title: What factors affect discordance between physicians and patients in the global assessment of disease activity in rheumatoid arthritis?
abstract: OBJECTIVE
  To identify the level of agreement between patients with rheumatoid arthritis (RA) and physicians in the global assessment of disease activity and to explore factors influencing their discordance.
  
  
  METHODS
  A total of 4368 patients with RA were analyzed from the KORean Observational study Network for Arthritis (KORONA) database. Patients were divided into four subgroups according to difference from their physicians in the assessment of disease activity by substracting physician's visual analog scale (VAS) from patient's VAS as follows: positive discordance group I (10 mm ≤ discordance <25 mm), positive discordance group II (≥25 mm), concordance (<|10| mm), and negative discordance (≤ -10mm). Multinomial logistic regression analysis was performed to identify factors associated with discordance.
  
  
  RESULTS
  Only 1350 (29.2%) patients were classified in the concordance group. Positive discordance was found in 52.3% of the patients (n = 2425), with 33.7% (n = 1563) showing marked discordance (≥25 mm). The high disease activity (OR =1.41), gastrointestinal (GI) disease (OR =1.28), pain (OR =1.12), fatigue (OR =1.07) were consistently associated with positive discordance.
  
  
  CONCLUSIONS
  More than half of patients with RA thought their disease more severe than their physicians. In addition to high disease activity, pain, fatigue, and sleep disturbance or GI disease were associated with the discordance between physicians and patients with RA.
authors.affiliation: a Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea.|b Clinical Research Center for Rheumatoid Arthritis (CRCRA) , Seoul , South Korea.
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Cho
authors.affiliation: a Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea.|b Clinical Research Center for Rheumatoid Arthritis (CRCRA) , Seoul , South Korea.
authors.forename: Yoon-Kyoung
authors.initials: YK
authors.lastname: Sung
authors.affiliation: a Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea.|b Clinical Research Center for Rheumatoid Arthritis (CRCRA) , Seoul , South Korea.
authors.forename: Chan-Bum
authors.initials: CB
authors.lastname: Choi
authors.affiliation: c Hanyang University Guri Hospital , Guri , South Korea.
authors.forename: So-Young
authors.initials: SY
authors.lastname: Bang
authors.affiliation: d Sungkyunkwan University School of Medicine, Samsung Medical Center , Seoul , South Korea.
authors.forename: Hoon-Suk
authors.initials: HS
authors.lastname: Cha
authors.affiliation: e Catholic University of Daegu School of Medicine , Daegu , South Korea.
authors.forename: Jung-Yoon
authors.initials: JY
authors.lastname: Choe
authors.affiliation: f Dong-A University Hospital , Busan , South Korea.
authors.forename: Won Tae
authors.initials: WT
authors.lastname: Chung
authors.affiliation: g Kyung Hee University Hospital , Seoul , South Korea.
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Hong
authors.affiliation: a Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea.
authors.forename: Jae-Bum
authors.initials: JB
authors.lastname: Jun
authors.affiliation: h Jeju National University Hospital , Jeju , South Korea.
authors.forename: Jinseok
authors.initials: J
authors.lastname: Kim
authors.affiliation: a Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea.
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Kim
authors.affiliation: i Chonnam National University Hospital , Gwangju , South Korea.
authors.forename: Tae-Jong
authors.initials: TJ
authors.lastname: Kim
authors.affiliation: d Sungkyunkwan University School of Medicine, Samsung Medical Center , Seoul , South Korea.
authors.forename: Eun-Mi
authors.initials: EM
authors.lastname: Koh
authors.affiliation: c Hanyang University Guri Hospital , Guri , South Korea.
authors.forename: Hye-Soon
authors.initials: HS
authors.lastname: Lee
authors.affiliation: j Ewha Women's University Mokdong Hospital , Seoul , South Korea.
authors.forename: Jisoo
authors.initials: J
authors.lastname: Lee
authors.affiliation: k Konkuk University Medical Center , Seoul , South Korea , and.
authors.forename: Sang-Heon
authors.initials: SH
authors.lastname: Lee
authors.affiliation: i Chonnam National University Hospital , Gwangju , South Korea.
authors.forename: Shin-Seok
authors.initials: SS
authors.lastname: Lee
authors.affiliation: f Dong-A University Hospital , Busan , South Korea.
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Lee
authors.affiliation: e Catholic University of Daegu School of Medicine , Daegu , South Korea.
authors.forename: Sung-Hoon
authors.initials: SH
authors.lastname: Park
authors.affiliation: a Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea.
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Yoo
authors.affiliation: l Inje University Ilsan Paik Hospital , Goyang , South Korea.
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Yoon
authors.affiliation: a Hanyang University Hospital for Rheumatic Diseases , Seoul , South Korea.|b Clinical Research Center for Rheumatoid Arthritis (CRCRA) , Seoul , South Korea.
authors.forename: Sang-Cheol
authors.initials: SC
authors.lastname: Bae
authors.affiliation: b Clinical Research Center for Rheumatoid Arthritis (CRCRA) , Seoul , South Korea.
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062072:Patient Acuity; D010820:Physicians; D056910:Republic of Korea; D064232:Visual Analog Scale
keywords: Arthritis; Discordance; Fatigue; Gastrointestinal diseases; Pain; Patient global assessment; Physician global assessment; Rheumatoid; Sleep