Six rheumatoid arthritis (RA) disease activity measures have been recommended for use in US clinical practice by an American College of Rheumatology (ACR) working group, the organization announced. After evaluating more than 60 measures on the basis of their reliability, validity, and responsiveness, the ACR group recommended the following ones:
• Clinical Disease Activity Index (CDAI).
• Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein level) (DAS-28).
• Patient Activity Scale (PAS).
• Routine Assessment of Patient Index Data with 3 measures (RAPID 3).
• Simplified Disease Activity Index (SDAI).
Although many health care professionals advocate standardized assessments for RA disease activity, US rheumatologists currently are not using uniform measures of RA activity, the ACR noted. Therefore, the RA Clinical Disease Activity Measures Working Group conducted a systematic review of the medical literature to identify disease activity measures for RA. They surveyed rheumatologists for input and used the feedback, along with psychometric analysis, to determine recommendations for RA disease activity assessments.
The goal was to determine which RA disease activity measures could distinguish the various levels of RA activity accurately and would be reasonable to implement in clinical practice. The recommended disease activity measures are detailed in Arthritis Care & Research, an ACR publication. You can also find a PDF of the new guidelines online at the ACR website.
In a podcast interview, a researcher involved in the guidelines development describes the reasons for the new guidelines and the main features of the measures.