71waiting area helps prepare the patient for the visit, improves doctor–patient com-
munication, and saves time for both doctor and patient. The MDHAQ allows a
health professional to obtain information in 5–10 s that otherwise would require
10–15 min of conversation. Nonetheless, self-report of a medical history always
requires interpretation by a knowledgeable health professional, as is the case with a
laboratory test such as ESR or CRP, or ancillary study such as ultrasound, as dis-
cussed later in the section on the RheuMetric checklist [ 76 ].
Routine Assessment of Patient Index Data (RAPID3): An Index
of Only Patient Self-Report Measures
RAPID3 is an index of only the 3 RA Core Data Set patient self-report measures
[ 77 , 78 ]. The MDHAQ (Appendix A) includes small boxes to enter scores for physi-
cal function (FN), pain (PN), patient global estimate of status (PATGL) (each scored
0–10), as well as a composite RAPID3 score (0–30), in “For Offi ce Use Only”
sections. RAPID3 on an MDHAQ is scored in about 5 s, versus almost 2 min for
Disease Activity Score (DAS28) or Clinical Disease Activity Index (CDAI) [ 71 ]
(Fig. 3.6 ). RAPID3 appears feasible to implement a treat-to-target strategy in usual
clinical care [ 79 ]. Four categories of RAPID3 scores—for high, moderate, and low
severity, and remission—are correlated signifi cantly with similar categories using
DAS28 and CDAI [ 71 , 78 , 80 ]. RAPID3 offers many scientifi c and pragmatic
advantages to patients and doctors [ 81 ] as discussed below.
Fig. 3.6 Time to score various rheumatoid arthritis indices in seconds, including 28 joint count,
health assessment questionnaire-disability index (HAQ-DI), disease activity score 28 (DAS28),
clinical disease activity index (CDAI), routine assessment of patient index data (RAPID3) scores
0–10, RAPID3 scored 0–30
3 PROMs (MDHAQ/RAPID3) and Physician RheuMetric Measures