What factors affect discordance between physicians and patients in the global assessment of disease activity in rheumatoid arthritis?

for the KORONA investigators

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To identify the level of agreement between patients with rheumatoid arthritis (RA) and physicians in the global assessment of disease activity and to explore factors influencing their discordance. Methods: A total of 4368 patients with RA were analyzed from the KORean Observational study Network for Arthritis (KORONA) database. Patients were divided into four subgroups according to difference from their physicians in the assessment of disease activity by substracting physician’s visual analog scale (VAS) from patient’s VAS as follows: positive discordance group I (10 mm ≤ discordance <25 mm), positive discordance group II (≥25 mm), concordance (<|10| mm), and negative discordance (≤ −10mm). Multinomial logistic regression analysis was performed to identify factors associated with discordance. Results: Only 1350 (29.2%) patients were classified in the concordance group. Positive discordance was found in 52.3% of the patients (n = 2425), with 33.7% (n = 1563) showing marked discordance (≥25 mm). The high disease activity (OR =1.41), gastrointestinal (GI) disease (OR =1.28), pain (OR =1.12), fatigue (OR =1.07) were consistently associated with positive discordance. Conclusion: More than half of patients with RA thought their disease more severe than their physicians. In addition to high disease activity, pain, fatigue, and sleep disturbance or GI disease were associated with the discordance between physicians and patients with RA.

Original languageEnglish
Pages (from-to)35-41
Number of pages7
JournalModern Rheumatology
Volume27
Issue number1
DOIs
Publication statusPublished - 2017 Jan 2
Externally publishedYes

Fingerprint

Rheumatoid Arthritis
Physicians
Gastrointestinal Diseases
Visual Analog Scale
Fatigue
Pain
Arthritis
Observational Studies
Sleep
Logistic Models
Regression Analysis
Databases

Keywords

  • Arthritis
  • Discordance
  • Fatigue
  • Gastrointestinal diseases
  • Pain
  • Patient global assessment
  • Physician global assessment
  • Rheumatoid
  • Sleep

ASJC Scopus subject areas

  • Rheumatology

Cite this

What factors affect discordance between physicians and patients in the global assessment of disease activity in rheumatoid arthritis? / for the KORONA investigators.

In: Modern Rheumatology, Vol. 27, No. 1, 02.01.2017, p. 35-41.

Research output: Contribution to journalArticle

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title = "What factors affect discordance between physicians and patients in the global assessment of disease activity in rheumatoid arthritis?",
abstract = "Objective: To identify the level of agreement between patients with rheumatoid arthritis (RA) and physicians in the global assessment of disease activity and to explore factors influencing their discordance. Methods: A total of 4368 patients with RA were analyzed from the KORean Observational study Network for Arthritis (KORONA) database. Patients were divided into four subgroups according to difference from their physicians in the assessment of disease activity by substracting physician’s visual analog scale (VAS) from patient’s VAS as follows: positive discordance group I (10 mm ≤ discordance <25 mm), positive discordance group II (≥25 mm), concordance (<|10| mm), and negative discordance (≤ −10mm). Multinomial logistic regression analysis was performed to identify factors associated with discordance. Results: Only 1350 (29.2{\%}) patients were classified in the concordance group. Positive discordance was found in 52.3{\%} of the patients (n = 2425), with 33.7{\%} (n = 1563) showing marked discordance (≥25 mm). The high disease activity (OR =1.41), gastrointestinal (GI) disease (OR =1.28), pain (OR =1.12), fatigue (OR =1.07) were consistently associated with positive discordance. Conclusion: More than half of patients with RA thought their disease more severe than their physicians. In addition to high disease activity, pain, fatigue, and sleep disturbance or GI disease were associated with the discordance between physicians and patients with RA.",
keywords = "Arthritis, Discordance, Fatigue, Gastrointestinal diseases, Pain, Patient global assessment, Physician global assessment, Rheumatoid, Sleep",
author = "{for the KORONA investigators} and Cho, {Soo Kyung} and Sung, {Yoon Kyoung} and Choi, {Chan Bum} and Bang, {So Young} and Cha, {Hoon Suk} and Choe, {Jung Yoon} and Chung, {Won Tae} and Hong, {Seung Jae} and Jun, {Jae Bum} and Jinseok Kim and Kim, {Tae Hwan} and Kim, {Tae Jong} and Koh, {Eun Mi} and Lee, {Hye Soon} and Jisoo Lee and Lee, {Sang Heon} and Lee, {Shin Seok} and Lee, {Sung Won} and Park, {Sung Hoon} and Yoo, {Dae Hyun} and Yoon, {Bo Young} and Bae, {Sang Cheol} and Ahn, {Joong Kyong} and Minyoung Her and Hong, {Yun Kyung} and Joung, {Chung Il} and Jung, {Young Ok} and Kang, {Young Mo} and Kim, {Dong Yook} and Kim, {Hae Rim} and Kim, {Hyoun Ah} and Kim, {Seong Kyu} and Kim, {Sung Il} and Lee, {Choong Ki} and Lee, {Sang Hoon} and Lee, {Yeon Ah} and Nah, {Seong Su} and Park, {So Yeon} and Sheen, {Dong Hyuk} and Jeeseon Shim and Shim, {Seung Cheol} and Song, {Gwan Gyu} and Suh, {Chang Hee} and Yoo, {Wan Hee}",
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AU - Choi, Chan Bum

