title: Patient-reported outcomes as assessment tools and predictors of long-term prognosis: a 7-year follow-up study of patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Whether the Boolean-based American College of Rheumatology/European League Against Rheumatism (EULAR) criteria for rheumatoid arthritis (RA) including patient-reported outcome measures (PROMs) for remission are strict for use in daily clinical practice is controversial. This study aimed to clarify the differences in the remission status defined by the criteria, including and excluding PROMs, and to identify the baseline predictors of long-term prognosis using 7-year follow-up data.
  
  
  METHODS
  A total of 103 RA outpatients completed the baseline and 7-year follow-up questionnaire surveys. Pain visual analogue scale (VAS) of ≤ 1/10 was used as a PROM criterion for remission.
  
  
  RESULTS
  Only 10 patients achieved full-remission, whereas 18 met the partial-remission criteria excluding PROM at baseline. Although 70.0% of those who achieved full remission at baseline had full or partial remission status, 77.8% of those with partial remission were categorized as having no remission at 7 years. Significant baseline differences in the remission status at 7 years were observed with regard to disease duration, pain VAS, and physical function (Short Form 36 [SF-36]). Stepwise logistic regression analysis adjusted for age and sex identified disease duration and general health perception (SF-36) as independent predictors of full-remission.
  
  
  CONCLUSIONS
  Remission criteria including PROMs are stringent but important to achieve sustained remission. Early intensive treatment and efforts to improve patients' health perceptions may result in better prognosis for RA.
authors.affiliation: Department of Public Health Nagoya City University Graduate School of Medical Science, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Kojima
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Kojima
authors.affiliation: Department of Public Health Nagoya City University Graduate School of Medical Science, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Sadao
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Nobunori
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Funahashi
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Asai
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yoshioka
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Kenya
authors.initials: K
authors.lastname: Terabe
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Asai
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Toki
authors.initials: T
authors.lastname: Takemoto
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya University Hospital, Nagoya University School of Medicine, Nagoya, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010147:Pain Measurement; D000071066:Patient Reported Outcome Measures; D012074:Remission Induction; D009626:Terminology as Topic; D013997:Time Factors; D016896:Treatment Outcome
keywords: epidemiology; outcome measure; prognostic factor