What are the 2012 ACR recommendations for the measurement of disease activity in rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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In April 2012, the ACR published new recommendations for the measurement of disease activity for clinical use at the point of care. The scales used included the following 6 recommended measures [2] :

  • Patient-driven composite tools – (1) PAS (patient activity scale): scale, 0-10; (2) PAS II: scale, 0-10; (3) RAPID-3 (routine assessment of patient index data with 3 measures): scale, 0-10; these can be completed easily by the patient before they are seen by clinicians

  • Patient and provider composite tool – (4) CDAI (clinical disease activity index): scale, 0-76

  • Patient, provider, and laboratory composite tools – (5) DAS28 (28-joint disease activity score) (ESR or CRP): scale, 0-9.4; (6) SDAI (simplified disease activity index): scale, 0-86

The 6 measures above result in a single continuous index with defined ranges for low, moderate, or high disease activity or clinical remission. [2] In addition, the data collected from these measures are not solely dependent on the patient’s report, the clinician’s assessment, or laboratory measurements.

For more detailed information on how to use these tools and how to calculate the measurement tools, see the 2012 Rheumatoid arthritis disease activity measures: American College of Rheumatology Recommendations for use in clinical practice.

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