Bansback et al developed a nomogram for predicting functional outcome in a patient with early rheumatoid arthritis. This can help identify a patient who may benefit from more aggressive management. The authors are from City Hospital, St. Albans, United Kingdom
Endpoint: probability of moderate to severe functional outcome
Parameters:
(1) Carstairs deprivation index
(2) functional grade at baseline
(3) functional grade at 1 year
(4) HAQ at baseline
(5) HAQ at 1 year
(6) hemoglobin at baseline in g/L
(7) DAS28 at 1 year
(8) Larsen index at baseline
Parameter |
Finding |
Points |
---|---|---|
Carstairs index |
1 |
9.4 |
|
2 |
0 |
|
3 |
22.7 |
|
4 |
30 |
|
5 |
35 |
functional grade at baseline |
I |
0 |
|
II, III or IV |
22 |
functional grade at 1 year |
I |
0 |
|
II |
25.6 |
|
III or IV |
64.3 |
points for HAQ at baseline
= (HAQ at baseline) * 20
points for HAQ at 1 year
= (HAQ at 1 year) * 33.3
Hemoglobin |
Points |
---|---|
<= 80 g/L |
0 |
80.01 - 180 g/L |
(0.5649 * (hemoglobin)) - 45.192 |
> 180 g/L |
56.5 |
points for Larsen at baseline =
= (Larsen score) * 0.4667
points for DAS28 at 1 year =
= (5.122 * ((DAS28) - 1))
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 400
• The higher the score the greater the risk of a moderate to severe impairment.
Total Score |
Probability of Moderate to Severe Impairment |
---|---|
< 49 points |
< 5% |
49 to 125 |
(0.000025 * ((points)^2)) - (0.00168 * (points)) + 0.07262 |
125 to 210 |
(0.005581 * (points)) - 0.4444 |
210 to 358 |
(-0.000057 * ((points)^2)) + (0.0218 * (points)) - 1.803 |
> 358 |
> 99% |
Purpose: To evaluate a patient with early rheumatoid arthritis for the risk of moderate-to-severe functional impairment using the nomogram of Bansback et al.
Specialty: Sports Medicine & Rehabilitation, Immunology/Rheumatology
Objective: severity, prognosis, stage, options, physical and lifestyle, disease progression, disability and performance, quality of life
ICD-10: M05, M06, M08, M09,