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Patient Global Assessment Discordance in RA vs OA

Rheumatol Int; ePub 2018 Oct 6; Castrejon, et al

Patients with osteoarthritis (OA) are more likely to be discordant with their rheumatologists than patients with rheumatoid arthritis (RA) because of a higher patient global assessment (PATGL), according to a recent investigation. Researchers conducted a cross-sectional study at an academic rheumatology center where all patients were asked to complete a Multi-Dimensional Health Assessment Questionnaire (MDHAQ), which includes a PATGL. Rheumatologists were encouraged to complete a physician questionnaire, which included a physician global assessment (DOCGL). Patients with either OA (n=243) or RA (n=216) were identified using ICD9 codes and classified as positive discordance (PATGL-DOCGL ≥ 2), negative discordance (PATGL-DOCGL ≤ − 2), and concordance (absolute difference between the 2 assessments <2). Researchers found:

  • Mean PATGL was higher in OA vs RA (5.4 vs 4.2), while mean DOCGL was similar (4.0 vs 3.8) leading to a higher patient–physician discordance in OA (1.35 vs 0.43).
  • Positive discordance occurred in 34% of OA vs 18% of RA patients.
  • Intraclass correlation coefficients were 0.43 in OA vs 0.60 in RA patients.
  • In logistic regressions, pain was the only statistically significant explanatory variable for discordance in both OA (OR 1.34) and RA (OR 1.47).

Citation:

Castrejon I, Shakoor N, Chia JR, Block JA. Discordance of global assessment by patients and physicians is higher in osteoarthritis than in rheumatoid arthritis: A cross-sectional study from routine care. [Published online ahead of print October 6, 2018]. Rheumatol Int. doi:10.1007/s00296-018-4166-2.

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