title: Brief Report: Predicting Functional Disability: One-Year Results From the Scottish Early Rheumatoid Arthritis Inception Cohort.
abstract: To identify baseline prognostic indicators of disability at 1 year within a contemporary early inflammatory arthritis inception cohort and then develop a clinically useful tool to support early patient education and decision-making.
  
  
  
  The Scottish Early Rheumatoid Arthritis (SERA) inception cohort is a multicenter, prospective study of patients with newly presenting RA or undifferentiated arthritis. SERA data were analyzed to determine baseline predictors of disability (defined as a Health Assessment Questionnaire [HAQ] score of ≥1) at 1 year. Clinical and psychosocial baseline exposures were entered into a forward stepwise logistic regression model. The model was externally validated using newly accrued SERA data and subsequently converted into a prediction tool.
  
  
  
  Of the 578 participants (64.5% female), 36.7% (n = 212) reported functional disability at 1 year. Functional disability was independently predicted by baseline disability (odds ratio [OR] 2.67 [95% confidence interval (95% CI) 1.98, 3.59]), depression (OR 2.52 [95% CI 1.18, 5.37]), anxiety (OR 2.37 [95% CI 1.33, 4.21]), being in paid employment with absenteeism during the last week (OR 1.19 [95% CI 0.63, 2.23]), not being in paid employment (OR 2.36 [95% CI 1.38, 4.03]), and being overweight (OR 1.61 [95% CI 1.04, 2.50]). External validation (using 113 newly acquired patients) evidenced good discriminative performance with a C statistic of 0.74, and the calibration slope showed no evidence of model overfit (P = 0.31).
  
  
  
  In the context of modern early inflammatory arthritis treatment paradigms, predictors of disability at 1 year appear to be dominated by psychosocial rather than more traditional clinical measures. This indicates the potential benefit of early access to nonpharmacologic interventions targeting key psychosocial factors, such as mental health and work disability.
authors: Cantonal Hospital Fribourg, Fribourg, Switzerland, and University of Aberdeen, Aberdeen, UK.
authors: Caroline
authors: C
authors: Kronisch
authors: University of Aberdeen, Aberdeen, UK.
authors: David J
authors: DJ
authors: McLernon
authors: University of Glasgow, Glasgow, UK.
authors: James
authors: 0000-0003-4769-8234
authors: J
authors: Dale
authors: University of Glasgow, Glasgow, UK.
authors: Caron
authors: C
authors: Paterson
authors: University of Edinburgh, Edinburgh, UK.
authors: Stuart H
authors: SH
authors: Ralston
authors: University of Aberdeen, Aberdeen, UK.
authors: David M
authors: DM
authors: Reid
authors: Glasgow Royal Infirmary, Glasgow, UK.
authors: Ann
authors: A
authors: Tierney
authors: Raigmore Hospital, Inverness, UK.
authors: John
authors: J
authors: Harvie
authors: Western General Hospital, Edinburgh, UK.
authors: Neil
authors: N
authors: McKay
authors: Stobhill General Hospital, Glasgow, UK.
authors: Hilary E
authors: HE
authors: Wilson
authors: Wishaw General Hospital, Lanarkshire, UK.
authors: Robin
authors: R
authors: Munro
authors: Glasgow Royal Infirmary, Glasgow, UK.
authors: Sarah
authors: S
authors: Saunders
authors: Borders General Hospital, Melrose, UK.
authors: Ruth
authors: R
authors: Richmond
authors: University Hospital Ayr, Ayr, UK.
authors: Derek
authors: D
authors: Baxter
authors: Dumfries & Galloway Royal Infirmary, Dumfries, UK.
authors: Mike
authors: M
authors: McMahon
authors: Ninewells Hospital, Dundee, UK.
authors: Vinod
authors: V
authors: Kumar
authors: Whyteman's Brae Hospital, Fife, UK.
authors: John
authors: J
authors: McLaren
authors: University of Glasgow, Glasgow, UK.
authors: Stefan
authors: S
authors: Siebert
authors: University of Glasgow, Glasgow, UK.
authors: Iain B
authors: IB
authors: McInnes
authors: University of Glasgow, Glasgow, UK.
authors: Duncan
authors: D
authors: Porter
authors: University of Aberdeen, Aberdeen, UK.
authors: Gary J
authors: GJ
authors: Macfarlane
authors: University of Aberdeen, Aberdeen, UK.
authors: Neil
authors: N
authors: Basu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult