Optimisation of rheumatology indices
RAPID3? Aptly named!
J.-M. Berthelot
CER7883
2014 Vol.32, N°5 ,Suppl.85
PI 0080, PF 0084
Optimisation of rheumatology indices
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PMID: 25365094 [PubMed]
Received: 01/09/2014
Accepted : 10/09/2014
In Press: 30/10/2014
Published: 03/11/2014
Abstract
The RAPID3 score is the sum of three 0-10 patient self-report scores: pain, functional impairment on MDHAQ, and patient global estimate. It requires 5 seconds for scoring and can be used in all rheumatologic conditions, although it has mostly been used in rheumatoid arthritis where cutoffs for low disease activity (<6/30) or high disease activity (>12/30) have been set. A RAPID3 score of ≤3/30 with 1 or 0 swollen joints (RAPID3≤3+≤SJ1) provides remission criteria comparable to Boolean, SDAI, CDAI, and DAS28 remission criteria, in far less time than a formal joint count. RAPID3 performs as well as the DAS28 in separating active drugs from placebos in clinical trials. RAPID3 also predicts subsequent structural disease progression. RAPID3 can be determined at short intervals at home, allowing the determination of the area under the curve of disease activity between two visits and flare detection. However, RAPID3 should not be seen as a substitute for DAS28 and face to face visits in routine care. Monitoring patient status with only self-report information without a rheumatologist`s advice (including joints and physical examination, and consideration of imaging and laboratory tests) may indeed be as undesirable for most patients than joint examination without a patient questionnaire. Conversely, combining the RAPID3 and the DAS28 may consist in faster or more sensitive confirmation that a medication is effective. Similarly, better enquiring of most important concerns of patients (pain, functional status and overall opinion on their disorder) should reinforces patients` confidence in their rheumatologist and treatments.