Can RAPID3, an Index Without Formal Joint Counts or Laboratory Tests, Serve to Guide Rheumatologists in Tight Control of Rheumatoid Arthritis in Usual Clinical Care? Bulletin of the NYU hospital for joint diseases [Bull NYU Hosp Jt Dis] Journal article | | Title | Can RAPID3, an Index Without Formal Joint Counts or Laboratory Tests, Serve to Guide Rheumatologists in Tight Control of Rheumatoid Arthritis in Usual Clinical Care? | | Author(s) | Pincus T | | Source | Bull NYU Hosp Jt Dis 2009; 67(3):254-66. | | Abstract | Tight control of rheumatoid arthritis (RA) may be guided by RAPID3 (routine assessment of patient index data), an indexwithout formal joint counts or laboratory tests, which canbe scored on a multidimensional health assessment questionnaire (MDHAQ) in 5 seconds, compared to 42 secondto score a standard HAQ, 90 seconds to perform a 28-join count, 114 seconds to score a disease activity score 28 (DAS28), and 106 seconds to score a clinical disease activity index (CDAI). RAPID3 scores are correlated signifcantly with DAS28 and CDAI (rho > 0.65, p < 0.001), and distin guish active from control treatment similarly to DAS28 and CDAI in clinical trials of methotrexate, lefunomide, adali mumab, abatacept, certolizumab, and infiximab. RAPID3 scores can be used to classify patient disease activity status as high (> 12), moderate (6.1-12), low (3.1-6), and remission (</= 3), analogous to activity categories of DAS28 and CDAI. In clinical care settings, 78% to 84% of patients who me the criteria for moderate-high activity status of greater than 3.2 for DAS28 and greater than 10 for CDAI had RAPID3 scores greater than 6, while 68% to 77% who met low activity-remission criteria of a DAS less than or equal to 3.2 and a CDAI of less than or equal to 10 also had RAPID3 scores that were less than or equal to 6. The most effective strategy to collect MDHAQ-RAPID3 data is for the receptionist to ask each patient to complete a questionnaire upon registration at each visit, prior to seeing the physician in the infrastructure of clinical care. Clinical judgment ultimately Theodore Pincus, M.D., Clinical Professor of Medicine, New York University School of Medicine, is within the Division of Rheumatology, Department of Medicine, NYU Hospital for Joint Diseases, NYU Langone Medical Center, New York, New York. Correspondence: Theodore Pincus, M.D., Clinical Professor of Medicine, Division of Rheumatology, Room 1608, NYU Hospital for Joint Diseases, 301 East 17th Street, New York, New York 10003; tedpincus@gmail.com.enters into all clinical decisions, but judgment is enhanced considerably by quantitative data provided by the MDHAQ and RAPID3 to supplement nonquantitative impressions. RAPID3 provides a feasible, informative quantitative index for busy clinical settings. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 19852747 |
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