Patient self-administered joint tenderness counts in rheumatoid arthritis are reliable and responsive to changes in disease activity.
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.
Figueroa
Fernando
F
Department of Medicine, Universidad de los Andes, Santiago de Chile, Chile.
Braun-Moscovici
Yolanda
Y
Khanna
Dinesh
D
Voon
Eching
E
Gallardo
Ly
L
Luinstra
Donna
D
Pina
Xiomara
X
Henstorf
Gretchen
G
Laurence
Sandy
S
Neiman
Richard
R
Furst
Daniel
D
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