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Minimal Clinically Important Improvement of Routine Assessment of Patient Index Data 3 in Rheumatoid Arthritis

Michael M Ward1,2, Isabel Castrejon3,4, Martin J Bergman3,4

  • 1From the Intramural Research Program, US National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland; Division of Rheumatology, Rush University Medical Center, Chicago, Illinois; Rheumatology, Taylor Hospital, Ridley Park, Pennsylvania, USA. wardm1@mail.nih.gov.

The Journal of Rheumatology
|October 17, 2018
PubMed
Abstract

Insights

A minimal clinically important improvement (MCII) for Routine Assessment of Patient Index Data 3 (RAPID-3) in rheumatoid arthritis (RA) was estimated. An improvement of 3.8/30 units on the RAPID-3 score indicates a meaningful change for RA patients.

Area of Science:

  • Rheumatology
  • Clinical Measurement
  • Patient-Reported Outcomes

Background:

  • Rheumatoid arthritis (RA) management relies on assessing treatment efficacy.
  • Routine Assessment of Patient Index Data 3 (RAPID-3) is a composite index for monitoring RA.
  • Establishing a minimal clinically important improvement (MCII) for RAPID-3 is crucial for clinical interpretation.

Purpose of the Study:

  • To determine the MCII for the RAPID-3 score in adult patients with active rheumatoid arthritis.
  • To provide a quantitative measure of clinically meaningful improvement in RA patients using RAPID-3.

Main Methods:

  • A prospective study involving adults with active RA.
  • RAPID-3 scores were collected before and after treatment escalation.
  • Patient-reported improvement was used as the reference standard to derive MCII via receiver-operating characteristic (ROC) curve analysis.

Main Results:

  • Mean RAPID-3 scores decreased from 16.3 to 11.1, indicating improvement.
  • MCII estimates ranged from -3.5 to -4.1, with -3.8 derived from simultaneously optimized sensitivity and specificity.
  • The calculated MCII suggests a meaningful change in RA disease activity.

Conclusions:

  • An improvement of 3.8/30 units on the RAPID-3 score is considered clinically meaningful for RA patients.
  • This finding aids clinicians in interpreting RAPID-3 changes and assessing treatment effectiveness.
  • The study establishes a benchmark for clinically significant improvement in RA using a validated patient-reported outcome measure.
Keywords:
PATIENT-REPORTED OUTCOMESRAPID-3RHEUMATOID ARTHRITIS

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