73Table 3.5 Correlations and
test-retest reliability of RA
measures and indices at 2
time points [ 111 ]
Measure/index Spearman rho ICC
TJC28 0.76 0.83
SJC28 0.74 0.78
Physician global 0.69 0.79
Patient global 0.80 0.78
Function 0.98 0.96
Pain 0.83 0.88
ESR 0.84 0.95
CRP 0.71 0.97
DAS28 0.85 0.85
SDAI 0.87 0.88
CDAI 0.89 0.89
RAPID3 0.88 0.90
RADAI 0.89 0.92similar results to DAS28 and CDAI to distinguish active from control treatments in
clinical trials of lefl unomide [ 93 ], methotrexate [ 93 ], adalimumab [ 94 ], abatacept
[ 77 ], and certolizumab [ 95 ].
RAPID3 is more likely to be abnormal in new patients with RA than laboratory
tests [ 81 ], and more likely than ESR to document incomplete responses to
methotrexate and initiation of a biological agent in RA [ 101 ] (Table 3.6 ). RAPID3
also provides criteria for remission in RA, documented in a recent report concern-
ing the ESPOIR usual care cohort in France [ 102 ]. MDHAQ/RAPID3 is informa-
tive to assess improvement or worsening of patient status over time in many
rheumatic diseases [ 104 ] (Fig. 3.9 , Table 3.7 [ 61 , 63 , 103 – 108 , 110 , 112 ]), includ-
ing systemic lupus erythematosus [ 103 , 104 ], osteoarthritis [ 104 ], ankylosing spon-
dylitis [ 104 – 108 ], psoriatic arthritis [ 104 ], gout [ 104 ], vasculitis [ 109 ], and others
[ 104 , 110 ]. These data indicate that patient self-report scores can be as “scientifi c”
as laboratory tests.
Pragmatic Advantages of MDHAQ/RAPID3
MDHAQ/ RAPID3 presents many pragmatic advantages to both patients and doc-
tors for rheumatology care (Table 3.8 ) [ 81 , 113 ]. Advantages to the patient include:
The patient prepares for the encounter by focusing on concerns to discuss with the
doctor. The MDHAQ empowers the patient as a partner in care, and improves doc-
tor/patient communication, with an “agenda” or “road map” available before the
encounter for both patient and doctor [ 113 ].
Pragmatic advantages to the rheumatologist include (Table 3.8 ): The patient does
almost all the work. MDHAQ/RAPID3 does not disrupt offi ce fl ow or require any
time and effort from the doctor to collect the data, when presented to each patient
3 PROMs (MDHAQ/RAPID3) and Physician RheuMetric Measures