Time to Score Quantitative Rheumatoid Arthritis Measures: 28-Joint Count, Disease Activity Score, Health Assessment Questionnaire (HAQ), Multidimensional HAQ (MDHAQ), and Routine Assessment of Patient Index Data (RAPID) Scores

YUSUF YAZICI, MARTIN BERGMAN, and THEODORE PINCUS

ABSTRACT.

Objective. To analyze the time required to score different measures used to assess patients with rheumatoid arthritis (RA), as a guide to feasibility in standard care. The measures studied were a 28-Joint Count, Disease Activity Score (DAS), Health Assessment Questionnaire (HAQ), Multidimensional HAQ (MDHAQ), and various Routine Assessment of Patient Index Data (RAPID) scores derived from the MDHAQ.

Methods. Three rheumatologists at 3 sites performed and timed 28-joint counts in 20 different patients at each site. Each rheumatologist scored and timed identical data in 5 groups of 10 from the same 50 patients seen in standard clinical care, including 50 DAS28 indices using the DAS Website, 50 identical HAQ, and 50 identical MDHAQ from the same patients. The MDHAQ includes 10 activities self-assessed for physical function, 21 circle visual analog scales (VAS) (rather than 10 cm lines), and scoring templates on the questionnaire for physical function, patient self-report joint count and RAPID composite scores. RAPID3 includes the 3 Core Data Set measures, RAPID4 adds the self-report joint count to RAPID3, and RAPID5 adds a physician global estimate to RAPID4.

Results. The median number of seconds to complete a 28-joint count was 90, compared to 41.9 s for a HAQ, 9.6 s for an MDHAQ RAPID3, and 19.4 s for RAPID5.

Conclusion. MDHAQ RAPID3 scores can be calculated in considerably less time than other RA measures, using scoring templates on the MDHAQ, to provide informative, feasible, quantitative measures for standard rheumatology clinical care. (J Rheumatol First Release Mar 1 2008)

Key Indexing Terms:

RHEUMATOID ARTHRITIS
PATIENT QUESTIONNAIRE
MULTIDIMENSIONAL HEALTH ASSESSMENT QUESTIONNAIRE
JOINT COUNT
ROUTINE ASSESSMENT OF PATIENT INDEX DATA
DISEASE ACTIVITY SCORE

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From New York University Hospital for Joint Diseases, New York, New York, and Arthritis and Rheumatology, Taylor Hospital, Ridley Park, Pennsylvania, USA.

Supported by grants from the Arthritis Foundation, Amgen, Bristol-Myers-Squibb, and the Jack C. Massey Foundation.

Y. Yazici, MD; T. Pincus, MD, NYU Hospital for Joint Diseases; M. Bergman, MD, Arthritis and Rheumatology, Taylor Hospital.

Address reprint requests to Dr. Y. Yazici, NYU Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.

Accepted for publication November 29, 2007.