title: A comparative study of patient-reported functional outcomes in acute rheumatoid arthritis.
abstract: OBJECTIVE
  To assess the performance of the Barthel Index (BI) in patients with rheumatoid arthritis (RA) in the acute care hospital, as compared to the Stanford Health Assessment Questionnaire (HAQ) and the Hannover Functional Questionnaire (Funktionsfragebogen Hannover, FFbH).
  
  
  METHODS
  A prospective study of 97 patients with RA admitted to an acute rheumatology hospital with new onset or acute flare of RA. Patients were required to self-complete the BI, the HAQ, and the FFbH. Disease activity was measured using the Disease Activity Score (DAS28).
  
  
  RESULTS
  Seventy-eight percent of patients were female, average age was 61.5 (SD 12.5) years, and 72.2% were rheumatoid factor-positive. The median HAQ was 1.29 (range 0-3), median FFbH was 50% (6-100%), and median BI was 95 (0-100), and distribution was highly skewed. All measures of physical functioning were significantly correlated with each other and with the DAS28; however, the BI discriminated poorly between low and high disease activity.
  
  
  CONCLUSIONS
  The BI is not a useful instrument to assess physical functioning in patients with acute symptoms of RA, but may have a role in assessing patients with comorbidities and in assessing nursing care needs in the acute care hospital.
authors.affiliation: Rheumazentrum-Ruhrgebiet, Herne, Germany.
authors.forename: Jane
authors.initials: J
authors.lastname: Zochling
authors.forename: Gerold
authors.initials: G
authors.lastname: Stucki
authors.forename: Eva
authors.initials: E
authors.lastname: Grill
authors.forename: Jürgen
authors.initials: J
authors.lastname: Braun
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000145:classification* / Q000503:physiopathology* / Q000628:therapy; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome