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Discordance and accordance between patient's and physician's assessments in rheumatoid arthritis.
Scand J Rheumatol. 2014; 43(4):291-5.SJ

Abstract

OBJECTIVES

The American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria for rheumatoid arthritis (RA) are more stringent than index-based criteria, making it more difficult to achieve a patient's global assessment (PGA) than an evaluator's global assessment (EGA). We investigated the reason for the discrepancy between the PGA and the EGA in a Japanese clinical cohort.

METHOD

We assessed clinical and laboratory variables in our clinical cohort. The frequency of remission achievement according to the ACR/EULAR remission criteria and predictors of the discrepancy between the PGA and EGA were analysed.

RESULTS

Of 370 patients with RA, 89 fulfilled PGA criteria and 167 patients fulfilled EGA criteria. The PGA was highly correlated with the visual analogue scale (VAS) pain score and non-inflammatory variables including Steinbrocker class and the Health Assessment Questionnaire Disability Index (HAQ-DI). Conversely, inflammatory variables, including swollen joint count (SJC), tender joint count (TJC), and C-reactive protein (CRP) levels, were significantly associated with the EGA. The main predictors of the discrepancy between the PGA and the EGA were patient's VAS pain score, SJC, and functional disability.

CONCLUSIONS

Increased pain and functional disability led to a discrepancy towards a worse PGA than EGA, whereas increased SJC led to an accordance towards a worse EGA.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Furu M
Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine , Kyoto , Japan.
Hashimoto M
No affiliation info available
Ito H
No affiliation info available
Fujii T
No affiliation info available
Terao C
No affiliation info available
Yamakawa N
No affiliation info available
Yoshitomi H
No affiliation info available
Ogino H
No affiliation info available
Ishikawa M
No affiliation info available
Matsuda S
No affiliation info available
Mimori T
No affiliation info available

MeSH

AdultAgedAged, 80 and overAntirheumatic AgentsArthritis, RheumatoidDisability EvaluationFemaleHumansMaleMiddle AgedPatientsPhysician-Patient RelationsRemission InductionRheumatologySeverity of Illness IndexYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24650255

Citation

Furu, M, et al. "Discordance and Accordance Between Patient's and Physician's Assessments in Rheumatoid Arthritis." Scandinavian Journal of Rheumatology, vol. 43, no. 4, 2014, pp. 291-5.
Furu M, Hashimoto M, Ito H, et al. Discordance and accordance between patient's and physician's assessments in rheumatoid arthritis. Scand J Rheumatol. 2014;43(4):291-5.
Furu, M., Hashimoto, M., Ito, H., Fujii, T., Terao, C., Yamakawa, N., Yoshitomi, H., Ogino, H., Ishikawa, M., Matsuda, S., & Mimori, T. (2014). Discordance and accordance between patient's and physician's assessments in rheumatoid arthritis. Scandinavian Journal of Rheumatology, 43(4), 291-5. https://doi.org/10.3109/03009742.2013.869831
Furu M, et al. Discordance and Accordance Between Patient's and Physician's Assessments in Rheumatoid Arthritis. Scand J Rheumatol. 2014;43(4):291-5. PubMed PMID: 24650255.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Discordance and accordance between patient's and physician's assessments in rheumatoid arthritis. AU - Furu,M, AU - Hashimoto,M, AU - Ito,H, AU - Fujii,T, AU - Terao,C, AU - Yamakawa,N, AU - Yoshitomi,H, AU - Ogino,H, AU - Ishikawa,M, AU - Matsuda,S, AU - Mimori,T, Y1 - 2014/03/21/ PY - 2014/3/22/entrez PY - 2014/3/22/pubmed PY - 2014/12/17/medline SP - 291 EP - 5 JF - Scandinavian journal of rheumatology JO - Scand J Rheumatol VL - 43 IS - 4 N2 - OBJECTIVES: The American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria for rheumatoid arthritis (RA) are more stringent than index-based criteria, making it more difficult to achieve a patient's global assessment (PGA) than an evaluator's global assessment (EGA). We investigated the reason for the discrepancy between the PGA and the EGA in a Japanese clinical cohort. METHOD: We assessed clinical and laboratory variables in our clinical cohort. The frequency of remission achievement according to the ACR/EULAR remission criteria and predictors of the discrepancy between the PGA and EGA were analysed. RESULTS: Of 370 patients with RA, 89 fulfilled PGA criteria and 167 patients fulfilled EGA criteria. The PGA was highly correlated with the visual analogue scale (VAS) pain score and non-inflammatory variables including Steinbrocker class and the Health Assessment Questionnaire Disability Index (HAQ-DI). Conversely, inflammatory variables, including swollen joint count (SJC), tender joint count (TJC), and C-reactive protein (CRP) levels, were significantly associated with the EGA. The main predictors of the discrepancy between the PGA and the EGA were patient's VAS pain score, SJC, and functional disability. CONCLUSIONS: Increased pain and functional disability led to a discrepancy towards a worse PGA than EGA, whereas increased SJC led to an accordance towards a worse EGA. SN - 1502-7732 UR - https://www.unboundmedicine.com/medline/citation/24650255/Discordance_and_accordance_between_patient's_and_physician's_assessments_in_rheumatoid_arthritis_ DB - PRIME DP - Unbound Medicine ER -
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