Article

OBJECTIVES: To assess the validity of the two self-report questionnaires RAPID3
and RADAI5 for measuring the activity of rheumatoid arthritis (RA) in everyday
practice, comparatively to the DAS28, CDAI, and SDAI. To determine cutoffs for
flare detection based on patients' and physicians' opinions. METHODS: The RAPID3
and RADAI5 questionnaires were completed by 200 consecutive patients with RA. The
DAS28, CDAI, and SDAI were computed in each patient. Patients and physicians
stated whether a flare was occurring. Pairwise Spearman correlation coefficients
were computed between the two scores and three indices. The kappa coefficient was
used to assess agreement between the patients and physicians regarding the
presence of a flare. Receiver-operating characteristic (ROC) curves were
constructed to determine cutoffs for flare detection. RESULTS: The 200 patients
had a mean age of 57 +/- 11.5 years, a mean RA duration of 13 +/- 8.3 years, a
mean DAS28 of 3.61 +/- 1.43, a mean CDAI of 12.7 +/- 9.89, and a mean SDAI of
13.4 +/- 10.45. The mean RAPID3 and RADAI5 scores were 3.45 +/- 2 and 3.93 +/-
2.18, respectively. The RAPID3 and RADAI5 scores correlated significantly with
the three composite activity indices, with rho values ranging from 0.64 to 0.74.
The flare rate was 35% according to the patients and 22% according to the
physicians, with moderate agreement between patients and physicians (kappa=0.44).
Flare cutoffs with satisfactory sensitivity and specificity values were obtained
for the two scores and three indices. For the three indices, flare cutoffs
according to the physicians were within the range indicating moderate disease
activity: 4.04 for the DAS28, 14.5 for the CDAI, and 16.7 for the SDAI. The
RAPID3 and RADAI5 flare cutoffs according to the physicians and patients were
similar, 4.27 and 4.33 for RAPID3 and 4.5 and 4.7 for RADAI5, respectively.
CONCLUSION: These results confirm the validity of the RAPID3 and RADAI5
self-report questionnaires and support their widespread use in everyday practice
in patients with RA. The self-report questionnaire scores correlate with the
composite activity index values and allow the detection of activity peaks or
flares.
CI - Copyright (c) 2011 Societe francaise de rhumatologie. Published by Elsevier SAS.
All rights reserved.

Langue : ANGLAIS