Comparison of four articular indices for use in clinical trials in rheumatoid arthritis: patient, order and observer variation.
Using a Latin square design, 4 patients were examined by 4 rheumatologists. Joints were scored for tenderness and inflammation. The Ritchie, the index of the American Rheumatism Association (ARA), the Hart modified Ritchie and a simplified Lansbury index were calculated from the raw data. The results suggest that an articular index consisting of a simple count of tender joints (Hart modified Ritchie) or a simple count of tender or swollen joints (ARA index) are the most reproducible with multiple observers. We suggest that these indices would be most appropriate for multicenter clinical trials.
Thompson
P W
PW
Bone and Joint Research Unit, London Hospital Medical College, UK.
Hart
L E
LE
Goldsmith
C H
CH
Spector
T D
TD
Bell
M J
MJ
Ramsden
M F
MF
D001172:Arthritis, Rheumatoid / Q000473:pathology*; D006801:Humans; D007596:Joints / Q000473:pathology; D012720:Severity of Illness Index