[Standardisation proposal for monitoring rheumatoid arthritis patients in Croatia]

Monitoring of outcome measures is carried out because of the assessment of medical care quality, also in scientific researches i.e. clinical trials. However, it is rarely carried out in daily clinical practice due to lack of time. Our goal was to choose the outcome measures set for monitoring disease activity in rheumatoid arthritis (RA) which encompasses validity, reliability and sensitivity and also primarily satisfies feasybility criteria in daily clinical practice. We have analyzed the following parametres in 83 unselected patients with RA diagnosis in our department: the mutual relation of single measures of the disease activity (Ritchie index, number of swollen joints, general health status assessment with VAS and SE), their relation to the DAS and HAQ and the relation between the DAS and HAQ. We have recently replaced the Ritchie index by 28DAS, and HAQ by mHAQ. The values of correlation between the single measures of the disease activity which we had found out by statistical processing justify their usage in assessment of the clinical status, however the non-existence of the correlations compared to HAQ points to unreliability when used in evaluation of the disease activity. Unlike the single measures, DAS has positive correlation compared to HAQ. Based on our experience in past two years and recommendations found in literature, we suggest introducing the outcome measures set for monitoring disease activity in rheumatoid arthritis in clinical care. That would be mHAQ as the long-term outcome in measuring the disease activity and parametres by which DAS28 (number of tender joints, number of swollen joints, general health status assessment by VAS, SE) can be calculated as short-term outcome.