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Protocol - Rheumatoid arthritis disease activity

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Description

Clinical assessment of tenderness and swelling in 28 body joints along with a single-item, Likert-style question for both patient and provider to evaluate how active the arthritis is. 

Specific Instructions

In the hands, the joints evaluated by a trained evaluator (usually a rheumatologist) who examines the joints, hands on, include the first through fifth metacarpophalangeal joint, the interphalangeal joint of the thumb, and the second through fifth proximal interphalangeal joint.

The PGA or Patient Global Assessment of disease activity estimate represents the patient's self-assessment of disease activity on a 0–10 scale where 10 means maximal activity.

The EGA or Evaluator Global disease Activity estimate represents the evaluator's assessment of disease activity on a 0–10 scale where 10 means maximal activity.

The tables below are completed by the evaluator. Patient feedback is sought when the examiner presses on each joint to determine whether it is tender.

Availability

Available

Protocol

Joint

Left

Right

Tender

Swollen

Tender

Swollen

Shoulder

Elbow

Wrist

MCP 1

MCP 2

MCP 3

MCP 4

MCP 5

PIP 1

PIP 2

PIP 3

PIP 4

PIP 5

Knee

Total

Tender:

Swollen:

171901_image1

Patient Global Assessment of Disease Activity

Considering all the ways your arthritis affects you, rate how well you are doing on the following scale:

Very Well

Very Poor

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

5.5

6.0

6.5

7.0

7.5

8.0

8.5

9.0

9.5

10.0

Your Name:
___________
Date of Birth:
___________
Today’s Date:
___________

Provider Global Assessment of Disease Activity

Very Well

Very Poor

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

O

0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

4.5

5.0

5.5

6.0

6.5

7.0

7.5

8.0

8.5

9.0

9.5

10.0

How to Score the CDAI

Variable

Range

Value

Tender joint Score

(0-28)

Swollen joint score

(0-28)

Patient global score

(0-10)

Provider global score

(0-10)

Add the above values to calculate the CDAI score

(0-76)

CDAI Score Interpretation

0.0 – 2.8

Remission

2.9 – 10.0

Low Activity

10.1 – 22.0

Moderate Activity

22.1 – 76.0

High Activity

Personnel and Training Required

Generally performed by rheumatologist or nurse who is trained in how to examine joints. Specialized training is required—although not for rheumatologists because the joint examination is a basic part of their training.

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training Yes
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Lifestage

Adolescent, Adult, Senior, Pregnancy

Participants

Patients with rheumatoid arthritis.

Selection Rationale

The Clinical Disease Activity Index (CDAI) assesses rheumatoid arthritis (RA) disease severity in an individual through clinical observation without requiring laboratory work thus providing immediate feedback to utilize in assessment of disease progression and treatment planning.

Language

English

Standards
StandardNameIDSource
Derived Variables

None

Process and Review

Not applicable.

Protocol Name from Source

Clinical Disease Activity Index (CDAI)

Source

Aletaha, D., & Smolen, J. (2005). The Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI): A review of their usefulness and validity in rheumatoid arthritis. Clinical and Experimental Rheumatology, 23(5 Suppl. 39), S100–S108.

General References

Aletaha, D., Nell, V. P., Stamm, T., Uffman, M., Pflugbeil, S., Machold, K., & Smolen, J. S. (2005). Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: Validation of a clinical activity score. Arthritis Research & Therapy, 7(4), R796–R806.

Heegaard, C., Dreyer, L., Egsmose, C., & Madsen, O. R. (2013). Test-retest reliability of the Disease Activity Score 28 CRP (DAS28-CRP), the Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) in rheumatoid arthritis when based on patient self-assessment of tender and swollen joints. Clinical Rheumatology, 32(10), 1493–1500.

Salaffi, F., Di Carlo, M., Farah, S., Marotto, D., Atzeni, F., & Sarzi-Puttini, P. (2021). Rheumatoid arthritis disease activity assessment in routine care: Performance of the most widely used composite disease activity indices and patient-reported outcome measures. Acta Bio Medica, 92(4), e2021238.

Smolen, J. S., & Aletaha, D. (2014). Scores for all seasons: SDAI and CDAI. Clinical and Experimental Rheumatology, 32(5 Suppl. 85), S-75–S-79.

