75
single observer (the patient) provides the data for clinical interpretation by the phy-
sician. Monitoring of a patient according to, say, DAS28 or CDAI may not be pos-
sible at the time of a patient contact or visit, due to: insuffi cient time to perform a
formal joint count, absence of a laboratory test (for DAS28), the patient has traveled
to another locale, and/or others. Collection of an MDHAQ/RAPID3 assures that
some quantitative data concerning patient status is recorded at every visit, and cer-
tainly does not preclude scoring a DAS28, CDAI, or any other quantitative measure
or index that is regarded as informative by the treating physician.
Fig. 3.8 ( a – d ) Relative effi ciencies of seven rheumatoid arthritis (RA) Core Data Set measures to
distinguish active from control treatments in 9 clinical trials, involving methotrexate, lefl unomide,
placebo, infl iximab, adalimumab, and abatacept according to arithmetic and percentage changes
0%
PATGL
PAIN
HAQ-FN
ESR/CRP
DOCGL
SJC
TJC
5 Highest Relative Efficiencies
20% 40% 60% 80% 100%
100%
78%
78%
44%
67%
33%
100%
PATGL
PAIN
HAQ-FN
ESR/CRP
DOCGL
SJC
TJC
4 Highest Relative Efficiencies
0% 20% 40% 60% 80% 100%
100%
67%
67%
44%
44%
0%
78%
A
B
3 PROMs (MDHAQ/RAPID3) and Physician RheuMetric Measures