Walker Ulrich A, Mueller Ruediger B, Jaeger Veronika K, Theiler Robert, Forster Adrian, Dufner Patrick, Ganz Fabiana, Kyburz Diego
Department of Rheumatology, University Hospital Basel, Basel.
Division of Rheumatology, Department of Internal Medicine, Kantonsspital St Gallen, St Gallen.
Rheumatology (Oxford). 2017 Oct 1;56(10):1707-1712. doi: 10.1093/rheumatology/kex229.
The aim was to evaluate patient self-assessment of RA disease activity in terms of Routine Assessment of Patient Index Data (RAPID) scores via a Web-based smartphone application (WebApp).
In this prospective, multicentre study, adult RA patients were examined by a rheumatologist at baseline and after 3 months. Patients were asked to complete WebApp questionnaires weekly. The time course of patient-assessed RAPID3/4 scores and their correlations with rheumatologist-assessed DAS28, as well as Clinical and Simplified Disease Activity Indices (CDAI/SDAI), were evaluated.
Eighty patients were included in the analysis (median RA duration, 4.5 years; age, 57 years; 59% female). At baseline, there was a moderate to strong correlation between RAPID3 and DAS28 (r = 0.63), CDAI (r = 0.65) and SDAI (r = 0.61) scores. Similar or stronger correlations were seen at the 3-month follow-up visit (DAS28 r = 0.66, CDAI r = 0.71 and SDAI r = 0.61). Similar correlations were seen between RAPID4 and rheumatologist assessments. Correlations were not influenced by demographics or RA treatment. In the 3-month period, the RAPID3 score changed into a higher severity category than the category at baseline at least once in 47% of patients. When DAS28 scores were predicted from the RAPID3, 11% of patients had an increase of > 1 DAS28 unit during the 3-month observation period.
Web-based patient assessments were strongly correlated with rheumatologist assessments of RA activity and showed considerable variation during follow-up. This provides a rationale for further exploration of their use as cost-effective tools to monitor RA activity between outpatient visits and to optimize tight control strategies.
旨在通过基于网络的智能手机应用程序（WebApp），依据患者指数数据常规评估（RAPID）评分来评估患者对类风湿关节炎（RA）疾病活动度的自我评估。
在这项前瞻性多中心研究中，成年RA患者在基线期和3个月后由风湿病学家进行检查。要求患者每周完成WebApp问卷。评估患者评估的RAPID3/4评分的时间进程及其与风湿病学家评估的DAS28以及临床和简化疾病活动指数（CDAI/SDAI）的相关性。
80名患者纳入分析（RA中位病程4.5年；年龄57岁；59%为女性）。在基线期，RAPID3与DAS28（r = 0.63）、CDAI（r = 0.65）和SDAI（r = 0.61）评分之间存在中度至高度相关性。在3个月随访时观察到相似或更强的相关性（DAS28 r = 0.66，CDAI r = 0.71，SDAI r = 0.61）。RAPID4与风湿病学家评估之间也观察到相似的相关性。相关性不受人口统计学或RA治疗的影响。在3个月期间，47%的患者中RAPID3评分至少有一次变为比基线期更高的严重程度类别。当根据RAPID3预测DAS28评分时，在3个月观察期内11%的患者DAS28单位增加>1。
基于网络的患者评估与风湿病学家对RA活动度的评估密切相关，且在随访期间显示出相当大的变化。这为进一步探索将其用作具有成本效益的工具以监测门诊就诊之间的RA活动度并优化严格控制策略提供了理论依据。
