Brief Report: To squeeze or not to squeeze, that is the question! Optimizing the Disease Activity Score in 28 joints by adding the squeeze test of metatarsophalangeal joints in early rheumatoid arthritis
Objective To optimize use of the Disease Activity Score in 28 joints (DAS28) in early rheumatoid arthritis (RA) by adding the “squeeze test” of forefeet. Methods The squeeze test is used to examine bilateral compression pain (BCP) across the metatarsophalangeal (MTP) joints. For this study, data for...
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| Veröffentlicht in: | Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2012-10, Vol.64 (10), p.3095-3101 |
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| creator | de Jong, P. H. Weel, A. E. de Man, Y. A. Huisman, A. M. Gerards, A. H. van Krugten, M. V. Luime, J. J. Hazes, J. M. |
| description | Objective
To optimize use of the Disease Activity Score in 28 joints (DAS28) in early rheumatoid arthritis (RA) by adding the “squeeze test” of forefeet.
Methods
The squeeze test is used to examine bilateral compression pain (BCP) across the metatarsophalangeal (MTP) joints. For this study, data for patients participating in the Treatment in the Rotterdam Early Arthritis Cohort study, an ongoing clinical trial that evaluates different induction therapies in patients with early RA, were randomly divided into 2 subsets. In subset 1 (149 patients and 819 disease activity assessments), the mathematical function of the DAS28‐squeeze was constructed using a linear regression model with the DAS as the dependent variable and the DAS28 and squeeze test as the independent variables. A DAS28‐BCP disease state was also constructed, in which DAS28 disease state categorizations were upgraded one state if the result of the squeeze test was positive. In subset 2 (153 patients and 754 assessments), concordance in disease states between the DAS28, DAS28‐squeeze, and DAS28‐BCP disease states was compared, using both the DAS and Boolean‐defined remission criteria as reference.
Results
Agreement between the DAS and the DAS28‐squeeze (82%) was significantly higher than agreement between the DAS and the DAS28 (76%). When we assessed the group of patients who had arthritis of the forefeet only (22 patients and 46 assessments), overall agreement between the DAS and the DAS28 was 40%, while agreement between the DAS and the DAS28‐squeeze was 59% and that between the DAS and the DAS28‐BCP disease state was 65%. Furthermore, the specificities of the DAS28‐squeeze and the DAS28‐BCP (80% and 81%, respectively) were higher than that of the DAS28 (76%), while the sensitivities of the DAS28, DAS28‐squeeze, and DAS28‐BCP to identify true remission according to the Boolean criteria were 88%, 87%, and 81%, respectively.
Conclusion
Adding the squeeze test of forefeet to the DAS28 has value for dependably classifying the disease state in patients with early RA. |
| doi_str_mv | 10.1002/art.34568 |
| format | Article |
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To optimize use of the Disease Activity Score in 28 joints (DAS28) in early rheumatoid arthritis (RA) by adding the “squeeze test” of forefeet.
Methods
The squeeze test is used to examine bilateral compression pain (BCP) across the metatarsophalangeal (MTP) joints. For this study, data for patients participating in the Treatment in the Rotterdam Early Arthritis Cohort study, an ongoing clinical trial that evaluates different induction therapies in patients with early RA, were randomly divided into 2 subsets. In subset 1 (149 patients and 819 disease activity assessments), the mathematical function of the DAS28‐squeeze was constructed using a linear regression model with the DAS as the dependent variable and the DAS28 and squeeze test as the independent variables. A DAS28‐BCP disease state was also constructed, in which DAS28 disease state categorizations were upgraded one state if the result of the squeeze test was positive. In subset 2 (153 patients and 754 assessments), concordance in disease states between the DAS28, DAS28‐squeeze, and DAS28‐BCP disease states was compared, using both the DAS and Boolean‐defined remission criteria as reference.
Results
Agreement between the DAS and the DAS28‐squeeze (82%) was significantly higher than agreement between the DAS and the DAS28 (76%). When we assessed the group of patients who had arthritis of the forefeet only (22 patients and 46 assessments), overall agreement between the DAS and the DAS28 was 40%, while agreement between the DAS and the DAS28‐squeeze was 59% and that between the DAS and the DAS28‐BCP disease state was 65%. Furthermore, the specificities of the DAS28‐squeeze and the DAS28‐BCP (80% and 81%, respectively) were higher than that of the DAS28 (76%), while the sensitivities of the DAS28, DAS28‐squeeze, and DAS28‐BCP to identify true remission according to the Boolean criteria were 88%, 87%, and 81%, respectively.
Conclusion
Adding the squeeze test of forefeet to the DAS28 has value for dependably classifying the disease state in patients with early RA.</description><identifier>ISSN: 0004-3591</identifier><identifier>ISSN: 2326-5191</identifier><identifier>EISSN: 1529-0131</identifier><identifier>EISSN: 2326-5205</identifier><identifier>DOI: 10.1002/art.34568</identifier><identifier>PMID: 22673898</identifier><identifier>CODEN: ARHEAW</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Agreements ; Arthritis, Rheumatoid - diagnosis ; Arthritis, Rheumatoid - physiopathology ; Cohort Studies ; Female ; Humans ; Male ; Mathematical functions ; Metatarsophalangeal Joint - physiopathology ; Middle Aged ; Pharmaceutical industry ; Sensitivity and Specificity ; Severity of Illness Index</subject><ispartof>Arthritis & rheumatology (Hoboken, N.J.), 2012-10, Vol.64 (10), p.3095-3101</ispartof><rights>Copyright © 2012 by the American College of Rheumatology</rights><rights>Copyright © 2012 by the American College of Rheumatology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3218-f80550d04b57b63a263d2040234e3c341361e0e7e2109dcf8adf345582b0abbc3</citedby><cites>FETCH-LOGICAL-c3218-f80550d04b57b63a263d2040234e3c341361e0e7e2109dcf8adf345582b0abbc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fart.34568$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fart.34568$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22673898$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de Jong, P. H.</creatorcontrib><creatorcontrib>Weel, A. E.</creatorcontrib><creatorcontrib>de Man, Y. A.</creatorcontrib><creatorcontrib>Huisman, A. M.</creatorcontrib><creatorcontrib>Gerards, A. H.</creatorcontrib><creatorcontrib>van Krugten, M. V.</creatorcontrib><creatorcontrib>Luime, J. J.</creatorcontrib><creatorcontrib>Hazes, J. M.</creatorcontrib><title>Brief Report: To squeeze or not to squeeze, that is the question! Optimizing the Disease Activity Score in 28 joints by adding the squeeze test of metatarsophalangeal joints in early rheumatoid arthritis</title><title>Arthritis & rheumatology (Hoboken, N.J.)</title><addtitle>Arthritis & Rheumatism</addtitle><description>Objective
To optimize use of the Disease Activity Score in 28 joints (DAS28) in early rheumatoid arthritis (RA) by adding the “squeeze test” of forefeet.
Methods
The squeeze test is used to examine bilateral compression pain (BCP) across the metatarsophalangeal (MTP) joints. For this study, data for patients participating in the Treatment in the Rotterdam Early Arthritis Cohort study, an ongoing clinical trial that evaluates different induction therapies in patients with early RA, were randomly divided into 2 subsets. In subset 1 (149 patients and 819 disease activity assessments), the mathematical function of the DAS28‐squeeze was constructed using a linear regression model with the DAS as the dependent variable and the DAS28 and squeeze test as the independent variables. A DAS28‐BCP disease state was also constructed, in which DAS28 disease state categorizations were upgraded one state if the result of the squeeze test was positive. In subset 2 (153 patients and 754 assessments), concordance in disease states between the DAS28, DAS28‐squeeze, and DAS28‐BCP disease states was compared, using both the DAS and Boolean‐defined remission criteria as reference.
Results
Agreement between the DAS and the DAS28‐squeeze (82%) was significantly higher than agreement between the DAS and the DAS28 (76%). When we assessed the group of patients who had arthritis of the forefeet only (22 patients and 46 assessments), overall agreement between the DAS and the DAS28 was 40%, while agreement between the DAS and the DAS28‐squeeze was 59% and that between the DAS and the DAS28‐BCP disease state was 65%. Furthermore, the specificities of the DAS28‐squeeze and the DAS28‐BCP (80% and 81%, respectively) were higher than that of the DAS28 (76%), while the sensitivities of the DAS28, DAS28‐squeeze, and DAS28‐BCP to identify true remission according to the Boolean criteria were 88%, 87%, and 81%, respectively.
Conclusion
Adding the squeeze test of forefeet to the DAS28 has value for dependably classifying the disease state in patients with early RA.</description><subject>Agreements</subject><subject>Arthritis, Rheumatoid - diagnosis</subject><subject>Arthritis, Rheumatoid - physiopathology</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mathematical functions</subject><subject>Metatarsophalangeal Joint - physiopathology</subject><subject>Middle Aged</subject><subject>Pharmaceutical industry</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><issn>0004-3591</issn><issn>2326-5191</issn><issn>1529-0131</issn><issn>2326-5205</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kd1u1DAQhS0EotvCBS-ABnEDEmn9k7_lbruFLqKiqF2ExI3lJJOut0kcbAdIX5GXwux29wKJq5Htcz7PzCHkGaPHjFJ-oqw_FnGS5g_IhCV8GlEm2EMyoZTGkUim7IAcOrcORy4S8ZgccJ5mIp_mE_L71Gqs4Qp7Y_1bWBpw3wfEOwRjoTMe_P7mDfiV8qBdqAjhznltuhdw2Xvd6jvd3WwezrRD5RBmpdc_tB_hujQWQXfAc1gb3XkHxQiqqnaO3Y8-EMHU0KJXXlln-pVqVHeDqtkZAwWVbUawKxxa5Y2uIEy_stpr94Q8qlXj8Ol9PSJf3r9bzhfRxeX5h_nsIioFZ3lU5zRJaEXjIsmKVCieiorTOOwmRlGKmImUIcUMOaPTqqxzVdVhu0nOC6qKohRH5NWW21uzWYNstSuxCb2iGZxkNGd5FjAiSF_-I12bwXahO8kSloX0KMuC6vVWVVrjnMVa9la3yo4BJf8mLMOMcpNw0D6_Jw5Fi9VeuYs0CE62gp-6wfH_JDm7Wu6Q0dahncdfe4eytzIws0R-_XQurxeL03n87bP8KP4A5PzBnQ</recordid><startdate>201210</startdate><enddate>201210</enddate><creator>de Jong, P. H.</creator><creator>Weel, A. E.</creator><creator>de Man, Y. A.</creator><creator>Huisman, A. M.</creator><creator>Gerards, A. H.</creator><creator>van Krugten, M. V.</creator><creator>Luime, J. J.</creator><creator>Hazes, J. M.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201210</creationdate><title>Brief Report: To squeeze or not to squeeze, that is the question! Optimizing the Disease Activity Score in 28 joints by adding the squeeze test of metatarsophalangeal joints in early rheumatoid arthritis</title><author>de Jong, P. H. ; Weel, A. E. ; de Man, Y. A. ; Huisman, A. M. ; Gerards, A. H. ; van Krugten, M. V. ; Luime, J. J. ; Hazes, J. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3218-f80550d04b57b63a263d2040234e3c341361e0e7e2109dcf8adf345582b0abbc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Agreements</topic><topic>Arthritis, Rheumatoid - diagnosis</topic><topic>Arthritis, Rheumatoid - physiopathology</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mathematical functions</topic><topic>Metatarsophalangeal Joint - physiopathology</topic><topic>Middle Aged</topic><topic>Pharmaceutical industry</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de Jong, P. H.</creatorcontrib><creatorcontrib>Weel, A. E.</creatorcontrib><creatorcontrib>de Man, Y. A.</creatorcontrib><creatorcontrib>Huisman, A. M.</creatorcontrib><creatorcontrib>Gerards, A. H.</creatorcontrib><creatorcontrib>van Krugten, M. V.</creatorcontrib><creatorcontrib>Luime, J. J.</creatorcontrib><creatorcontrib>Hazes, J. M.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Jong, P. H.</au><au>Weel, A. E.</au><au>de Man, Y. A.</au><au>Huisman, A. M.</au><au>Gerards, A. H.</au><au>van Krugten, M. V.</au><au>Luime, J. J.</au><au>Hazes, J. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brief Report: To squeeze or not to squeeze, that is the question! Optimizing the Disease Activity Score in 28 joints by adding the squeeze test of metatarsophalangeal joints in early rheumatoid arthritis</atitle><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle><addtitle>Arthritis & Rheumatism</addtitle><date>2012-10</date><risdate>2012</risdate><volume>64</volume><issue>10</issue><spage>3095</spage><epage>3101</epage><pages>3095-3101</pages><issn>0004-3591</issn><issn>2326-5191</issn><eissn>1529-0131</eissn><eissn>2326-5205</eissn><coden>ARHEAW</coden><abstract>Objective
To optimize use of the Disease Activity Score in 28 joints (DAS28) in early rheumatoid arthritis (RA) by adding the “squeeze test” of forefeet.
Methods
The squeeze test is used to examine bilateral compression pain (BCP) across the metatarsophalangeal (MTP) joints. For this study, data for patients participating in the Treatment in the Rotterdam Early Arthritis Cohort study, an ongoing clinical trial that evaluates different induction therapies in patients with early RA, were randomly divided into 2 subsets. In subset 1 (149 patients and 819 disease activity assessments), the mathematical function of the DAS28‐squeeze was constructed using a linear regression model with the DAS as the dependent variable and the DAS28 and squeeze test as the independent variables. A DAS28‐BCP disease state was also constructed, in which DAS28 disease state categorizations were upgraded one state if the result of the squeeze test was positive. In subset 2 (153 patients and 754 assessments), concordance in disease states between the DAS28, DAS28‐squeeze, and DAS28‐BCP disease states was compared, using both the DAS and Boolean‐defined remission criteria as reference.
Results
Agreement between the DAS and the DAS28‐squeeze (82%) was significantly higher than agreement between the DAS and the DAS28 (76%). When we assessed the group of patients who had arthritis of the forefeet only (22 patients and 46 assessments), overall agreement between the DAS and the DAS28 was 40%, while agreement between the DAS and the DAS28‐squeeze was 59% and that between the DAS and the DAS28‐BCP disease state was 65%. Furthermore, the specificities of the DAS28‐squeeze and the DAS28‐BCP (80% and 81%, respectively) were higher than that of the DAS28 (76%), while the sensitivities of the DAS28, DAS28‐squeeze, and DAS28‐BCP to identify true remission according to the Boolean criteria were 88%, 87%, and 81%, respectively.
Conclusion
Adding the squeeze test of forefeet to the DAS28 has value for dependably classifying the disease state in patients with early RA.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>22673898</pmid><doi>10.1002/art.34568</doi><tpages>7</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Agreements Arthritis, Rheumatoid - diagnosis Arthritis, Rheumatoid - physiopathology Cohort Studies Female Humans Male Mathematical functions Metatarsophalangeal Joint - physiopathology Middle Aged Pharmaceutical industry Sensitivity and Specificity Severity of Illness Index |
| title | Brief Report: To squeeze or not to squeeze, that is the question! Optimizing the Disease Activity Score in 28 joints by adding the squeeze test of metatarsophalangeal joints in early rheumatoid arthritis |
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