| Joint counts to assess rheumatoid arthritis for clinical research and usual clinical care: advantages and limitations. | |
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MedLine Citation:
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PMID: 19962615 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A joint examination is prerequisite to a diagnosis of rheumatoid arthritis (RA), and quantitative counts of swollen and tender joints are the most specific of the 7 RA Core Data Set measures for patient assessment. Therefore, joint counts are weighted of greater importance than the other 5 Core Data Set measures in American College of Rheumatology response criteria and all RA indices in which it is included. Nonetheless, several limitations to the joint count have been recognized: (1) poor reproducibility with a requirement to be performed by the same observer at each visit; (2) likelihood to improve with placebo treatment as much or more than the other 5 RA Core Data Set measures; (3) similar or lower relative efficiencies than global and patient measures to document differences between active and control treatments in clinical trials; (4) improvement over 5 years while joint damage and functional disability may progress; (5) lower sensitivity in detecting inflammatory activity than ultrasound and magnetic resonance imaging. Most visits to a rheumatologist do not include a formal quantitative joint count. Quantitative patient self-report data are as sensitive to change and as informative about prognosis and outcomes as joint counts. It may be suggested that a careful qualitative (nonquantitative) joint examination, supplemented by quantitative self-report questionnaire scores to interpret physical examination findings, may be adequate to monitor patients and document changes in status in busy clinical settings. |
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Authors:
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Tuulikki Sokka; Theodore Pincus |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Rheumatic diseases clinics of North America Volume: 35 ISSN: 1558-3163 ISO Abbreviation: Rheum. Dis. Clin. North Am. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-12-07 Completed Date: 2010-02-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8708093 Medline TA: Rheum Dis Clin North Am Country: United States |
Other Details:
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Languages: eng Pagination: 713-22, v-vi Citation Subset: IM |
Affiliation:
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Jyv?skyl? Central Hospital, Jyv?skyl?, and Medcare Oy, A?nekoski, Finland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Arthritis, Rheumatoid
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pathology* Disability Evaluation* Humans Joints / pathology* Physical Examination / methods*, standards Questionnaires* / standards Reproducibility of Results Sensitivity and Specificity Severity of Illness Index* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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