Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice
Open accessAbstract
Objective: Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice. Methods: The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations. Results: Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR‐recommended RA disease activity measures. Conclusion: We recommend the Clinical Disease Activity Index, Disease Activity Score with 28‐joint counts (erythrocyte sedimentation rate or C‐reactive protein), Patient Activity Scale (PAS), PAS‐II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings.
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The Patient's Global Assessment is a common tool for assessing rheumatic conditions.
“This is a common tool for assessment of rheumatic conditions.25,26”
From Mindfulness is associated with psychological health and moderates the impact of fibromyalgia (2019) · cites this paper as [25]
The Discussion describes Patient’s Global Assessment (PtGA) as a component of several rheumatoid arthritis disease-activity measures, and reports that surveyed ACR members rated it highly feasible for clinical practice. That supports its use in rheumatoid arthritis, but the paper does not establish that PtGA is commonly used across rheumatic conditions more broadly. The Discussion’s statement about use beyond rheumatoid arthritis concerns RAPID-3, not PtGA specifically. (LLM, conf=0.82)
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Mindfulness is associated with psychological health and moderates the impact of fibromyalgia
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- Authors
- Anderson, J., Caplan, L., Yazdany, J., Robbins, M. L., Neogi, T., Michaud, K., Saag, K. G., O'dell, J. R., & Kazi, S.
- Affiliations
- University of Nebraska Medical Center (US)
- Denver VA Medical Center (US)
- University of California, San Francisco (US)
- Harvard Vanguard Medical Associates (US)
- Boston University (US)
- The National Databank for Rheumatic Diseases (US)
- University of Alabama at Birmingham (US)
- Genentech (US)
- Corresponding author
- Kazi, Salahuddin
- ORCID
- Venue
- Arthritis Care & Research
- Publisher
- Wiley
- Published
- 2012-04-02
- Volume
- 64
- Issue
- 5
- Pages
- 640-647
- ISSN
- 0893-7524 (ISSN-L)
- 2151-464X
- 2151-4658
- PMC
- PMC4028066
- OpenAlex
- W2126525702
- Cited by
- 748
- References
- 27
- Citations by year
- 2026: 26 · 2025: 34 · 2024: 48 · 2023: 65 · 2022: 43 · 2021: 73 · 2020: 68 · 2019: 73 · 2018: 63 · 2017: 69 · 2016: 56 · 2015: 45 · 2014: 45 · 2013: 27 · 2012: 12
- FWCI
- 31.35
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Arthritis Care & Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Abbott Laboratories
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (K23AR060259)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Hematology › Autoimmune and Inflammatory Disorders Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Systemic Sclerosis and Related Diseases
- Keywords
- rheumatoid arthritis, disease activity index, clinical guidelines, American College of Rheumatology, Clinical Disease Activity Index, erythrocyte sedimentation rate, C-reactive protein, SDAI, remission criteria, psychometric properties, sensitivity to change
- MeSH terms
- Arthritis, Rheumatoid, Health Surveys, Humans, Rheumatology, Severity of Illness Index, Societies, Medical, United States, Practice Guidelines as Topic, Antirheumatic Agents
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