Page 143 - THE EVOLUTION OF EARLY ARTHRITIS AND CARDIOVASCULAR RISK Samina A. Turk

Table 2. Agreement between different definitions of response and remission
PAIN, SLEEP AND EMOTIONAL WELL-BEING
Physician- perceived remission
Physician- perceived remission
Patient- 67% perceived Ƙ=0.318 remission P=0.003
DAS44 74% remission Ƙ=0.439 P<0.001
EULAR good 79% response Ƙ=0.484 P<0.001
ACR70 60% response Ƙ=0.281 P=0.001
Boolean 57% remission Ƙ=0.248 P=0.002
Patient- perceived remission
67% Ƙ=0.318 P=0.003
46% Ƙ=0.516 P<0.001
69% Ƙ=0.356 P<0.001
69% Ƙ=0.398 P<0.001
67% Ƙ=0.354 P<0.001
DAS44 EULAR good ACR70
Boolean remission
57% Ƙ=0.248 P=0.002
67% Ƙ=0.354 P<0.001
67% Ƙ=0.392 P<0.001
50% Ƙ=0.199 P=0.002
74% Ƙ=0.359 P=0.001
remission response
74% 79% Ƙ=0.439 Ƙ=0.484 P<0.001 P<0.001
46% 69% Ƙ=0.516 Ƙ=0.356 P<0.001 P<0.001
83% Ƙ=0.622 P<0.001
83% Ƙ=0.622 P<0.001
64% 52% Ƙ=0.343 Ƙ=0.220 P<0.001 P=0.001
67% 50% Ƙ=0.392 Ƙ=0.199 P<0.001 P=0.002
response
60% Ƙ=0.281 P=0.001
69% Ƙ=0.398 P<0.001
64% Ƙ=0.343 P<0.001
52% Ƙ=0.220 P=0.001
74% Ƙ=0.359 P=0.001
x
x
x
x
x
x
Numbers are presented as level of agreement (%), kappa value (K) and p-value (P).
Physician-perceived remission was defined as a VAS of ≤10 mm as answer to the question:
“How active do you think the rheumatoid arthritis of your patient is today?”.
Patient-perceived remission was defined as “yes” or “no” as answer to the question: “Would
you say that, at this moment, your disease activity is as good as gone?” 7 ACR70: American College of Rheumatology 70 response, DAS44: disease activity score of 44
joints, EULAR: European League Against Rheumatism, mm: millimeter
Discordance between physicians and patients in remission
In this subgroup analyses, only patients in physician-perceived remission were included. Patients in self-perceived remission showed the same improvement in DAS44, tender and swollen joint count after 12 weeks of treatment, compared to those who categorized themselves not in self-perceived remission (Figure 1). A trend was seen in the difference on the change in ESR: 3.5 versus 13.0 mm/hour (p=0.07). An improvement on all questions on the RAID was seen, however, patients in self-perceived remission improved significantly more on the question about sleep, compared to patients not in self-perceived remission: 2.9 versus 0.6 (p=0.01). A significant difference was seen in improvement on the questions pain and emotional well-being, between patients in self-perceived remission compared to those not in self-perceived remission (p-value for both 0.04). Looking retrospectively at the baseline values for the differences between patients in and not in self-perceived remission no significant differences were found(Table 3)(30).
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