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Brief Report: Predicting Functional Disability: One-Year Results From the Scottish Early Rheumatoid Arthritis

Caroline Kronisch1, David J McLernon2, James Dale3

  • 1Cantonal Hospital Fribourg, Fribourg, Switzerland, and University of Aberdeen, Aberdeen, UK.

Arthritis & Rheumatology (Hoboken, N.J.)
|February 12, 2016
PubMed
Summary
This summary is machine-generated.

Psychosocial factors like depression and anxiety, not just clinical measures, predict disability in early inflammatory arthritis. Early nonpharmacologic interventions targeting mental health and work are recommended.

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Area of Science:

  • Rheumatology
  • Clinical Epidemiology

Background:

  • Early inflammatory arthritis requires understanding predictors of long-term disability.
  • Contemporary treatment paradigms necessitate updated prognostic indicators.

Purpose of the Study:

  • To identify baseline prognostic indicators of 1-year disability in an early inflammatory arthritis cohort.
  • To develop a clinical tool for patient education and decision-making.

Main Methods:

  • Analysis of the Scottish Early Rheumatoid Arthritis (SERA) inception cohort.
  • Forward stepwise logistic regression to identify predictors of disability (Health Assessment Questionnaire [HAQ] score ≥1 at 1 year).
  • External validation and conversion into a prediction tool.

Main Results:

  • Baseline disability, depression, anxiety, unemployment, and being overweight predicted 1-year functional disability.
  • Psychosocial factors were dominant predictors.
  • External validation showed good discriminative performance (C statistic = 0.74).

Conclusions:

  • Psychosocial factors significantly predict disability in early inflammatory arthritis.
  • Nonpharmacologic interventions targeting mental health and work disability may be beneficial.
  • A validated prediction tool can aid early patient management.