title: Patient self-administered joint tenderness counts in rheumatoid arthritis are reliable and responsive to changes in disease activity.
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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, Universidad de los Andes, Santiago de Chile, Chile.
authors.forename: Fernando
authors.initials: F
authors.lastname: Figueroa
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Braun-Moscovici
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
authors.forename: Eching
authors.initials: E
authors.lastname: Voon
authors.forename: Ly
authors.initials: L
authors.lastname: Gallardo
authors.forename: Donna
authors.initials: D
authors.lastname: Luinstra
authors.forename: Xiomara
authors.initials: X
authors.lastname: Pina
authors.forename: Gretchen
authors.initials: G
authors.lastname: Henstorf
authors.forename: Sandy
authors.initials: S
authors.lastname: Laurence
authors.forename: Richard
authors.initials: R
authors.lastname: Neiman
authors.forename: Daniel
authors.initials: D
authors.lastname: Furst
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000145:classification* / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006306:Health Surveys; D006801:Humans; D007596:Joints / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D016353:Self-Examination / Q000379:methods*; D012720:Severity of Illness Index