Protocol ID

171901

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
PX171901_Rheumatoid_Arthritis_Disease_Activity_Patient_Assessment
PX171901530000 Considering all the ways your arthritis more
affects you, rate how well you are doing on the following scale: show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Patient_Assessment_Date_Birth
PX171901550000 Date of Birth: N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Patient_Assessment_Date_Today
PX171901560000 Today's Date N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Patient_Assessment_Name
PX171901540000 Your Name: N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Provider_Assessment
PX171901570000 Rate how well the patient is doing on the more
following scale: show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_Elbow
PX171901020000 Please indicate if the following joint feels more
swollen: Left Elbow show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_MCP 1
PX171901040000 Please indicate if the following joint feels more
swollen: Left MCP 1 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_MCP 2
PX171901050000 Please indicate if the following joint feels more
swollen: Left MCP 2 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_MCP 3
PX171901060000 Please indicate if the following joint feels more
swollen: Left MCP 3 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_MCP 4
PX171901070000 Please indicate if the following joint feels more
swollen: Left MCP 4 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_MCP 5
PX171901080000 Please indicate if the following joint feels more
swollen: Left MCP 5 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_PIP 1
PX171901090000 Please indicate if the following joint feels more
swollen: Left PIP 1 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_PIP 2
PX171901100000 Please indicate if the following joint feels more
swollen: Left PIP 2 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_PIP 3
PX171901110000 Please indicate if the following joint feels more
swollen: Left PIP 3 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_PIP 4
PX171901120000 Please indicate if the following joint feels more
swollen: Left PIP 4 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_PIP 5
PX171901130000 Please indicate if the following joint feels more
swollen: Left PIP 5 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_Shoulder
PX171901010000 Please indicate if the following joint feels more
swollen: Left Shoulder show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Left_Wrist
PX171901030000 Please indicate if the following joint feels more
swollen: Left Wrist show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_Elbow
PX171901150000 Please indicate if the following joint feels more
swollen: Right Elbow show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_MCP 1
PX171901170000 Please indicate if the following joint feels more
swollen: Right MCP 1 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_MCP 2
PX171901180000 Please indicate if the following joint feels more
swollen: Right MCP 2 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_MCP 3
PX171901190000 Please indicate if the following joint feels more
swollen: Right MCP 3 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_MCP 4
PX171901200000 Please indicate if the following joint feels more
swollen: Right MCP 4 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_MCP 5
PX171901210000 Please indicate if the following joint feels more
swollen: Right MCP 5 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_PIP 1
PX171901220000 Please indicate if the following joint feels more
swollen: Right PIP 1 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_PIP 2
PX171901230000 Please indicate if the following joint feels more
swollen: Right PIP 2 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_PIP 3
PX171901240000 Please indicate if the following joint feels more
swollen: Right PIP 3 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_PIP 4
PX171901250000 Please indicate if the following joint feels more
swollen: Right PIP 4 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_PIP 5
PX171901260000 Please indicate if the following joint feels more
swollen: Right PIP 5 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_Shoulder
PX171901140000 Please indicate if the following joint feels more
swollen: Right Shoulder show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Swollen_Right_Wrist
PX171901160000 Please indicate if the following joint feels more
swollen: Right Wrist show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_Elbow
PX171901280000 Please indicate if the following joint feels more
tender: Left Elbow show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_MCP 1
PX171901300000 Please indicate if the following joint feels more
tender: Left MCP 1 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_MCP 2
PX171901310000 Please indicate if the following joint feels more
tender: Left MCP 2 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_MCP 3
PX171901320000 Please indicate if the following joint feels more
tender: Left MCP 3 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_MCP 4
PX171901330000 Please indicate if the following joint feels more
tender: Left MCP 4 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_MCP 5
PX171901340000 Please indicate if the following joint feels more
tender: Left MCP 5 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_PIP 1
PX171901350000 Please indicate if the following joint feels more
tender: Left PIP 1 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_PIP 2
PX171901360000 Please indicate if the following joint feels more
tender: Left PIP 2 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_PIP 3
PX171901370000 Please indicate if the following joint feels more
tender: Left PIP 3 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_PIP 4
PX171901380000 Please indicate if the following joint feels more
tender: Left PIP 4 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_PIP 5
PX171901390000 Please indicate if the following joint feels more
tender: Left PIP 5 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_Shoulder
PX171901270000 Please indicate if the following joint feels more
tender: Left Shoulder show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Left_Wrist
PX171901290000 Please indicate if the following joint feels more
tender: Left Wrist show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_Elbow
PX171901410000 Please indicate if the following joint feels more
tender: Right Elbow show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_MCP 1
PX171901430000 Please indicate if the following joint feels more
tender: Right MCP 1 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_MCP 2
PX171901440000 Please indicate if the following joint feels more
tender: Right MCP 2 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_MCP 3
PX171901450000 Please indicate if the following joint feels more
tender: Right MCP 3 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_MCP 4
PX171901460000 Please indicate if the following joint feels more
tender: Right MCP 4 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_MCP 5
PX171901470000 Please indicate if the following joint feels more
tender: Right MCP 5 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_PIP 1
PX171901480000 Please indicate if the following joint feels more
tender: Right PIP 1 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_PIP 2
PX171901490000 Please indicate if the following joint feels more
tender: Right PIP 2 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_PIP 3
PX171901500000 Please indicate if the following joint feels more
tender: Right PIP 3 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_PIP 4
PX171901510000 Please indicate if the following joint feels more
tender: Right PIP 4 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_PIP 5
PX171901520000 Please indicate if the following joint feels more
tender: Right PIP 5 show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_Shoulder
PX171901400000 Please indicate if the following joint feels more
tender: Right Shoulder show less
N/A
PX171901_Rheumatoid_Arthritis_Disease_Activity_Tender_Right_Wrist
PX171901420000 Please indicate if the following joint feels more
tender: Right Wrist show less
N/A
Bone and Joint
Measure Name

Rheumatoid arthritis disease activity

Release Date

October 21, 2022

Definition

A hands-on assessment, performed by a trained evaluator (usually a rheumatologist), of tenderness and swelling in 28 joints that are associated with rheumatoid arthritis disease activity. In addition to the clinical observation, there is a 10-point scale for the evaluator to estimate the activity of the patient’s arthritis and a similar scale for the patient to rate how active they believe their arthritis is.

Purpose

To screen for and assess the progression of disease activity for rheumatoid arthritis.

Keywords

Rheumatoid arthritis, Clinical Disease Activity Index (CDAI), bone and joint, pain

Measure Protocols
Protocol ID Protocol Name
171901 Rheumatoid arthritis disease activity
Publications

There are no publications listed for this protocol.