RESEARCH - Patient self-administered joint tenderness counts in RA are reliable and responsive to changes in disease activity

January 21, 2007

Journal of Rheumatology

January 2007

Patient Self-Administered Joint Tenderness Counts in Rheumatoid Arthritis

Are Reliable and Responsive to Changes in Disease Activity

FERNANDO FIGUEROA, YOLANDA BRAUN-MOSCOVICI, DINESH KHANNA, ECHING VOON, LY

GALLARDO, DONNA LUINSTRA, XIOMARA PINA, GRETCHEN HENSTORF, SANDY LAURENCE,

RICHARD NEIMAN, and DANIEL FURST

ABSTRACT.

Objective. To examine whether self-assessment of tender and swollen joints

by patients with rheumatoid arthritis (RA) can be used to evaluate changes

in disease activity instead of joint counts by physicians.

Methods. Eighty-two patients with RA taking part in controlled studies were

recruited for investigation. The patient's self-assessment of joint

tenderness and swelling was completed both before and 30 minutes after

examination by a physician. Examinations of tender and swollen joints by a

rheumatologist were performed at baseline and 3 months later. The

correlations and verification of agreement of these clinical assessments

were analyzed.

Results. Within-patient and patient-physician correlations for joint

tenderness counts were high (r = 0.96 and 0.78, respectively).

Patient-physician correlation for joint swelling counts was still

significant, although much lower (r = 0.34). Patients' and physicians'

estimations of the change in disease activity over 3 months did not differ

(p > 0.76 for all comparisons).

Conclusion. Joint tenderness counts were consistent when comparing

intra-patient and patient-physician assessments, while joint swelling counts

were poorly correlated. Patient and physician assessments of change over 3

months were parallel and similar for joint tenderness count.

Self-administered tender joint counts might be a useful tool to evaluate the

response to therapy in RA. (First Release Nov 1 2006; J Rheumatol

2007;34:54-6)

Not an MD

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