Prajapati et al.

Twenty-Eight Joint counts: Twenty-eight joints are MCP (10), PIP (10), wrist

(2), elbow (2), shoulder (2) and knee (2) joints are examined for the presence

or absence of tenderness or pain on motion, swelling, or deformity (Smollen et

al., 1995).

Patient’s global assessment of disease activity: It represents patients overall

assessment of how the arthritis is doing. Patients are asked to mark a cross on a 0

to 10 cm scale (Visual analogue scale) for how well he/she is doing by considering

all the ways the arthritis affect the life.

Change of DAS score from Baseline is categorized as good improvement if DAS

change ≥ 1.2, moderate > 0.6 but ≤ 1.2, and no improvement ≤ 0.6 (Van Gestel et

al., 1998). The Disease Activity Score is widely used to quantify disease activity

and gauge the response to treatment. A rather complex calculation conceals the

relative contribution of each measure to the composite score.

(iii) Paulus : The Paulus response criteria is based on 20% improvement in 4

of 6 measures: Joint tenderness score, joint swelling scores, physician’s global

assessment, patient’s global assessment, ESR, and morning stiffness (Paulus et

al., 1990).

The current standards of disease activity indices for clinical trials are the EULAR

Disease Activity score (DAS) and the ACR 20% response criteria.

Disability

Disability in RA is associated with the extent of joint damage, and influenced

by factor such as age, female gender, low socio economic status, income and

educational level, and pain and depression (Fries, Spitz, Youg, 1982). The effects

of disability have a substantial impact on individuals and their role, and on their

families. Disability influences psychosocial function and can lead to anxiety,

depression and fatigue. Health assessment Questionnaire- Disability index (HAQ-

DI) (Chopra, 2004) and Global function performance (GPF) (Agustin, Roy,

Rincon, 2004) is expressed as measure of disability.

Health assessment Questionnaire (HaQ) : A new approach to assess disability

in RA was introduced by Fries et al., 1980, the Stanford Health Assessment

Questionnaire (HAQ).They developed a structure of patient outcome measurement

representing five separate dimensions: Death, Disability, Discomfort, Drug

(therapeutic) toxicity and Dollar cost. The Full HAQ assesses all the above

mentioned five dimensions of health outcome. The Short HAQ questionnaire

that only assesses disability (HAQ Disability Index, HAQ-DI) is often used by

itself, and is here referred to as HAQ. The HAQ-DI was originally developed

and validated for English speaking populations in the United States and Canada,

and has since been translated or culturally adapted into more than 60 different

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Int. J. Bioinformatics and Biological Sci.: v.2 n.1&2, p. 85-94. March & June 2014