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fering from infl ammatory arthritic conditions, a mutual index of several measures
has been recommended for assessment of disease activity and monitoring response
to therapy. The most widely used indices in RA are the ACR core dataset, disease
activity score (DAS-28), and clinical disease activity index (CDAI) [ 4 , 42 , 43 , 45 ,
46 ]. Specifi c multidimensional PROMs have been developed to capture those ele-
ments of health outcome measures of relevance to a specifi c patient group. Therefore,
it represents the best available tool offering a quantitative “gestalt” impression of
the outcome measures for a specifi c condition. Multidimensional PROMs question-
naire are already available for rheumatoid arthritis (examples are shown in Table 4.1
[ 12 , 13 , 18 , 62 , 63 , 66 – 69 ]). In all these conditions, PROMs has shown both a diag-
nostic value in helping to identify those who might be suffering from early infl am-
matory condition and a therapeutic impact as it helps to monitor response to therapy
over time [ 65 ].
Patient-Reported Outcome Measures Evolving from Static
to Dynamic
In acute diseases in hospital settings (the primary setting of most traditional medical
practice, education, training, and research) quantitative data regarding blood pres-
sure, temperature, and body weight come as a priority, whereas no data are collected
concer ning functional status or pain since success or failure of the treatment is obvi-
ous within a short period. However, in chronic diseases such as in the standard
rheumatology outpatient setting (the primary locale of almost all contemporary
rheumatologic care), such information is critical for the documentation of patient
Table 4.1 Patient-reported outcome measures for rheumatoid arthritis
Type Measure Score Generic Specifi c tools
Unidimensional Single
construct
Items
(questions)
are added to
yield overall
score
- EurQoL [ 62 ]
- Nottingham
Health
Profi le [ 63 ]- Pain questionnaire [ 12 ]
- Bristol rheumatoid
arthritis fatigue
numerical rating scales
(BRAF- NRS) [ 66 ] - Rheumatoid arthritis-
specifi c work
productivity survey
(WPS-RA) [ 67 ]
Multidimensional Health
concepts of
relevance to
a wide range
of patients
Specifi c
score for
each domain
- -SF-36 [ 13 ]
- MDHAQ
[ 68 ]- MDPROMs-RA [ 18 ]
- Bristol rheumatoid
arthritis fatigue
multidimensional
questionnaire
(BRAF-MDQ) [ 66 ] - Rheumatic arthritis
impact of disease
(RAID) [ 69 ]
- MDHAQ
Y. El Miedany