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Near misses of ACR/EULAR criteria for remission: effects of patient global assessment in Boolean and index-based definitions.
Ann Rheum Dis. 2012 Oct; 71(10):1702-5.AR

Abstract

BACKGROUND

The American College of Rheumatology/European League Against Rheumatism remission criteria for rheumatoid arthritis (RA) have been published recently.

OBJECTIVE

To quantify the proportions of patients fulfilling only three of the four Boolean criteria and the relevance of patient global assessment (PGA) in context of remission.

METHODS

From an observational prospective RA database the first visit of patients, fulfilling just three of the four Boolean criteria was identified. Logistic regression and descriptive analyses were processed, also defining remission by index-based (Simplified Disease Activity Index (SDAI)) definition and comparing outcomes with the evaluator global assessment (EGA).

RESULTS

52% had at least one visit, fulfilling just three criteria (not fulfilled were: PGA 61%; swollen joints 20%; tender joints 13%; C-reactive-protein 7%). 67% of patients not fulfilling the PGA criterion had an EGA≤1 cm, 25% of those fulfilled the SDAI definition. Increased pain (OR=1.28), EGA (OR=1.10) and discrepancy towards higher PGA than EGA (OR=1.28) could explain PGA failure to reach remission.

CONCLUSIONS

PGA is often the limiting factor for reaching remission; index-based remission showed balancing effects by adjusting for elevated variables in the summative score.

Authors+Show Affiliations

Division of Rheumatology, Department of Internal Medicine 3, Medical University Vienna, 1090 Vienna, Austria.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22736085

Citation

Studenic, Paul, et al. "Near Misses of ACR/EULAR Criteria for Remission: Effects of Patient Global Assessment in Boolean and Index-based Definitions." Annals of the Rheumatic Diseases, vol. 71, no. 10, 2012, pp. 1702-5.
Studenic P, Smolen JS, Aletaha D. Near misses of ACR/EULAR criteria for remission: effects of patient global assessment in Boolean and index-based definitions. Ann Rheum Dis. 2012;71(10):1702-5.
Studenic, P., Smolen, J. S., & Aletaha, D. (2012). Near misses of ACR/EULAR criteria for remission: effects of patient global assessment in Boolean and index-based definitions. Annals of the Rheumatic Diseases, 71(10), 1702-5. https://doi.org/10.1136/annrheumdis-2012-201519
Studenic P, Smolen JS, Aletaha D. Near Misses of ACR/EULAR Criteria for Remission: Effects of Patient Global Assessment in Boolean and Index-based Definitions. Ann Rheum Dis. 2012;71(10):1702-5. PubMed PMID: 22736085.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Near misses of ACR/EULAR criteria for remission: effects of patient global assessment in Boolean and index-based definitions. AU - Studenic,Paul, AU - Smolen,Josef S, AU - Aletaha,Daniel, Y1 - 2012/06/26/ PY - 2012/6/28/entrez PY - 2012/6/28/pubmed PY - 2012/12/10/medline SP - 1702 EP - 5 JF - Annals of the rheumatic diseases JO - Ann Rheum Dis VL - 71 IS - 10 N2 - BACKGROUND: The American College of Rheumatology/European League Against Rheumatism remission criteria for rheumatoid arthritis (RA) have been published recently. OBJECTIVE: To quantify the proportions of patients fulfilling only three of the four Boolean criteria and the relevance of patient global assessment (PGA) in context of remission. METHODS: From an observational prospective RA database the first visit of patients, fulfilling just three of the four Boolean criteria was identified. Logistic regression and descriptive analyses were processed, also defining remission by index-based (Simplified Disease Activity Index (SDAI)) definition and comparing outcomes with the evaluator global assessment (EGA). RESULTS: 52% had at least one visit, fulfilling just three criteria (not fulfilled were: PGA 61%; swollen joints 20%; tender joints 13%; C-reactive-protein 7%). 67% of patients not fulfilling the PGA criterion had an EGA≤1 cm, 25% of those fulfilled the SDAI definition. Increased pain (OR=1.28), EGA (OR=1.10) and discrepancy towards higher PGA than EGA (OR=1.28) could explain PGA failure to reach remission. CONCLUSIONS: PGA is often the limiting factor for reaching remission; index-based remission showed balancing effects by adjusting for elevated variables in the summative score. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/22736085/Near_misses_of_ACR/EULAR_criteria_for_remission:_effects_of_patient_global_assessment_in_Boolean_and_index_based_definitions_ DB - PRIME DP - Unbound Medicine ER -