Symmons et al developed a simple measure for the overall status in rheumatoid arthritis (OSRA). This can be used to monitor patients in routine clinical practice. The authors are from the University of Manchester, Keele University, Manchester Royal Infirmary, and Royal Hospital Buxton in England.
Patient selection: rheumatoid arthritis
Parameters:
(1) disease duration in years
(2) well-being
(3) joint point
(4) early morning stiffness (EMS) in minutes
(5) active joint count
(6) extra-articular disease
(7) functional impairment
(8) social life
(9) number of destroyed or replaced large joints
(10) small joint damage
(11) organ impairment (6.01 to 12 months)
(12) drug therapy
|
Parameter |
Finding |
Code |
|---|---|---|
|
disease duration |
< 10 years |
A |
|
|
10 to 20 years |
B |
|
|
> 20 |
C |
|
drug therapy |
none or analgesics |
A |
|
|
NSAIDS only |
B |
|
|
second line |
C |
|
|
second-line plus steroid |
D |
|
|
cytotoxic with or without steroids |
E |
|
|
steroids |
F |
|
|
biologics |
G |
|
Parameter |
Finding |
Points |
|---|---|---|
|
well-being |
better |
0 |
|
|
same |
0 |
|
|
worse |
1 |
|
|
much worse |
2 |
|
joint pain |
none |
0 |
|
|
mild |
0 |
|
|
moderate |
1 |
|
|
severe |
2 |
|
early-morning stiffness |
< 30 minutes |
0 |
|
|
30 to 60 minutes |
1 |
|
|
> 60 minutes |
2 |
|
active joint count |
< 3 |
0 |
|
|
3 to 10 |
1 |
|
|
> 10 |
2 |
|
extra-articular disease |
none |
0 |
|
|
new nodules |
1 |
|
|
vasculitis, serositis, other |
2 |
|
functional impairment |
mild |
0 |
|
|
problems with ADL (dressing, eating, climbing stairs) |
1 |
|
|
housebound |
2 |
|
social life |
normal |
0 |
|
|
moderately impaired |
1 |
|
|
severely impaired |
2 |
|
large joints destroyed or replaced |
0 |
0 |
|
|
1 or 2 |
1 |
|
|
>= 3 |
2 |
|
small joint damage |
mild |
0 |
|
|
needs collar, special shoes, hand splint, etc |
1 |
|
|
surgery |
2 |
|
organ impairment |
none |
0 |
|
|
mild |
0 |
|
|
skin or muscle |
1 |
|
|
major organ(s) |
2 |
subscore for activity =
= SUM(points for items 2 through 6)
subscore for damage or impact =
= SUM(points for items 7 through 11)
Interpretatation:
• minimum activity and damage subscores: 0
• maximum activity and damage subscores: 10
• The higher the subscores the more severe the RA.
Performance:
• The OSRA was validated in Symmons et al with demonstration of face validity, content validity, construct validity, criterion validity, and discriminant validity.
Specialty: Immunology/Rheumatology
ICD-10: ,
