WHY NOT USE OSRA - A COMPARISON OF OVERALL STATUS IN RHEUMATOID-ARTHRITIS (RA) WITH ACR CORE SET AND OTHER INDEXES OF DISEASE-ACTIVITY IN RA

Objective. The Overall Status in Rheumatoid Arthritis (OSRA) is a rece ntly validated measure designed for routine immediate clinical use in patients with rheumatoid arthritis (RA). It is composed of demographic data, activity score (activity total), damage score (damage total), a nd drug treatment. We tested the hypothesis that this tool relates to existing measures and pooled indices of disease activity, including th e SF-36. Methods. Demographic information, OSRA, SF-36, and the ACR co re set [inflammatory indicators (ESR, CRP), tender and swollen joints, visual analog scale for pain, Patient and Physician Global Assessment , and Health Assessment Questionnaire (HAQ)] were collected for 86 con secutive outpatients with RA who were starting or changing second-line therapy and again at 6 months. OSRA measures were examined for their relationship to all core set variables (SF-36, HAQ, Stoke Index, Disea se Activity Score, and Mallya-Mace) using Spearman's rank correlation. OSRA was used to audit 246 consecutive outpatients with RA to determi ne its clinical utility. Results. The median age was 58 years (range 2 9-82); median disease duration 63 mo (range 3-384); OSRA disease activ ity (mean 3.8, range 0-8) and damage (mean 2.7, range 0-7) scores were strongly associated with specific ACR core set and SF-36 measures, an d all pooled indices examined. OSRA disease activity was significantly higher in outpatients in whom second-line therapy was changed. Conclu sion. (1) The OSRA was highly correlated with HAQ and core set measure s of disease activity; (2) the OSRA damage total was strongly associat ed with HAQ and correlated strongly with both duration and Larsen scor e; (3) OSRA scores also correlated well with specific SF-36 measures ( activity total with Physical Functioning and Bodily Pain; damage total with Physical and Social Functioning); (4) OSRA shows good correlatio n with pooled indices that cannot be performed immediately in clinic; and (5) the OSRA activity score shows a strong association with clinic al decisions made in the outpatient department.