title: Discordance and accordance between patient's and physician's assessments in rheumatoid arthritis.
abstract: OBJECTIVE
  The American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) remission criteria for rheumatoid arthritis (RA) are more stringent than index-based criteria, making it more difficult to achieve a patient's global assessment (PGA) than an evaluator's global assessment (EGA). We investigated the reason for the discrepancy between the PGA and the EGA in a Japanese clinical cohort.
  
  
  METHODS
  We assessed clinical and laboratory variables in our clinical cohort. The frequency of remission achievement according to the ACR/EULAR remission criteria and predictors of the discrepancy between the PGA and EGA were analysed.
  
  
  RESULTS
  Of 370 patients with RA, 89 fulfilled PGA criteria and 167 patients fulfilled EGA criteria. The PGA was highly correlated with the visual analogue scale (VAS) pain score and non-inflammatory variables including Steinbrocker class and the Health Assessment Questionnaire Disability Index (HAQ-DI). Conversely, inflammatory variables, including swollen joint count (SJC), tender joint count (TJC), and C-reactive protein (CRP) levels, were significantly associated with the EGA. The main predictors of the discrepancy between the PGA and the EGA were patient's VAS pain score, SJC, and functional disability.
  
  
  CONCLUSIONS
  Increased pain and functional disability led to a discrepancy towards a worse PGA than EGA, whereas increased SJC led to an accordance towards a worse EGA.
authors.affiliation: Department of the Control for Rheumatic Diseases, Kyoto University Graduate School of Medicine , Kyoto , Japan.
authors.forename: M
authors.initials: M
authors.lastname: Furu
authors.forename: M
authors.initials: M
authors.lastname: Hashimoto
authors.forename: H
authors.initials: H
authors.lastname: Ito
authors.forename: T
authors.initials: T
authors.lastname: Fujii
authors.forename: C
authors.initials: C
authors.lastname: Terao
authors.forename: N
authors.initials: N
authors.lastname: Yamakawa
authors.forename: H
authors.initials: H
authors.lastname: Yoshitomi
authors.forename: H
authors.initials: H
authors.lastname: Ogino
authors.forename: M
authors.initials: M
authors.lastname: Ishikawa
authors.forename: S
authors.initials: S
authors.lastname: Matsuda
authors.forename: T
authors.initials: T
authors.lastname: Mimori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology; D010817:Physician-Patient Relations; D012074:Remission Induction; D012219:Rheumatology; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents