Castrejon et al developed the HUPI (Hospital Universitario de la Princessa Index) to evaluate a patient with early arthritis. It is a relatively simple measure of disease activity. The authors are from Madrid, Spain.
The authors prepared multiple versions using the first 4 parameters, with version 10 selected as the final version.
Parameters:
(1) swollen joint count (SJC)
(2) tender joint count (TJC)
(3) GDA-P2 (Global Disease Assessment by patient irrespective of age) based on 100-mm VAS scale
(4) acute phase reactant (APR) using ESR and/or CRP
(5) gender
|
Parameter |
Finding |
Points |
|
swollen joint count |
0 |
0 |
|
|
1 or 2 |
1 |
|
|
3 or 4 |
2 |
|
|
>= 5 |
3 |
|
tender joint count |
female and 0 joints |
0 |
|
|
female and 1 or 2 joints |
1 |
|
|
female and 3 to 6 joints |
2 |
|
|
female and >= 7 joints |
3 |
|
|
male and 0 joints |
0 |
|
|
male and 1 joint |
1 |
|
|
male and 2 or 3 joints |
2 |
|
|
male and >= 4 joints |
3 |
|
Global Disease Assessment |
0 to 15 mm |
0 |
|
|
16 to 30 mm |
1 |
|
|
31 to 50 mm |
2 |
|
|
> 50 mm |
3 |
subscore for first 3 parameters =
= SUM(points for all 3 parameters)
|
Parameter |
Finding |
Points |
|
CRP |
<= 0.1 mg/dL |
0 |
|
|
0.11 to 0.8 mg/dL |
1 |
|
|
0.81 to 1.50 mg/dL |
2 |
|
|
>= 1.51 mg/dL |
3 |
|
ESR |
female and 0 to 15 mm |
0 |
|
|
female and 16 to 20 mm |
1 |
|
|
female and 21 to 30 mm |
2 |
|
|
female and >= 31 mm |
3 |
|
|
male and 0 to 10 mm |
0 |
|
|
male and 11 to 15 mm |
1 |
|
|
male and 16 to 20 mm |
2 |
|
|
male and >= 20 mm |
3 |
If only 1 of ASR measures is available then the ASR subscore is based on available points.
If both of the ASR measures are available then the ASR subscore is the average of the two.
total HUOI index =
= (subscore for first 3 items) + (subscore for ASR)
Interpretation:
• minimum index: 0
• maximum index: 12
• The higher the index the more severe the arthritis.
Performance:
• The index is sensitive to change.
• Area under the ROC curve 0.956 versus minimal disease activity (Figure 2).
Specialty: Immunology/Rheumatology
