19 research outputs found
RADIOGRAPHIC PROGRESSION ON RADIOGRAPHS OF HANDS AND FEET DURING THE FIRST 3 YEARS OF RHEUMATOID-ARTHRITIS MEASURED ACCORDING TO SHARP METHOD (VANDERHEIJDE MODIFICATION)
Objective. To determine the development rate of erosions and joint space narrowing in a cohort of patients during the first 3 years of rheumatoid arthritis (RA). Methods. All consecutive patients fulfilling the American Rheumatism Association criteria and seen within the 1st year of the disease were followed prospectively with biannual radiographs of hands and feet. One hundred and forty-seven patients were followed for 2 years and 90 patients for 3 years. Erosions and joint space narrowing were scored with a modified version of Sharp's method (van der Heijde modification). Wilcoxon's rank sum test was used to test differences between joints and between erosions and joint space narrowing. Results. On average, at 3 year followup most groups of joints showed about 8% of the maximum possible score. In most groups of joints about 20% of the joints were affected, At the start more foot joints were affected than hand joints. However, the increase in the number of affected joints and in the radiographic damage was similar in hands and feet. Consequently, the predominance of affected foot joints was still present after 3 years. The progression in the 3rd year was statistically significantly less compared to the 1st year. This was more pronounced for the number of affected joints than for radiographic damage. Conclusion. We found that 70% of the patients showed radiographic damage after 3 years and this group could already be selected after 1 year. Overall, +/- 18-20% of the joints were affected after 3 years, with relatively few abnormalities per joint (+/- 8% of the maximum possible score was reached). The rate of progression in the 1st year was significantly more than in the 2nd and 3rd years, indicating a flattening of the curve of radiographic progression
VALIDITY OF SINGLE VARIABLES AND COMPOSITE INDEXES FOR MEASURING DISEASE-ACTIVITY IN RHEUMATOID-ARTHRITIS
There is no agreement as to which variable best mirrors disease activity in rheumatoid arthritis (RA) and no studies have been performed on the validity of disease activity variables. In this study the validity of 10 commonly used single variables and three composite indices was tested. All patients participated in a large follow up study in two clinics. The patients (n = 233) had classical or definite RA and a disease duration of less than one year at entry. The mean follow up time was 30 months; the follow up frequency was once every four weeks; 6011 records were used in the analysis. The validation criteria included correlations with the other variables (correlational validity), with the physical disability (criterion validity I), and with the radiographically determined damage of hands and feet (construct validity). The judgment of a group of rheumatologists in clinical practice was also used as a model of criterion validity (II). In this comparison the disease activity score and Mallya index showed the best validity. The best single variable was the number of swollen joints. The validity of most single variables was poor and these variables were not suitable as single endpoint measures in clinical trials
VALIDITY OF SINGLE VARIABLES AND COMPOSITE INDEXES FOR MEASURING DISEASE-ACTIVITY IN RHEUMATOID-ARTHRITIS
There is no agreement as to which variable best mirrors disease activity in rheumatoid arthritis (RA) and no studies have been performed on the validity of disease activity variables. In this study the validity of 10 commonly used single variables and three composite indices was tested.All patients participated in a large follow up study in two clinics. The patients (n = 233) had classical or definite RA and a disease duration of less than one year at entry. The mean follow up time was 30 months; the follow up frequency was once every four weeks; 6011 records were used in the analysis. The validation criteria included correlations with the other variables (correlational validity), with the physical disability (criterion validity I), and with the radiographically determined damage of hands and feet (construct validity). The judgment of a group of rheumatologists in clinical practice was also used as a model of criterion validity (II).In this comparison the disease activity score and Mallya index showed the best validity. The best single variable was the number of swollen joints. The validity of most single variables was poor and these variables were not suitable as single endpoint measures in clinical trials.</p