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Table 4 Comparison of patient characteristics between the discordant and concordant groups according to clinical disease activity level in the overall retrospective study populationa

From: Patient-provider discordance between global assessments of disease activity in rheumatoid arthritis: a comprehensive clinical evaluation

  Remission/low disease activity Moderate-to-high disease activity
Characteristic Concordant group
(n = 157)
Discordant group
(n = 53)
P value Concordant group
(n = 79)
Discordant group
(n = 50)
P value
Age, years 64.9 (55.1–74.3) 66.3 (59.8–72.3) .46 61.1 (55.1–71.5) 59.0 (50.3–71.0) .23
Sex    .70    .15
 Female 102 (65%) 36 (68%)   56 (71%) 41 (82%)  
 Male 55 (35%) 17 (32%)   23 (29%) 9 (18%)  
Disease duration, years 7.0 (5.2–11.8) 7.9 (3.1–11.1) .84 8.8 (2.2–11.6) 5.2 (1.6–7.8) .47
Provider type    .60    .90
 NP/PA 108 (69%) 39 (74%)   52 (66%) 31 (62%)  
 Physician 37 (24%) 12 (23%)   24 (30%) 17 (34%)  
 Fellow 12 (8%) 2 (4%)   3 (4%) 2 (4%)  
Comorbidities
 Fibromyalgia 5 (3%) 8 (15%) .002 5 (6%) 10 (20%) .018
 Depression 42 (27%) 25 (47%) .006 19 (24%) 15 (30%) .46
 Osteoarthritis 76 (48%) 39 (74%) .001 45 (57%) 24 (48%) .32
 Sleep apnea 26 (17%) 10 (19%) .70 21 (27%) 6 (12%) .047
 Obesity (BMI ≥ 30 kg/m2) 50 (34%) 23 (47%) .12 37 (48%) 20 (48%) .96
 BMI (kg/m2) 27.6
(23.7–31.8)
29.0
(26.8–34.0)
.017 29.8
(25.8–35.4)
29.6
(26.1–38.3)
.75
Disease assessments
 Patient global (0–100) 10 (4–22) 50 (40–60) <.001 49 (27–68) 66 (55–77) < .001
 Provider global (0–100) 10 (5–15) 10 (5–10) .97 45 (30–60) 20 (15–30) < .001
 Pain (0–100 mm) 15 (5–28) 50 (37–66) <.001 55 (32–76) 66 (57–80) .007
 Tender joint count ≥ 2 12 (8%) 9 (17%) .05 63 (80%) 37 (74%) .45
 Swollen joint count ≥ 2 21 (31%) 17 (13%) .98 61 (77%) 33 (66%) .16
 DAS28-CRP 1.9 (1.7–6.0) 2.6 (2.5–2.7) .002 4.1 (3.6–5.0) 4.4 (3.4–5.0) .98
 CDAI 2.9 (1.1–5.5) 6.8 (5.5–8.7) <.001 18.9 (13.6–30.8) 15.7 (12.0–21.5) .026
Laboratory assessments
 CRP, mg/L 3.0 (2.9–7.7) 2.9 (2.9–6.6) .58 4.1 (2.9–14.7) 5.4 (2.9–9.5) .97
 RF, positive 115 (76%) 29 (58%) .017 58 (74%) 31 (65%) .24
 ACPA, positive 93 (69%) 27 (56%) .10 53 (74%) 28 (62%) .19
Radiographic joint erosions 96 (62%) 18 (35%) .001 37 (47%) 21 (44%) .69
Medication use
 Prednisone 62 (39%) 21 (40%) .99 39 (49%) 28 (56%) .46
 Methotrexate 94 (60%) 40 (75%) .041 54 (68%) 27 (54%) .10
 Biologics 52 (33%) 18 (34%) .91 31 (39%) 24 (48%) .33
 Change of RA medications at index visit? 34 (22%) 6 (11%) .10 35 (44%) 16 (32%) .16
Opioid 10 (6%) 5 (9%) .16 12 (15%) 11 (22%) .32
Fibromyalgia medication 8 (5%) 6 (11%) .12 8 (10%) 11 (22%) .06
Sleep aid 12 (8%) 9 (17%) .05 6 (8%) 9 (18%) .07
Anti-depressant or anxiolytic 28 (18%) 21 (40%) .001 17 (22%) 14 (28%) .40
  1. Values are median (interquartile range) or number (%)
  2. aDiscordant group contains only those with patient global assessment greater than physician global assessment
  3. ACPA anti-cyclic citrullinated peptide antibody, BMI body mass index, CDAI Clinical Disease Activity Index, CRP C-reactive protein, DAS28-CRP Disease Activity Score in 28 joints using C-reactive protein, NP nurse practitioner, PA physician assistant, RA rheumatoid arthritis, RF rheumatoid factor