Zijlstra T R, Bernelot Moens H J, Bukhari M A S
Department of Rheumatology, Medisch Spectrum Twente, Enschede, The Netherlands.
Ann Rheum Dis. 2002 Jan;61(1):20-3. doi: 10.1136/ard.61.1.20.
To design and validate a clinical method for scoring irreversible long term articular damage in rheumatoid arthritis (RA).
The rheumatoid arthritis articular damage score (RAAD score) is based on examination of 35 large and small joints. Concise definitions were formulated to score each joint on a three point scale (0, no irreversible damage; 1, partially damaged; 2, severe damage, ankylosis, or prosthesis). The RAAD score was determined for 121 patients with RA with a large range of disease duration. Interobserver agreement was studied in 39 patients scored by three observers. Data on disease duration, Health Assessment Questionnaire, disease activity score, and Larsen score were collected for 121, 78, 47, and 45 patients, respectively.
The RAAD score correlated well with the Larsen score (r(s)=0.81) and disease duration (r(s)=0.68) and (as intended) not with disease activity (r(s)=0.10). Good interobserver agreement was found for total scores and individual joints. The wide range of RAAD scores for patients with the same disease duration suggested good discriminating power, especially after >10 years.
The RAAD score is a quick and feasible method for measuring the long term articular damage in large RA populations. It has good reliability and construct validity and deserves further study to assess its discriminant validity.
设计并验证一种用于评估类风湿关节炎（RA）不可逆长期关节损伤的临床方法。
类风湿关节炎关节损伤评分（RAAD评分）基于对35个大、小关节的检查。制定了简明的定义，以便以三分制对每个关节进行评分（0分，无不可逆损伤；1分，部分损伤；2分，严重损伤、关节强直或假体植入）。对121例病程范围广泛的类风湿关节炎患者确定了RAAD评分。由三名观察者对39例患者进行评分，研究观察者间的一致性。分别收集了121例、78例、47例和45例患者的病程、健康评估问卷、疾病活动评分和Larsen评分数据。
RAAD评分与Larsen评分（r(s)=0.81）和病程（r(s)=0.68）相关性良好，（正如预期的那样）与疾病活动度（r(s)=0.10）无关。观察者间在总分和各个关节评分上一致性良好。病程相同的患者RAAD评分范围广泛，表明该评分具有良好的鉴别能力，尤其是在病程超过10年后。
RAAD评分是一种快速且可行的方法，用于测量大量类风湿关节炎患者的长期关节损伤。它具有良好的可靠性和结构效度，值得进一步研究以评估其判别效度。
