4454 634 2106 30 468 66 patients concordant higher lower patient rating groups respectively odds higher patient rating increased higher pain fatigue psychological distress age morning stiffness decreased higher sjc tjc esr lower patient rating odds increased higher sjc tjc esr decreased lower fatigue levels conclusion nearly 36 patients discordance ra activity assessment physicians sensitivity disease experience patients particularly pain fatigue warranted effective care ra