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Evaluation of established rheumatoid arthritis
1Department of Rheumatology, University Hospital Nijmegen, The Netherlands.
Bailliere'S Best Practice & Research. Clinical Rheumatology
|February 1, 2000
Summary
Evaluating established rheumatoid arthritis (RA) requires assessing disease activity, damage, and health status. New measures for established RA may offer practical alternatives to current standards.
Area of Science:
- Rheumatology
- Clinical Assessment
- Patient Outcomes
Background:
- Established rheumatoid arthritis (RA) assessment involves evaluating disease progression and intervention effects.
- Current assessment methods may not be fully applicable to established RA, necessitating investigation into their suitability.
- Disease activity, tissue damage, and health status are key evaluation components, with interdependencies.
Purpose of the Study:
- To explore appropriate evaluation methods for established rheumatoid arthritis (RA).
- To determine if existing improvement/remission criteria for early RA apply to established RA.
- To identify reliable, valid, and sensitive measures for disease activity, tissue damage, and health status in established RA.
Main Methods:
- Review of current assessment standards for established RA.
- Investigation into the applicability of early RA improvement/remission criteria to established RA.
- Evaluation of alternative measures for tissue damage (e.g., range-of-motion, muscle strength) versus radiographs.
- Consideration of health status instruments and their pretesting for clinical settings.
Main Results:
- Established RA evaluation requires distinct approaches compared to early RA.
- Disease activity, tissue damage, and health status are interconnected and influence each other.
- Radiographs are standard for damage assessment, but range-of-motion and muscle strength offer practical alternatives.
- Health status instruments require careful selection and pretesting for specific settings.
Conclusions:
- Established RA assessment needs validated measures for disease activity, tissue damage, and health status.
- Alternative methods like range-of-motion and muscle strength indices may be practical for assessing damage.
- Existing remission criteria for early RA may need re-evaluation for established RA patients.
- Careful selection and validation of health status instruments are crucial for accurate patient outcome assessment.