PROMs (MDHAQ/RAPID3) and Physician RheuMetric Measures

摘要: Information from a medical history and physical examination are far more prominent in diagnosis management decisions rheumatoid arthritis (RA) than vital signs, laboratory tests, or ancillary studies, contrast to many other prevalent chronic diseases, such as hypertension diabetes, particularly tests have limitations rheumatic diseases. Medical information can be recorded scores on patient self-report questionnaires, advance assessment of status traditional “gestalt,” narrative impressions quantitative data for diagnosis, management, prognosis, outcomes. An index only measures, RAPID3 (routine data) an MDHAQ (multidimensional health questionnaire) is effective indices that include formal joint counts distinguish active control treatments RA clinical trials, document remission severity status, monitor outcomes routine care all Physical function questionnaire significant radiographs the prognosis severe work disability, costs, mortality. The also includes scales fatigue, count, review systems, exercise, change morning stiffness, recent history, demographic data, feasible busy settings. calculated 5 s, versus almost 2 min DAS28 CDAI correlated significantly with both these indices. RheuMetric physician checklist four 0–10 global estimate, well inflammation—reversible findings, damage—irreversible distress—symptoms explained by neither inflammation nor damage. Most most DAS28, CDAI, RAPID3, WOMAC, BASDAI, others, at least 1 measure, designed initially assess inflammation. However, high suggesting may result organ damage (e.g., joint, kidney) and/or distress fibromyalgia, depression). Recognition whether findings reversible, irreversible, distress-related, 3 bases, viewed expertise rheumatologist; recording contribute decisions. results indicating patients inflammatory diseases substantial evidence explain part why rheumatology visits generally complex types internal medicine encounters. MDHAQ/RAPID3 recommended care, improve assessment, monitoring, documentation,