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Arthritis
Volume 2011 (2011), Article ID 146398, 5 pages
http://dx.doi.org/10.1155/2011/146398
Clinical Study

Use of Clinical Disease Activity Index Score for Assessment of Disease Activity in Rheumatoid Arthritis Patients: An Indian Experience

Department of Medicine, Pt. BDS PGIMS, Haryana Rohtak 124001, India

Received 26 August 2011; Revised 10 November 2011; Accepted 15 November 2011

Academic Editor: George D. Kitas

Copyright © 2011 H. Singh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Serial objective assessment of disease activity in Rheumatoid Arthritis (RA) is imperative to achieve remission. The CDAI score appears more practical than DAS-28 in routine assessment of disease activity in RA patients. Objective. To evaluate correlation and agreement of the DAS-28 with CDAI in RA patients. Methods. A total of 200 patients of RA were evaluated by DAS-28 and CDAI and divided into 4 categories of disease activity i.e. Group-I: Remission (DAS-28 < 2.6; CDAI < 2.8), Group II: Low disease activity (DAS-28 = 2.6–3.2; CDAI = 2.8–10), Group III: Moderate disease activity (DAS-28 = 3.2– 5.1; CDAI = 10–22), Group IV: High disease activity (DAS-28 > 5.1; CDAI > 22). DAS-28 was compared to CDAI in each group using spearman correlation coefficient and kappa statistics. Results. Group I shows mean DAS-28 of 1 . 9 9 ± 0 . 3 8 ; mean CDAI of 0 . 9 0 ± 0 . 6 5 , ( 𝑃 = 0.0001). Group II shows mean DAS-28 of 3 . 0 4 ± 0 . 1 7 ; mean CDAI of 6 . 4 5 ± 0 2 . 3 5 , ( 𝑃 = 0.0001). Group III shows mean DAS-28 of 4 . 2 5 ± 0 . 5 8 ; mean CDAI of 1 6 . 4 6 ± 3 . 3 1 ( 𝑃 < 0.0001). Group IV shows mean DAS-28 of 6 . 3 8 ± 0 . 8 7 ; mean CDAI of 3 8 . 5 6 ± 1 1 . 8 8 ( 𝑃 < 0.0001). Kappa statistics ( 𝜅 ) of the above comparison was 0.533. Conclusion. Our findings indicate that CDAI—a composite score that employs only clinical variables and omits assessment of Acute Phase Reactant (APR), has moderate to good correlation (Kappa value = 0.533) to DAS-28 for assessment of disease activity in RA patients.