Skip to main content
  • Poster presentation
  • Open access
  • Published:

Discrepancy between patient and physician in assessment of global severity in early rheumatoid arthritis

Objective

To evaluate the discrepancy between patient and physician in assessment of global severity in early rheumatoid arthritis (RA) and to explore factors affecting the discrepancy at 1-year since the diagnosis of RA.

Methods

One hundred nine patients with RA with median disease duration of 4 months were enrolled in this study. The global assessment was performed using 100 mm-visual analog scale (VAS). The difference between patient's and physician's assessment wascalculated by subtracting physician's VAS from patient's VAS, and the difference more than 20 mm was defined as discordant. RA patients were stratified by concordance and discordance of VAS scoring at 1-year after the diagnosis. To clarify the factors affecting the discrepancy, clinical characteristics, disease activity using Disease Activity Score (DAS28) 3-variables, functional status by Health Assessment Questionnaire (HAQ) were compared between patients with concordance and discordance.

Results

The discordance between patient's and physician's VAS at 1-year was found in 41 patients (37%), consisting of 5 patients whose VAS was better than physicians and 36 patients whose VAS was worse than physicians. Tender joint count, DAS28 3-variables, CRP and HAQ were significantly higher in patients with discordance group where patients rated themselves worse than physicians than in patients with concordance (p < 0.05). HAQ score was correlated with the degree of the difference (R = 0.49, p < 0.05).

Conclusions

Higher disease activity and higher HAQ score was associated the discordance between patient's and physician's VAS in early RA patients, indicating the possibility of physicians underestimating the patient's global disease severity at 1-year since diagnosis.

Author information

Authors and Affiliations

Authors

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Kaneko, Y., Kuwana, M. & Takeuchi, T. Discrepancy between patient and physician in assessment of global severity in early rheumatoid arthritis. Arthritis Res Ther 14 (Suppl 1), P30 (2012). https://doi.org/10.1186/ar3631

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/ar3631

Keywords