The following is a summary of “Can a simple 0–10 RheuMetric physician estimate of inflammatory activity (DOCINF) depict a detailed swollen joint count (SJC) as accurately as a DAS28 or CDAI in patients with rheumatoid arthritis?,” published in the June 2024 issue of Rheumatology by Pincus et al.

In this study, researchers aimed to evaluate the utility of a physician’s sub-global estimate of inflammatory activity (DOCINF) on a RheuMetric checklist compared to formal swollen joint counts (SJC) and other disease activity score 28 (DAS28) and clinical disease activity index (CDAI) in patients with rheumatoid arthritis (RA). The study group acknowledged the potentially confounding influences of joint damage and patient distress on disease assessments, especially since formal joint counts are not consistently recorded during routine care visits. The cross-sectional analysis included 173 patients with RA with long disease durations, where rheumatologists completed a RheuMetric checklist incorporating four 0-10 visual numeric scales (VNS) for DOCGL and sub-global estimates for DOCINF, DOCDAM (joint damage), and DOCDIS (patient distress). The investigators utilized Spearman correlation coefficients and regression analyses to explore the relationship between SJC and individual components of DAS28 and CDAI, both with and without DOCINF as an independent variable.

The findings indicated that incorporating DOCINF significantly enhanced the explanatory power of models predicting SJC. Specifically, regressions incorporating DOCINF alongside individual measures of DAS28 or CDAI explained 46% of the variation in SJC, compared to 23% when DOCINF was not included. Notably, DOCINF demonstrated greater explanatory value for SJC than the composite DAS28 or CDAI indices, despite these indices including SJC as a component.

In conclusion, the study suggests that DOCINF on the RheuMetric checklist provides a practical and informative alternative to formal joint counts in assessing inflammatory activity among patients with RA during routine clinical visits. This approach offers a feasible quantitative measure and enhances the accuracy of disease activity assessments, streamlining clinical evaluations without compromising diagnostic precision. These findings underscore the utility of DOCINF in routine RA management, offering clinicians a valuable tool to monitor disease progression and treatment efficacy efficiently.

Source: sciencedirect.com/science/article/abs/pii/S0049017224001252