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A New Disease Activity Index for Rheumatoid Arthritis: Mean Overall Index for Rheumatoid Arthritis (MOI-RA) HEIDI MÄKINEN, HANNU KAUTIAINEN, PEKKA HANNONEN, and TUULIKKI SOKKA
ABSTRACT. Methods. The MOI-RA is the mean of standardized values of tender and swollen joint counts (28, 42, or 66/68 joint counts), physical function (Health Assessment Questionnaire 0–3), patient's and physician's assessments of global health and patient's assessment of pain (visual analog scale 0–100 mm) and erythrocyte sedimentation rate (1–100). All the 7 components were standardized (0–100), and the mean of standardized values was calculated. The range of MOI-RA is 0–100; higher values indicate poorer outcomes. The validity and measurement properties of MOI-RA were analyzed in 169 patients in the Finnish RA Combination therapy trial. Results. The mean MOI-RA28 decreased from 38.5 to 13.3 [standardized response mean (SRM) = 1.8, effect size (ES) = 1.9] from baseline to 6 months, compared to Disease Activity Score (DAS) 28, which decreased from 5.55 to 2.77 (SRM = 2.0, ES = 2.8). Correlation between MOI-RA28 and DAS28 was 0.90. When compared to the ACR response categories (20/50/ACR remission), changes in MOI-RA versions (using 28/42/66 joints) were similar. The reproducibility of MOI-RA with different joint counts was 0.97. A simulation in which 15% of the component values of MOI-RA were randomly omitted indicated an intraclass correlation coefficient of 0.98 between incomplete and complete data. Conclusion. MOI-RA is a simple and feasible index based on the ACR core data set of disease activity measures for assessment of disease activity and treatment response in RA trials and clinical settings. (First Release May 15 2008; J Rheumatol 2008;35:1522-7) Key Indexing Terms:
DISEASE ACTIVITY
From Jyväskylä Central Hospital, Jyväskylä; and Rheumatism Foundation Hospital, Heinola, Finland. H. Mäkinen, MD; P. Hannonen, MD, PhD; T. Sokka, MD, PhD, Jyväskylä Central Hospital; H. Kautiainen, BA, Rheumatism Foundation Hospital. Address reprint requests to Dr. H. Mäkinen, Jyväskylä Central Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland. E-mail: heidi.makinen@ksshp.fi Accepted for publication January 24, 2008. |
