An external validation study reporting poor correlation between the claims-based index for rheumatoid arthritis severity and the disease activity score

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An external validation study reporting poor correlation between the claims-based index for rheumatoid arthritis severity and the disease activity score

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Title: An external validation study reporting poor correlation between the claims-based index for rheumatoid arthritis severity and the disease activity score
Author: Desai, Rishi J; Solomon, Daniel H; Weinblatt, Michael E; Shadick, Nancy; Kim, Seoyoung C

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Citation: Desai, Rishi J, Daniel H Solomon, Michael E Weinblatt, Nancy Shadick, and Seoyoung C Kim. 2015. “An external validation study reporting poor correlation between the claims-based index for rheumatoid arthritis severity and the disease activity score.” Arthritis Research & Therapy 17 (1): 83. doi:10.1186/s13075-015-0599-0. http://dx.doi.org/10.1186/s13075-015-0599-0.
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Abstract: Introduction: We conducted an external validation study to examine the correlation of a previously published claims-based index for rheumatoid arthritis severity (CIRAS) with disease activity score in 28 joints calculated by using C-reactive protein (DAS28-CRP) and the multi-dimensional health assessment questionnaire (MD-HAQ) physical function score. Methods: Patients enrolled in the Brigham and Women’s Hospital Rheumatoid Arthritis Sequential Study (BRASS) and Medicare were identified and their data from these two sources were linked. For each patient, DAS28-CRP measurement and MD-HAQ physical function scores were extracted from BRASS, and CIRAS was calculated from Medicare claims for the period of 365 days prior to the DAS28-CRP measurement. Pearson correlation coefficient between CIRAS and DAS28-CRP as well as MD-HAQ physical function scores were calculated. Furthermore, we considered several additional pharmacy and medical claims-derived variables as predictors for DAS28-CRP in a multivariable linear regression model in order to assess improvement in the performance of the original CIRAS algorithm. Results: In total, 315 patients with enrollment in both BRASS and Medicare were included in this study. The majority (81%) of the cohort was female, and the mean age was 70 years. The correlation between CIRAS and DAS28-CRP was low (Pearson correlation coefficient = 0.07, P = 0.24). The correlation between the calculated CIRAS and MD-HAQ physical function scores was also found to be low (Pearson correlation coefficient = 0.08, P = 0.17). The linear regression model containing additional claims-derived variables yielded model R2 of 0.23, suggesting limited ability of this model to explain variation in DAS28-CRP. Conclusions: In a cohort of Medicare-enrolled patients with established RA, CIRAS showed low correlation with DAS28-CRP as well as MD-HAQ physical function scores. Claims-based algorithms for disease activity should be rigorously tested in distinct populations in order to establish their generalizability before widespread adoption.
Published Version: doi:10.1186/s13075-015-0599-0
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394559/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:15034803
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