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Methodological issues in the design of a rheumatoid arthritis activity score and its cut-offs

Authors Collignon O

Received 25 March 2014

Accepted for publication 9 May 2014

Published 10 July 2014 Volume 2014:6 Pages 221—226

DOI https://doi.org/10.2147/CLEP.S64811

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5


Video abstract presented by Olivier Collignon

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Olivier Collignon

Centre de Recherche Public de la Santé (CRP-Santé), Competences Centre for Methodology and Statistics (CCMS), Strassen, Luxembourg

Abstract: Activity of rheumatoid arthritis (RA) can be evaluated using several scoring scales based on clinical features. The most widely used one is the Disease Activity Score involving 28 joint counts (DAS28) for which cut-offs were proposed to help physicians classify patients. However, inaccurate scoring can lead to inappropriate medical decisions. In this article some methodological issues in the design of such a score and its cut-offs are highlighted in order to further propose a strategy to overcome them. As long as the issues reviewed in this article are not addressed, results of studies based on standard disease activity scores such as DAS28 should be considered with caution.

Keywords: DAS28, disease activity score, penalized logistic regression, clinical prediction, modeling

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