Email updates

Keep up to date with the latest news and content from Arthritis Research & Therapy and BioMed Central.

This article is part of the supplement: Proceedings of the 8th Global Arthritis Research Network (GARN) Meeting and 1st Bio-Rheumatology International Congress (BRIC)

Open Badges Poster presentation

Discrepancy between patient and physician in assessment of global severity in early rheumatoid arthritis

Yuko Kaneko*, Masataka Kuwana and Tsutomu Takeuchi

  • * Corresponding author: Yuko Kaneko

Author Affiliations

Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Japan

For all author emails, please log on.

Arthritis Research & Therapy 2012, 14(Suppl 1):P30  doi:10.1186/ar3631

The electronic version of this article is the complete one and can be found online at:

Published:9 February 2012

© 2012 Kaneko et al.; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


To evaluate the discrepancy between patient and physician in assessment of global severity in early rheumatoid arthritis (RA) and to explore factors affecting the discrepancy at 1-year since the diagnosis of RA.


One hundred nine patients with RA with median disease duration of 4 months were enrolled in this study. The global assessment was performed using 100 mm-visual analog scale (VAS). The difference between patient's and physician's assessment wascalculated by subtracting physician's VAS from patient's VAS, and the difference more than 20 mm was defined as discordant. RA patients were stratified by concordance and discordance of VAS scoring at 1-year after the diagnosis. To clarify the factors affecting the discrepancy, clinical characteristics, disease activity using Disease Activity Score (DAS28) 3-variables, functional status by Health Assessment Questionnaire (HAQ) were compared between patients with concordance and discordance.


The discordance between patient's and physician's VAS at 1-year was found in 41 patients (37%), consisting of 5 patients whose VAS was better than physicians and 36 patients whose VAS was worse than physicians. Tender joint count, DAS28 3-variables, CRP and HAQ were significantly higher in patients with discordance group where patients rated themselves worse than physicians than in patients with concordance (p < 0.05). HAQ score was correlated with the degree of the difference (R = 0.49, p < 0.05).


Higher disease activity and higher HAQ score was associated the discordance between patient's and physician's VAS in early RA patients, indicating the possibility of physicians underestimating the patient's global disease severity at 1-year since diagnosis.