Proposed Metrics for the Determination of Rheumatoid Arthritis Outcome and Treatment Success and Failure
Proposed Metrics for the Determination of Rheumatoid Arthritis Outcome and Treatment Success and Failure
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DOI：
10.3899/jrheum.080591
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发表时间：
2009-01-01
影响因子：
3.9
通讯作者：
Michaud, Kaleb
中科院分区：
文献类型：
--
作者：
Wolfe, Frederick;Michaud, Kaleb
目标。类风湿性关节炎（RA）患者和他们的医生经常不同意治疗成功或RA的结果。然而，指南（如DAS评分的EULAR标准）严重偏重于关节计数和实验室检查，并且没有针对患者报告结果的指南。我们的目标是：(1)提供基于患者的RA成功结局或治疗成功和失败的定义；(2)描述符合此定义的患者特征；(3)描述残疾和合并症等外部状态如何影响健康结果的定义；(4)推导定义的替代度量切点。共20,268例RA患者（5132例无合并症）采用递归划分和回归方法进行研究，以确定RA治疗和结果成功与不成功之间的最佳分点。采用0-10视觉模拟量表（VAS）对患者进行整体评估，疼痛，疲劳和RA活动，并进行健康评估问卷（HAQ）。14.5%的患者和22.9%的无合并症患者对自己的健康非常满意（成功）。在某种程度上，病人是全球性的
Objective. Patients with rheumatoid arthritis (RA) and their physicians often disagree as to the success of RA treatment or RA outcomes. However, guidelines (such as EULAR criteria for DAS scores) are heavily weighted toward Joint counts and laboratory tests, and no guidelines exist for patient reported outcomes. Our aims were (1) to provide a patient-based definition of successful RA outcome or of treatment success and failure;, (2) to describe the characteristics of patients meeting this definition; (3) to describe how external states such as disability and comorbidity influence definitions of health outcome; and (4) to derive surrogate-measure cutpoints for the definition.Methods. A total of 20,268 patients with RA (5132 without comorbidity) were studied by recursive partitioning and regression methods to determine best dividing points between RA treatment and outcome success and non-success Using 0-10 Visual analog scales (VAS) for patient global assessment, pain, fatigue, and RA activity, and a Health Assessment Questionnaire (HAQ) settle.Results. 14.5%, of all patients and 22.9% of those without comorbidity were very satisfied with their health (Success). Patient global at a level