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dc.contributor.authorBentley, Mary Jane
dc.contributor.authorGreenberg, Jeffrey D.
dc.contributor.authorReed, George W.
dc.date2022-08-11T08:08:38.000
dc.date.accessioned2022-08-23T16:01:42Z
dc.date.available2022-08-23T16:01:42Z
dc.date.issued2010-08-01
dc.date.submitted2009-08-12
dc.identifier.issn0315-162X
dc.identifier.pmid20595282
dc.identifier.urihttp://hdl.handle.net/20.500.14038/31193
dc.description.abstractOBJECTIVE: To develop and validate a modified version of the Disease Activity Score with 28 joint count (mDAS28), for use in epidemiological research, when acute-phase reactant values are unavailable. METHODS: In a cross-sectional development cohort (5729 patients), statistically significant predictors of the logarithm of erythrocyte sedimentation rate (lnESR) were identified. After computation of the mDAS28, a cross-sectional validation cohort (5578 patients) was used to evaluate internal, criterion, and construct validities. The ability of the mDAS28 to discriminate between disease states was also assessed. A second validation cohort (longitudinal, 336 pairs of patient visits) was used to assess sensitivity to change. RESULTS: Significant predictors of lnESR included tender and swollen joints with 28 counts, patient's and physician's assessments of global health, and patient's assessment of pain (visual analog scale 0-100 mm) and a physical function (modified Health Assessment Questionnaire 0-3; mHAQ). Satisfactory internal validity (alpha = 0.72) and strong criterion validity compared to the DAS28, the Simplified Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI) (r = 0.87-0.96) were found. Predictive validity was demonstrated by good correlation with the mHAQ (r = 0.58). The mDAS28 showed substantial agreement with the DAS28, SDAI, and CDAI in discriminating between disease states (kappa = 0.70-0.77) and moderate to substantial agreement between response levels (kappa = 0.52-0.73). Both mDAS28 and DAS28 measures classified patients similarly in remission compared to the SDAI and CDAI. The mDAS28 was superior in detecting change (standardized response mean = 0.58) followed by the DAS28, CDAI, and SDAI. CONCLUSION: The mDAS28 is a valid and sensitive tool to assess disease activity in epidemiological research, as an alternative to the DAS28, when acute-phase reactant values are unavailable.
dc.language.isoen_US
dc.publisherJournal Of Rheumatology Publishing Co.
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20595282&dopt=Abstract">Link to article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.3899/jrheum.090831
dc.rightsCitation: J Rheumatol. 2010 Aug 1;37(8):1607-14. Epub 2010 Jul 1. <a href="http://dx.doi.org/10.3899/jrheum.090831">Link to article on publisher's website</a>
dc.subjectArthritis, Rheumatoid
dc.subjectRheumatology
dc.subjectSeverity of Illness Index
dc.subjectHealth Services Research
dc.subjectMusculoskeletal Diseases
dc.titleA modified rheumatoid arthritis disease activity score without acute-phase reactants (mDAS28) for epidemiological research
dc.typeJournal Article
dc.source.journaltitleThe Journal of rheumatology
dc.source.volume37
dc.source.issue8
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/gsbs_cphr/25
dc.identifier.contextkey936330
html.description.abstract<p>OBJECTIVE: To develop and validate a modified version of the Disease Activity Score with 28 joint count (mDAS28), for use in epidemiological research, when acute-phase reactant values are unavailable.</p> <p>METHODS: In a cross-sectional development cohort (5729 patients), statistically significant predictors of the logarithm of erythrocyte sedimentation rate (lnESR) were identified. After computation of the mDAS28, a cross-sectional validation cohort (5578 patients) was used to evaluate internal, criterion, and construct validities. The ability of the mDAS28 to discriminate between disease states was also assessed. A second validation cohort (longitudinal, 336 pairs of patient visits) was used to assess sensitivity to change.</p> <p>RESULTS: Significant predictors of lnESR included tender and swollen joints with 28 counts, patient's and physician's assessments of global health, and patient's assessment of pain (visual analog scale 0-100 mm) and a physical function (modified Health Assessment Questionnaire 0-3; mHAQ). Satisfactory internal validity (alpha = 0.72) and strong criterion validity compared to the DAS28, the Simplified Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI) (r = 0.87-0.96) were found. Predictive validity was demonstrated by good correlation with the mHAQ (r = 0.58). The mDAS28 showed substantial agreement with the DAS28, SDAI, and CDAI in discriminating between disease states (kappa = 0.70-0.77) and moderate to substantial agreement between response levels (kappa = 0.52-0.73). Both mDAS28 and DAS28 measures classified patients similarly in remission compared to the SDAI and CDAI. The mDAS28 was superior in detecting change (standardized response mean = 0.58) followed by the DAS28, CDAI, and SDAI.</p> <p>CONCLUSION: The mDAS28 is a valid and sensitive tool to assess disease activity in epidemiological research, as an alternative to the DAS28, when acute-phase reactant values are unavailable.</p>
dc.identifier.submissionpathgsbs_cphr/25
dc.contributor.departmentMedicine
dc.contributor.departmentMorningside Graduate School of Biomedical Sciences
dc.source.pages1607-1614
dc.contributor.studentMary J. Bentley
dc.description.thesisprogramClinical and Population Health Research


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