Mäkinen Heidi, Kautiainen Hannu, Hannonen Pekka, Sokka Tuulikki
Jyväskylä Central Hospital, Jyväskylä, Finland.
J Rheumatol. 2008 Aug;35(8):1522-7. Epub 2008 May 15.
To develop a continuous composite index of disease activity for rheumatoid arthritis (RA) based on the 7 American College of Rheumatology (ACR) core data set of disease activity measures: Mean Overall Index for Rheumatoid Arthritis (MOI-RA).
The MOI-RA is the mean of standardized values of tender and swollen joint counts (28, 42, or 66/68 joint counts), physical function (Health Assessment Questionnaire 0-3), patient's and physician's assessments of global health and patient's assessment of pain (visual analog scale 0-100 mm) and erythrocyte sedimentation rate (1-100). All the 7 components were standardized (0-100), and the mean of standardized values was calculated. The range of MOI-RA is 0-100; higher values indicate poorer outcomes. The validity and measurement properties of MOI-RA were analyzed in 169 patients in the Finnish RA Combination therapy trial.
The mean MOI-RA28 decreased from 38.5 to 13.3 [standardized response mean (SRM) = 1.8, effect size (ES) = 1.9] from baseline to 6 months, compared to Disease Activity Score (DAS) 28, which decreased from 5.55 to 2.77 (SRM = 2.0, ES = 2.8). Correlation between MOI-RA28 and DAS28 was 0.90. When compared to the ACR response categories (20/50/ACR remission), changes in MOI-RA versions (using 28/42/66 joints) were similar. The reproducibility of MOI-RA with different joint counts was 0.97. A simulation in which 15% of the component values of MOI-RA were randomly omitted indicated an intraclass correlation coefficient of 0.98 between incomplete and complete data.
MOI-RA is a simple and feasible index based on the ACR core data set of disease activity measures for assessment of disease activity and treatment response in RA trials and clinical settings.
基于美国风湿病学会（ACR）7项疾病活动度测量核心数据集，开发一种用于类风湿关节炎（RA）的疾病活动度连续综合指数：类风湿关节炎平均总体指数（MOI-RA）。
MOI-RA是压痛和肿胀关节计数（28、42或66/68关节计数）的标准化值、身体功能（健康评估问卷0-3）、患者和医生对整体健康的评估、患者对疼痛的评估（视觉模拟评分0-100mm）以及红细胞沉降率（1-100）的平均值。所有7个组成部分均进行标准化（0-100），并计算标准化值的平均值。MOI-RA的范围是0-100；值越高表明结果越差。在芬兰类风湿关节炎联合治疗试验的169例患者中分析了MOI-RA的有效性和测量特性。
从基线到6个月，MOI-RA28的平均值从38.5降至13.3[标准化反应均值（SRM）=1.8，效应量（ES）=1.9]，而疾病活动度评分（DAS）28从5.55降至2.77（SRM=2.0，ES=2.8）。MOI-RA28与DAS28之间的相关性为0.90。与ACR反应类别（20/50/ACR缓解）相比，MOI-RA版本（使用28/42/66个关节）的变化相似。不同关节计数的MOI-RA的再现性为0.97。一项模拟研究中，随机省略MOI-RA 15%的组成部分值，结果显示不完整数据与完整数据之间的组内相关系数为0.98。
MOI-RA是一种基于ACR疾病活动度测量核心数据集的简单可行的指数，用于评估RA试验和临床环境中的疾病活动度及治疗反应。
