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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