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Response criteria for rheumatoid arthritis in clinical practice - how useful are they?

Gülfe, Anders LU ; Geborek, Pierre LU and Saxne, Tore LU (2005) In Annals of the Rheumatic Diseases 64(8). p.1186-1189
Abstract
Objective: To compare the performance of the American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), and simple disease activity index (SDAI) response criteria for rheumatoid arthritis at the individual level in an observational cohort. Methods: 184 outpatients were followed using a structured protocol. For each patient, the responses according to ACR 20% and 50%, EULAR moderate and good, and SDAI minor and major responses were calculated. For comparison, improvements in health assessment questionnaire (HAQ) score of 0.22 and 0.5 were calculated. The numbers of individuals fulfilling the criteria at each level were compared, and the numbers fulfilling any two sets of response criteria calculated. The EULAR... (More)
Objective: To compare the performance of the American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), and simple disease activity index (SDAI) response criteria for rheumatoid arthritis at the individual level in an observational cohort. Methods: 184 outpatients were followed using a structured protocol. For each patient, the responses according to ACR 20% and 50%, EULAR moderate and good, and SDAI minor and major responses were calculated. For comparison, improvements in health assessment questionnaire (HAQ) score of 0.22 and 0.5 were calculated. The numbers of individuals fulfilling the criteria at each level were compared, and the numbers fulfilling any two sets of response criteria calculated. The EULAR "moderate'' and "good'' responses were grouped together as "overall,'' and SDAI "minor'' and "major'' were merged into SDAI "overall''. Results: All 94 ACR 20 responders were found in the EULAR and SDAI "overall'' response groups, and 118 of 124 SDAI "overall'' responders were found in the EULAR "overall'' group. In contrast, of 53 ACR 50 responders, only 34 were found in the EULAR "good'' or SDAI "major'' group. Among the 56 patients in the EULAR "good'' response group, only 26 met the SDAI "major'' response. Improvement in HAQ score performed similarly to the other response criteria sets at the group levels. Conclusions: For individual patients, agreement is good at the level of ACR 20 response, when EULAR overall, SDAI overall, or HAQ 0.22 criteria are applied. Agreement between ACR 50, EULAR good, SDAI major, and HAQ 0.5 response is poor. This should be considered when response criteria are used for clinical decisions. (Less)
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organization
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type
Contribution to journal
publication status
published
subject
in
Annals of the Rheumatic Diseases
volume
64
issue
8
pages
1186 - 1189
publisher
British Medical Association
external identifiers
  • wos:000230478200015
  • pmid:15760931
  • scopus:23444436349
ISSN
1468-2060
DOI
10.1136/ard.2004.027649
language
English
LU publication?
yes
id
91f39284-0f2e-4d86-b4bb-97d5c7e99db0 (old id 135062)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15760931&dopt=Abstract
date added to LUP
2007-07-24 14:46:56
date last changed
2017-01-01 07:22:17
@article{91f39284-0f2e-4d86-b4bb-97d5c7e99db0,
  abstract     = {Objective: To compare the performance of the American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), and simple disease activity index (SDAI) response criteria for rheumatoid arthritis at the individual level in an observational cohort. Methods: 184 outpatients were followed using a structured protocol. For each patient, the responses according to ACR 20% and 50%, EULAR moderate and good, and SDAI minor and major responses were calculated. For comparison, improvements in health assessment questionnaire (HAQ) score of 0.22 and 0.5 were calculated. The numbers of individuals fulfilling the criteria at each level were compared, and the numbers fulfilling any two sets of response criteria calculated. The EULAR "moderate'' and "good'' responses were grouped together as "overall,'' and SDAI "minor'' and "major'' were merged into SDAI "overall''. Results: All 94 ACR 20 responders were found in the EULAR and SDAI "overall'' response groups, and 118 of 124 SDAI "overall'' responders were found in the EULAR "overall'' group. In contrast, of 53 ACR 50 responders, only 34 were found in the EULAR "good'' or SDAI "major'' group. Among the 56 patients in the EULAR "good'' response group, only 26 met the SDAI "major'' response. Improvement in HAQ score performed similarly to the other response criteria sets at the group levels. Conclusions: For individual patients, agreement is good at the level of ACR 20 response, when EULAR overall, SDAI overall, or HAQ 0.22 criteria are applied. Agreement between ACR 50, EULAR good, SDAI major, and HAQ 0.5 response is poor. This should be considered when response criteria are used for clinical decisions.},
  author       = {Gülfe, Anders and Geborek, Pierre and Saxne, Tore},
  issn         = {1468-2060},
  language     = {eng},
  number       = {8},
  pages        = {1186--1189},
  publisher    = {British Medical Association},
  series       = {Annals of the Rheumatic Diseases},
  title        = {Response criteria for rheumatoid arthritis in clinical practice - how useful are they?},
  url          = {http://dx.doi.org/10.1136/ard.2004.027649},
  volume       = {64},
  year         = {2005},
}