RAPID3 (Routine Assessment of Patient Index Data 3) severity categories and response criteria: Similar results to DAS28 (Disease Activity Score) and CDAI (Clinical Disease Activity Index) in the RAPID 1 (Rheumatoid Arthritis Prevention of Structural Damag

2011 ◽  
Vol 63 (8) ◽  
pp. 1142-1149 ◽  
Author(s):  
Theodore Pincus ◽  
Victoria Furer ◽  
Edward Keystone ◽  
Yusuf Yazici ◽  
Martin J. Bergman ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Activity Index ◽  
Disease Activity Index ◽  
Clinical Disease ◽  
Activity Score ◽  
Response Criteria ◽  
Index Data ◽  
Routine Assessment

Should Quantitative Measures and Management of Rheumatoid Arthritis Include More Than Control of Inflammatory Activity?

2021 ◽  
pp. jrheum.210953
Author(s):  
Theodore Pincus ◽  
Martin J. Bergman ◽  
Yusuf Yazici
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Clinical Disease ◽  
Inflammatory Activity ◽  
Clinical Disease Activity ◽  
Sequential Study ◽  
Index Data ◽  
Routine Assessment

We agree strongly with Kremer et al that "metrics are essential for evaluating disease activity in patients with rheumatoid arthritis (RA)."1 Nonetheless, data reported from the Corrona and the Brigham and Women's Rheumatoid Arthritis Sequential Study (BRASS) registries for Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) are quite similar to those reported in the initial 2008 RAPID3 report.2

scholarly journals AB0119 DISCORDANCE OF RAPID3 AND CDAI IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1088.2-1089
Author(s):  
L. A. Ramrattan ◽  
Z. Vaghaiwalla ◽  
S. Singh ◽  
K. Ramsubeik ◽  
M. Thway ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Clinical Disease Activity Index ◽  
Clinical Disease ◽  
Clinical Disease Activity ◽  
Clinic Staff ◽  
Index Data ◽  
Routine Assessment

Background:The Clinical Disease Activity Index (CDAI) and the Routine Assessment of Patient Index Data 3 (RAPID3) ascertain rheumatoid arthritis (RA) disease activity and inform treatment decisions. The CDAI has provider and patient components, whilst the RAPID3 only has patient driven measures. During the COVID-19 pandemic, telemedicine visits relied on RAPID3 as a clinical outcome measure and subsequently was incorporated into all clinical visits in addition to the CDAI. On an ad-hoc basis, discrepancies were noted for the disease activity level generated by these two measures. The purpose of this retrospective study was to formally analyze the relationship between these measures.Objectives:To determine the concordance of the outcome measures RAPID3 with CDAI in patients with established RA as a quality improvement project.Methods:This is a retrospective study of 49 patients that fulfilled the American College of Rheumatology 2010 criteria for Rheumatoid Arthritis. IRB approval was obtained. The medical records of patients seen between June to October 2020 at the rheumatology department at UF health were reviewed. Data collected included age, gender, race, number of years with RA, Rheumatoid factor (RF) and anti-citrullinated protein antibody (CCP Ab) positivity, disease modifying treatments, ESR and CRP as well as CDAI and RAPID3 scores as calculated by clinic staff. The charts were reviewed by the authors and RAPID3 scores were verified.Results:The population ranged from 35- 90 years and duration of RA from 1- 30 years. CCP Ab was present in 75% of patients and RF in 71%. Patients were on DMARDs either monontherapy (29%), dual therapy (60%) or triple therapy (10%). Antirheumatic medications used were plaquenil, methotrexate, leflunomide, etanercept, adalimumab, infliximab, tofacitinib, upadacitinib and rituximab. ESR range was 2-110 and CRP 0.2- 83.1. The CDAI and RAPID3 concordance was found to be 37% with RAPID3 being higher in 45% of patients. RAPID3 was lower only in 14% of patients. There was incorrect calculation of the RAPID3 26% of the time by clinic staff. Table 1 summarizes this data. Figure 1 shows RAPID3 and CDAI compared in scatterplots.Table 1.Patient PopulationAge35-90 yearsRaceAfrican American-13Caucasian-10Hispanic-3Not Hispanic=13RF Positive35/49 (71)%CCP Ab37/49 (75%)Both RF and CCP Ab Positive32/49 (65%)Patients on monotherapy14/48 (29%)Patients on dual therapy29/48 (60%)Patients on triple therapy5/48 (10)Antirheumatic Drugs usedPlaquenil, methotrexate, leflunomide, etanercept, adalimumab, infliximab, tofacitinib, upadacitinib, rituximabCDAI and RAPID3 Concordance18/49 (37%)RAPID 3 Higher than CDAI22/49 (45%)RAPID 3 lower than CDAI7/49 (14%)Incorrect Calculation of RAPID3 by clinic staff11/42 (26%)Figure 1.Scatterplots of three RAPID3 strata. Red dots represent discordant subjects when compared to CDAI. Note: Panel C demonstrates the subjects that were in low disease activity in red that had a high severity RAPID3 scoreConclusion:This study shows that RAPID3 may overestimate disease activity level for patients above low disease activity. Treatment escalation based on RAPID3 in discordant patients may be inappropriate. When making treatment decisions, a measure that includes objective physical examination and provider judgment is desirable.References:[1]Kumar, B. S., Suneetha, P., Mohan, A., Kumar, D. P. & Sarma, K. V. S. Comparison of Disease Activity Score in 28 joints with ESR (DAS28), Clinical Disease Activity Index (CDAI), Health Assessment Questionnaire Disability Index (HAQ-DI) & Routine Assessment of Patient Index Data with 3 measures (RAPID3) for assessing disease activity in patients with rheumatoid arthritis at initial presentation. Indian J Med Res146, S57–S62 (2017).[2]Pincus, T., Swearingen, C. J., Bergman, M. & Yazici, Y. RAPID3 (Routine Assessment of Patient Index Data 3), a Rheumatoid Arthritis Index Without Formal Joint Counts for Routine Care: Proposed Severity Categories Compared to Disease Activity Score and Clinical Disease Activity Index Categories. The Journal of Rheumatology35, 2136–2147 (2008).Disclosure of Interests:None declared

