Evaluating disease activity in rheumatoid arthritis: Which composite index is best? A systematic literature analysis of studies comparing the psychometric properties of the DAS, DAS28, SDAI and CDAI - 03/03/12
, Gaël Mouterde b, Athan Baillet c, Pascal Claudepierre d, Bruno Fautrel a, Xavier Le Loët e, Jean-Francis Maillefert f, g
Corresponding author. Tel.: +33 1 42 17 78 21; fax: +33 1 42 17 79 55.Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
| pagine | 7 |
| Iconografia | 1 |
| Video | 0 |
| Altro | 0 |
Abstract |
Objectives |
To evaluate and compare four composite indices for assessing the activity of rheumatoid arthritis (RA).
Methods |
We conducted a systematic literature review by searching Medline via PubMed and Embase and Cochrane databases for articles published up to March 2009. We selected studies that directly compared at least two of the four composite indices. The DAS (Disease Activity Score), DAS28, Simplified Disease Activity Index (SDAI) and Clinical Disease Activity Index (CDAI) were evaluated in terms of reproducibility, construct validity, discriminative performance, and sensitivity to change.
Results |
We included 61 articles. The only study that directly compared the intraobserver reproducibility of the DAS28, SDAI, and CDAI found comparable intraclass correlation coefficients ranging from 0.85 to 0.89. Concordance among indices was good (kappa values of 
0.7), except between the DAS28 and the other indices in definition of remission (kappa 0.48–0.63). The indices had good construct validity by their similar fair-to-good correlations with the Health Assessment Questionnaire (HAQ) score and structural damage. Discriminative performance was comparable and satisfactory for treatment changes or remission according to the American College of Rheumatology (ACR). Two studies evaluated the sensitivity to change of the SDAI and CDAI; both indices detected a difference between responders and non-responders according to ACR definitions.
Conclusion |
The DAS, DAS28, SDAI, and CDAI are valid tools for evaluating the activity of RA. The DAS28 is less conservative in defining remission than are the other three indices. Longitudinal studies of individual patients are needed to confirm these results.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Composite indices, Disease activity, Rheumatoid arthritis, Metrologic properties, Reliability, Validity, Responsiveness
Mappa
Vol 79 - N° 2
P. 149-155 - marzo 2012 Ritorno al numero
Articolo precedente
- Associations of vitamin D receptor gene polymorphisms FokI and BsmI with susceptibility to rheumatoid arthritis and Behçet’s disease in Tunisians
- Emna Fakhfakh Karray, Imen Ben Dhifallah, Kawther Ben Abdelghani, Imed Ben Ghorbel, Monia Khanfir, Habib Houman, Kamel Hamzaoui, Leith Zakraoui
- Septic arthritis with negative bacteriological findings in adult native joints: A retrospective study of 74 cases
- Julie Eberst-Ledoux, Anne Tournadre, Sylvain Mathieu, Natacha Mrozek, Martin Soubrier, Jean-Jacques Dubost
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.
Già abbonato a @@106933@@ rivista ?