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Evaluating severity and status in rheumatoid arthritis
F Wolfe1, J R O'Dell, A Kavanaugh
1National Data Bank for Rheumatic Diseases, Arthritis Research Center Foundation, Inc. and University of Kansas School of Medicine, Wichita, Kansas, USA. fwolfe@arthritis-research.org
The Journal of Rheumatology
|June 21, 2001
Summary
This study introduces new methods for assessing rheumatoid arthritis (RA) severity in individual patients, improving clinical practice and clinical trials. These validated, shortened joint counts offer reliable disease status evaluation.
Area of Science:
- Rheumatology
- Clinical Epidemiology
- Biostatistics
Background:
- Current methods for evaluating rheumatoid arthritis (RA) status in clinical trials are not always practical for individual patient assessment due to time constraints.
- Lack of guidelines for determining actual disease status, as opposed to change in status, hinders effective patient management and research.
- Existing clinical trial evaluation methods may not be suitable for routine clinical practice.
Framework:
- Develop and validate modified evaluation methods for rheumatoid arthritis (RA) status applicable to both clinical practice and research.
- Utilize data bank research to refine existing assessment techniques and introduce new ones.
- Focus on methods that balance reliability and validity with the time constraints of clinical settings.
Implementation:
- Introduce shortened joint counts (clinical-18 and clinical-16) based on the Ritchie method for efficient RA assessment.
- Apply percentile methods to quantify disease severity status using data from longitudinal observational studies.
- Develop percentile charts for evaluating disease activity in routine clinical practice and randomized controlled trials (RCTs).
Implications:
- Enable quantitative assessment of disease activity status for improved patient prognosis and treatment decisions in rheumatoid arthritis (RA).
- Facilitate better evaluation of treatment appropriateness and response to disease-modifying antirheumatic drugs (DMARDs) and biologic therapies.
- Enhance the evaluation of patient severity status in RCTs and improve the generalizability of research findings.