RAPID3 (Routine Assessment of Patient Index Data 3), a Rheumatoid Arthritis Index Without Formal Joint Counts for Routine Care: Proposed Severity Categories Compared to Disease Activity Score and Clinical Disease Activity Index Categories

2008 ◽  
Vol 35 (11) ◽  
pp. 2136-2147 ◽  
Author(s):  
THEODORE PINCUS ◽  
CHRISTOPHER J. SWEARINGEN ◽  
MARTIN BERGMAN ◽  
YUSUF YAZICI
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Clinical Disease ◽  
Self Report ◽  
Global Estimate ◽  
Clinical Disease Activity ◽  
Index Data ◽  
Routine Assessment

ObjectiveTo compare 4 categories (high, moderate, and low severity, and near-remission) of RAPID3 (Routine Assessment of Patient Index Data 3), an index without formal joint counts, which is scored in < 10 seconds to 4 categories of the DiseaseActivity Score (DAS28) and Clinical Disease Activity Index (CDAI) in patients with rheumatoid arthritis (RA).MethodsAll patients complete a Multidimensional Health Assessment Questionnaire (MDHAQ) at each visit. A physician/assessor 28-joint count and erythrocyte sedimentation rate (ESR) were completed in 285 patients with RA in usual care by 3 rheumatologists to score DAS28, CDAI, and RAPID3. RAPID3 includes the 3 MDHAQ patient self-report RA Core Data Set measures for physical function, pain, and patient global estimate. Proposed RAPID3 (range 0–10) severity categories of high (> 4), moderate (2.01–4), low (1.01–2), and near-remission (≤ 1) were compared to DAS (0–10) activity categories of high (> 5.1), moderate (3.21–5.1), low (2.61–3.2), and remission (≤ 2.6), and CDAI (0–76) categories of > 22, 10.1–22.0, 2.9–10.0, and ≤ 2.8. Additional RAPID scores, which add to RAPID3 a physician/assessor or patient self-report joint count and/or assessor global estimate, were also analyzed. Statistical significance was analyzed using Spearman correlations, cross-tabulations, and kappa statistics.ResultsAll RAPID scores were correlated significantly with DAS28 and CDAI (rho > 0.65, p < 0.001). Overall, 78%–84% of patients who met DAS28 or CDAI moderate/high activity criteria met similar RAPID severity criteria, and 68%–77% who met DAS28 or CDAI remission/low activity criteria also met similar RAPID criteria. RAPID3 was as informative as other indices.ConclusionRAPID3 provides a feasible, informative quantitative index for busy clinical settings.

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