基于患者报告的综合评估 3 项指标（RAPID3）评估类风湿关节炎的疾病活动度及其与 28 个关节疾病活动度评分（DAS28）和临床疾病活动指数（CDAI）的相关性：一项印度研究。
Evaluation of disease activity in rheumatoid arthritis by Routine Assessment of Patient Index Data 3 (RAPID3) and its correlation to Disease Activity Score 28 (DAS28) and Clinical Disease Activity Index (CDAI): an Indian experience.
机构信息
Department of Medicine, Pt. B.D. Sharma PGIMS, DLF Colony, Rohtak, Haryana, India.
出版信息
Clin Rheumatol. 2012 Dec;31(12):1663-9. doi: 10.1007/s10067-012-2070-9. Epub 2012 Sep 15.
Serial objective assessment of disease activity in rheumatoid arthritis (RA) is imperative to achieve remission. Routine Assessment of Patient Index Data 3 (RAPID3), an index without formal joint counts, appears attractive for evaluation of disease activity in RA patients in a busy clinical setting. This study aims to evaluate correlation and agreement of RAPID3 with Disease Activity Score 28 (DAS28) and Clinical Disease Activity Index (CDAI) in RA patients. All patients completed a Multidimensional Health Assessment Questionnaire (MDHAQ) at each visit. A physician/assessor 28-joint count and erythrocyte sedimentation rate were completed in 200 literate patients with RA to score DAS28, CDAI, and RAPID3. RAPID3 includes the three MDHAQ patient self-report RA core dataset measures for physical function, pain, and patient global estimate. Proposed RAPID3 (range, 0-30) severity categories of high (>12), moderate (6.1-12.0), low (3.1-6.0), and near remission (≤3) were compared to DAS28 (0-10) activity categories of high (> 5.1), moderate (3.21-5.1), low (2.61-3.2), and remission (≤ 2.6), and CDAI (0-76) categories of >22, 10.1-22.0, 2.9-10.0, and ≤2.8. Statistical significance was analyzed using Spearman correlations, cross-tabulations, and kappa statistics. Comparison of RAPID3 with DAS28 and CDAI indicated Spearman rank-order correlation coefficients for DAS28 with RAPID3 of 0.910, and for CDAI with RAPID3 of 0.907, all highly significant (P < 0.001). There was substantial agreement between RAPID3 and DAS28 (kappa value = 0.634, P < 0.001) and also between RAPID3 and CDAI (kappa value = 0.690, P < 0.001). Overall, 89-94 % of patients who met DAS28 or CDAI moderate/high activity criteria met similar RAPID severity criteria and 84-88 % who met DAS28 or CDAI remission/low activity criteria also met similar RAPID criteria. RAPID3 scores provide similar quantitative information to DAS28 and CDAI, and hence, is an informative index for evaluation of disease activity in RA in busy clinical settings.
对类风湿关节炎 (RA) 的疾病活动进行连续的客观评估对于实现缓解至关重要。不包括正式关节计数的常规评估患者指数数据 3 (RAPID3) 对于评估繁忙临床环境中的 RA 患者的疾病活动似乎很有吸引力。本研究旨在评估 RAPID3 与 RA 患者的疾病活动评分 28 (DAS28) 和临床疾病活动指数 (CDAI) 的相关性和一致性。所有患者在每次就诊时都完成了多维健康评估问卷 (MDHAQ)。在 200 名有读写能力的 RA 患者中，由医生/评估员完成 28 个关节计数和红细胞沉降率，以评分 DAS28、CDAI 和 RAPID3。RAPID3 包括三个 MDHAQ 患者自我报告的 RA 核心数据集测量，用于身体功能、疼痛和患者总体估计。建议的 RAPID3（范围 0-30）严重程度类别为高 (>12)、中度 (6.1-12.0)、低 (3.1-6.0) 和接近缓解 (≤3)，与 DAS28（0-10）的活动类别为高 (> 5.1)、中度 (3.21-5.1)、低 (2.61-3.2) 和缓解 (≤ 2.6) 和 CDAI（0-76）类别为>22、10.1-22.0、2.9-10.0 和 ≤2.8。使用 Spearman 相关系数、交叉表和 kappa 统计分析进行统计学意义分析。RAPID3 与 DAS28 和 CDAI 的比较表明，DAS28 与 RAPID3 的 Spearman 秩相关系数为 0.910，CDAI 与 RAPID3 的 Spearman 秩相关系数为 0.907，均具有高度显著性 (P < 0.001)。RAPID3 与 DAS28 之间存在显著的一致性（kappa 值=0.634，P < 0.001），与 CDAI 之间也存在显著的一致性（kappa 值=0.690，P < 0.001）。总体而言，符合 DAS28 或 CDAI 中度/高度活动标准的患者中有 89-94%符合类似的 RAPID 严重程度标准，符合 DAS28 或 CDAI 缓解/低度活动标准的患者中有 84-88%也符合类似的 RAPID 标准。RAPID3 评分提供与 DAS28 和 CDAI 相似的定量信息，因此，是评估繁忙临床环境中 RA 疾病活动的信息性指标。
Zotero 插件