RAPID3-an index of physical function, pain, and global status as "vital signs" to improve care for people with chronic rheumatic diseases.
A guide to RAPID3 (routine assessment of patient index data), an index of three patient self-report measures-physical function, pain, and patient global estimate of status-on a multidimensional health assessment questionnaire (MDAQ) is presented, including development, scoring, use in standard care, and rationale. RAPID3 and its individual components are regarded as "vital signs," which may alert a health professional to unsuspected patient problems, provide a baseline measure to support a change in therapy, and numerically document improvement or worsening over time to complement clinical impressions. MDHAQ-RAPID3 can be incorporated into the infrastructure of standard rheumatology care for completion in the waiting room by every patient with any rheumatic disease at every visit: if there is a reason for a visit, there is a reason for RAPID3 vital signs. RAPID3 is calculated in 5 to 10 seconds, providing similar information to DAS28 (disease activity score) and CDAI (clinical disease activity index), which require a mean of 114 and 106 seconds, respectively. MDHAQ-RAPID3 presents an additional advantage for the patient to optimize the office encounter by completion of the questionnaire in the waiting room. The MDHAQ also includes a review of systems and recent medical history, which can save 2 to 3 minutes per visit for other patient concerns. A physician's clinical decisions ultimately require synthesis and interpretation of all available data, ranging from laboratory tests to patient questionnaire scores. RAPID3 vital signs can contribute to this synthesis toward improved quality, outcomes, and documentation of rheumatology care.
Pincus
Theodore
T
New York University School of Medicine, New York, NY, USA. tedpincus@gmail.com
Bergman
Martin J
MJ
Yazici
Yusuf
Y
D000203:Activities of Daily Living; D002908:Chronic Disease; D003661:Decision Support Techniques; D006305:Health Status Indicators; D006801:Humans; D009819:Office Visits; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011787:Quality of Health Care; D012216:Rheumatic Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires