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Minimal Clinically Important Improvement of Routine Assessment of Patient Index Data 3 in Rheumatoid Arthritis

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Ward MM1, Castrejon I1, Bergman MJ1, Alba MI1, Guthrie LC1, Pincus T1. J Rheumatol. 2018 Oct 15. pii: jrheum.180153. doi: 10.3899/jrheum.180153. [Epub ahead of print]

Abstract

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1 From the Intramural Research Program, US National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), Bethesda, Maryland; Division of Rheumatology, Rush University Medical Center, Chicago, Illinois; Rheumatology, Taylor Hospital, Ridley Park, Pennsylvania, USA. This study was supported in part by the Intramural Research Program, NIAMS, NIH, and US Public Health Service grant AR45177. M.M. Ward, MD, MPH, Intramural Research Program, NIAMS, NIH; I. Castrejon, MD, PhD, Division of Rheumatology, Rush University Medical Center; M.J. Bergman, MD, Rheumatology, Taylor Hospital; M.I. Alba, MD, Intramural Research Program, NIAMS, NIH; L.C. Guthrie, BSN, Intramural Research Program, NIAMS, NIH; T. Pincus, MD, Division of Rheumatology, Rush University Medical Center. Address correspondence to Dr. M.M. Ward, Intramural Research Program, NIAMS/NIH, Building 10 CRC, Room 4-1339, 10 Center Drive, Bethesda, Maryland 20892-1468, USA. E-mail: wardm1@mail.nih.gov. Accepted for publication July 19, 2018.

Abstract

OBJECTIVE: To estimate minimal clinically important improvement (MCII) of RAPID-3 (Routine Assessment of Patient Index Data 3) in rheumatoid arthritis (RA).

METHODS: RAPID-3 was computed before and after treatment escalation in a prospective study of adults with active RA. Patient judgment of improvement was used as the standard for a receiver-operating characteristic curve, from which MCII was estimated.

RESULTS: Mean RAPID-3 improved from 16.3 to 11.1 between visits. MCII was -3.8 based on simultaneously optimized sensitivity and specificity, -3.5 using the 0.80 specificity criterion, and -4.1 using the Youden index.

CONCLUSION: RAPID-3 improvement of 3.8/30 units appears clinically meaningful.