AU - Bang, So Young

AU - Cha, Hoon Suk

AU - Choe, Jung Yoon

AU - Chung, Won Tae

AU - Hong, Seung Jae

AU - Jun, Jae Bum

AU - Kim, Jinseok

AU - Kim, Tae Hwan

AU - Kim, Tae Jong

AU - Koh, Eun Mi

AU - Lee, Hye Soon

AU - Lee, Jisoo

AU - Lee, Sang Heon

AU - Lee, Shin Seok

AU - Lee, Sung Won

AU - Park, Sung Hoon

AU - Yoo, Dae Hyun

AU - Yoon, Bo Young

AU - Bae, Sang Cheol

AU - Ahn, Joong Kyong

AU - Her, Minyoung

AU - Hong, Yun Kyung

AU - Joung, Chung Il

AU - Jung, Young Ok

AU - Kang, Young Mo

AU - Kim, Dong Yook

AU - Kim, Hae Rim

AU - Kim, Hyoun Ah

AU - Kim, Seong Kyu

AU - Kim, Sung Il

AU - Lee, Choong Ki

AU - Lee, Sang Hoon

AU - Lee, Yeon Ah

AU - Nah, Seong Su

AU - Park, So Yeon

AU - Sheen, Dong Hyuk

AU - Shim, Jeeseon

AU - Shim, Seung Cheol

AU - Song, Gwan Gyu

AU - Suh, Chang Hee

AU - Yoo, Wan Hee

PY - 2017/1/2

Y1 - 2017/1/2

N2 - Objective: To identify the level of agreement between patients with rheumatoid arthritis (RA) and physicians in the global assessment of disease activity and to explore factors influencing their discordance. Methods: A total of 4368 patients with RA were analyzed from the KORean Observational study Network for Arthritis (KORONA) database. Patients were divided into four subgroups according to difference from their physicians in the assessment of disease activity by substracting physician’s visual analog scale (VAS) from patient’s VAS as follows: positive discordance group I (10 mm ≤ discordance <25 mm), positive discordance group II (≥25 mm), concordance (<|10| mm), and negative discordance (≤ −10mm). Multinomial logistic regression analysis was performed to identify factors associated with discordance. Results: Only 1350 (29.2%) patients were classified in the concordance group. Positive discordance was found in 52.3% of the patients (n = 2425), with 33.7% (n = 1563) showing marked discordance (≥25 mm). The high disease activity (OR =1.41), gastrointestinal (GI) disease (OR =1.28), pain (OR =1.12), fatigue (OR =1.07) were consistently associated with positive discordance. Conclusion: More than half of patients with RA thought their disease more severe than their physicians. In addition to high disease activity, pain, fatigue, and sleep disturbance or GI disease were associated with the discordance between physicians and patients with RA.

AB - Objective: To identify the level of agreement between patients with rheumatoid arthritis (RA) and physicians in the global assessment of disease activity and to explore factors influencing their discordance. Methods: A total of 4368 patients with RA were analyzed from the KORean Observational study Network for Arthritis (KORONA) database. Patients were divided into four subgroups according to difference from their physicians in the assessment of disease activity by substracting physician’s visual analog scale (VAS) from patient’s VAS as follows: positive discordance group I (10 mm ≤ discordance <25 mm), positive discordance group II (≥25 mm), concordance (<|10| mm), and negative discordance (≤ −10mm). Multinomial logistic regression analysis was performed to identify factors associated with discordance. Results: Only 1350 (29.2%) patients were classified in the concordance group. Positive discordance was found in 52.3% of the patients (n = 2425), with 33.7% (n = 1563) showing marked discordance (≥25 mm). The high disease activity (OR =1.41), gastrointestinal (GI) disease (OR =1.28), pain (OR =1.12), fatigue (OR =1.07) were consistently associated with positive discordance. Conclusion: More than half of patients with RA thought their disease more severe than their physicians. In addition to high disease activity, pain, fatigue, and sleep disturbance or GI disease were associated with the discordance between physicians and patients with RA.

KW - Arthritis

KW - Discordance

KW - Fatigue

KW - Gastrointestinal diseases

KW - Pain

KW - Patient global assessment

KW - Physician global assessment

KW - Rheumatoid

KW - Sleep

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