How does one assess early rheumatoid arthritis in daily clinical practice?

In past years, consensus has been reached on the assessment of rheumatoid arthritis in clinical trials. Next to a core set of disease activity variables, response criteria have been developed and validated. These criteria are, however, of limited value in daily clinical practice. In this situation, emphasis should be paid to accurate measurement of disease activity on a continuous scale using the lowest possible number of core set variables. Different studies have shown that the DAS28 is a valuable instrument for this purpose. Many factors have been identified to possess a prognostic value; however, the IgM rheumatoid factor is still the only one which is of any importance in daily clinical practice.