title: Rheumatoid arthritis disease activity measures: American College of Rheumatology recommendations for use in clinical practice.
abstract: OBJECTIVE
  Although the systematic measurement of disease activity facilitates clinical decision making in rheumatoid arthritis (RA), no recommendations currently exist on which measures should be applied in clinical practice in the US. The American College of Rheumatology (ACR) convened a Working Group (WG) to comprehensively evaluate the validity, feasibility, and acceptability of available RA disease activity measures and derive recommendations for their use in clinical practice.
  
  
  METHODS
  The Rheumatoid Arthritis Clinical Disease Activity Measures Working Group conducted a systematic review of the literature to identify RA disease activity measures. Using exclusion criteria, input from an Expert Advisory Panel (EAP), and psychometric analysis, a list of potential measures was created. A survey was administered to rheumatologists soliciting input. The WG used these survey results in conjunction with the psychometric analyses to derive final recommendations.
  
  
  RESULTS
  Systematic review of the literature resulted in identification of 63 RA disease activity measures. Application of exclusion criteria and ratings by the EAP narrowed the list to 14 measures for further evaluation. Practicing rheumatologists rated 9 of these 14 measures as most useful and feasible. From these 9 measures, the WG selected 6 with the best psychometric properties for inclusion in the final set of ACR-recommended RA disease activity measures.
  
  
  CONCLUSIONS
  We recommend the Clinical Disease Activity Index, Disease Activity Score with 28-joint counts (erythrocyte sedimentation rate or C-reactive protein), Patient Activity Scale (PAS), PAS-II, Routine Assessment of Patient Index Data with 3 measures, and Simplified Disease Activity Index because they are accurate reflections of disease activity; are sensitive to change; discriminate well between low, moderate, and high disease activity states; have remission criteria; and are feasible to perform in clinical settings.
authors.affiliation: University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Jaclyn
authors.initials: J
authors.lastname: Anderson
authors.forename: Liron
authors.initials: L
authors.lastname: Caplan
authors.forename: Jinoos
authors.initials: J
authors.lastname: Yazdany
authors.forename: Mark L
authors.initials: ML
authors.lastname: Robbins
authors.forename: Tuhina
authors.initials: T
authors.lastname: Neogi
authors.forename: Kaleb
authors.initials: K
authors.lastname: Michaud
authors.forename: Kenneth G
authors.initials: KG
authors.lastname: Saag
authors.forename: James R
authors.initials: JR
authors.lastname: O'Dell
authors.forename: Salahuddin
authors.initials: S
authors.lastname: Kazi
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000473:pathology* / Q000628:therapy; D006306:Health Surveys / Q000379:methods; D006801:Humans; D017410:Practice Guidelines as Topic / Q000592:standards*; D012219:Rheumatology / Q000379:methods / Q000592:standards*; D012720:Severity of Illness Index; D012955:Societies, Medical / Q000592:standards*; D014481:United States
chemical_list: D018501:Antirheumatic Agents