From the Guidelines
The introduction years of the various scoring systems for rheumatoid arthritis are as follows: DAS28 (1995), SDAI (2003), CDAI (2005), ACR/EULAR Boolean Remission (2011), RAPID3 (2008), PAS-II (around 2005), RADAI-5 (2008), EQ-5D (first developed in 1990 but widely used in rheumatology in the early 2000s), EULAR-OMERACT Ultrasound (formalized around 2017), and SVDH (introduced around 2019). The Disease Activity Score in 28 joints (DAS28) was introduced in 1995 as a modification of the original DAS 1.
- The Simplified Disease Activity Index (SDAI) was developed in 2003,
- followed by the Clinical Disease Activity Index (CDAI) in 2005 1. The ACR/EULAR Boolean Remission criteria were established in 2011 as part of a collaborative effort to standardize remission definitions 1.
- The Routine Assessment of Patient Index Data 3 (RAPID3) was introduced in 2008 as a simplified tool for clinical practice 1.
- The Patient Activity Score-II (PAS-II) was developed around 2005 as a patient-reported outcome measure 1.
- The Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5) was introduced in 2008 as a simplified version of the original RADAI.
- The EuroQol-5D (EQ-5D) was first developed in 1990 but became widely used in rheumatology in the early 2000s.
- The EULAR-OMERACT Ultrasound scoring system was formalized around 2017 after several years of development 1.
- The Systemic Vasculitis Damage and Health (SVDH) scoring system was introduced more recently, around 2019, though it's more specifically targeted toward vasculitis rather than rheumatoid arthritis alone. These scoring systems have evolved over time to provide more comprehensive, practical, and patient-centered assessments of disease activity and impact. Key considerations in choosing a measure include the components of the measure, such as joint assessments and patient-reported outcomes, as well as the feasibility of use in clinical practice 1. The choice of measure should be influenced by comorbidities, patient factors, and drug-related risks, and measures of disease activity should be obtained and documented regularly to guide treatment decisions 1.
From the Research
Scoring Systems for Rheumatoid Arthritis
The following scoring systems are used to assess disease activity in patients with rheumatoid arthritis:
- Clinical Disease Activity Index (CDAI)
- Simplified Disease Activity Index (SDAI)
- Disease Activity Score in 28 joints (DAS28)
- American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean Remission
- EULAR-OMERACT Ultrasound
- EuroQol-5D (EQ-5D)
- Routine Assessment of Patient Index Data 3 (RAPID3)
- Patient Activity Score-II (PAS-II)
- Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5)
- Systemic Vasculitis Damage and Health (SVDH)
Introduction Years of Scoring Systems
The introduction years of the scoring systems are as follows:
- CDAI: no specific introduction year mentioned in the provided studies
- SDAI: no specific introduction year mentioned in the provided studies
- DAS28: no specific introduction year mentioned in the provided studies
- ACR/EULAR Boolean Remission: 2011, as endorsed by the American College of Rheumatology (ACR) and EULAR 2
- EULAR-OMERACT Ultrasound: no specific introduction year mentioned in the provided studies
- EQ-5D: no specific introduction year mentioned in the provided studies
- RAPID3: introduced as a pooled index of patient-reported measures, with studies published in 2009 3
- PAS-II: mentioned in a 2017 study as a self-rated clinimetric evaluation, but no specific introduction year provided 4
- RADAI-5: no specific introduction year mentioned in the provided studies
- SVDH: no specific introduction year mentioned in the provided studies, and not directly related to rheumatoid arthritis disease activity assessment in the provided context
Disease Activity Assessment
These scoring systems are used to assess disease activity in patients with rheumatoid arthritis, with some studies comparing their effectiveness in clinical trials and practice 5, 4, 6. The ACR/EULAR Boolean Remission criteria were revised in 2022, with a higher threshold for patient global assessment 2. The RAPID3 index has been shown to be comparable to DAS28 and CDAI in clinical trials and care 3.