ArticleArthritis care & research2011
Rheumatoid arthritis patients and rheumatologists approach the decision to escalate care differently: results of a maximum difference scaling experiment.
Article in Arthritis care & research, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Using Best-Worst Scaling to Investigate Preferences in Health Care.PharmacoEconomics · 2016Pooled it
- Enhancing Patient Understanding of Medication Risks and Benefits.Arthritis care & research · 2022Trial
- Cluster-Randomized Trial of a Behavioral Intervention to Incorporate a Treat-to-Target Approach to Care of US Patients With Rheumatoid Arthritis.Arthritis care & research · 2018Trial
- Use of Decision Support for Improved Knowledge, Values Clarification, and Informed Choice in Patients With Rheumatoid Arthritis.Arthritis care & research · 2015Trial
- Dose REduction strategy of subcutaneous TNF inhibitors in rheumatoid arthritis: design of a pragmatic randomised non inferiority trial, the DRESS study.BMC musculoskeletal disorders · 2013Trial
- Prioritized barriers to implementation of personalized immunotherapy for sepsis patients.Implementation science communications · 2026Article
- Improving Clinical Management and Patient-Reported Outcomes Among Patients with Rheumatoid Arthritis in China via Real-world Evidence (IMPROVE Study): A Multicenter Prospective Cohort Study.Advances in therapy · 2025Article
- Integrating PROMIS Measures in a Treat-to-Target Approach to Standardize Patient-Centered Treatment of Rheumatoid Arthritis.The Journal of rheumatology · 2023Observational
- Belgian rheumatologists' preferences regarding measures of disease activity in patients with rheumatoid arthritis: results from a mixed-methods study.Rheumatology international · 2022Article
- Importance of Shared Treatment Goal Discussions in Rheumatoid Arthritis-A Cross-Sectional Survey: Patients Report Providers Seldom Discuss Treatment Goals and Outcomes Improve When Goals Are Discussed.ACR open rheumatology · 2021Article
- What Are the Preferences of Patients With Rheumatoid Arthritis for Treatment Modification? A Scoping Review.The patient · 2021Article
- Co-Design of a Disease Activity Based Self-Management Approach for Patients with Rheumatoid Arthritis.Mediterranean journal of rheumatology · 2021Article
- Ranking facilitators and barriers of medication adherence by patients with inflammatory arthritis: a maximum difference scaling exercise.BMC musculoskeletal disorders · 2021Article
- Influence of Age and Sex on Disease Course and Treatment in Rheumatoid Arthritis.Open access rheumatology : research and reviews · 2021Article
- Is a treat-to-target strategy in osteoporosis applicable in clinical practice? Consensus among a panel of European experts.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Understanding the Role of Interleukin-6 (IL-6) in the Joint and Beyond: A Comprehensive Review of IL-6 Inhibition for the Management of Rheumatoid Arthritis.Rheumatology and therapy · 2020Review
- Real-world questions and concerns about disease-modifying antirheumatic drugs (DMARDs): a retrospective analysis of questions to a medicine call center.BMC rheumatology · 2020Article
- Association between pain phenotype and disease activity in rheumatoid arthritis patients: a non-interventional, longitudinal cohort study.Arthritis research & therapy · 2019Article
- Examination of Patient-Reported Outcomes in Association with TNF-Inhibitor Treatment Response: Results from a US Observational Cohort Study.Rheumatology and therapy · 2018Article
- Comparison of preferences of healthcare professionals and MS patients for attributes of disease-modifying drugs: A best-worst scaling.Health expectations : an international journal of public participation in health care and health policy · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveAntirheumatic treatment is frequently not appropriately modified, according to American College of Rheumatology guidelines, in patients with active rheumatoid arthritis (RA) as defined by a Disease Activity Score in 28 joints (DAS28) score greater than 3.2. The objective of this study was to determine which factors most strongly influence patients' and rheumatologists' decisions to escalate care.
methodsWe administered a Maximum Difference Scaling survey to 106 rheumatologists and 213 patients with RA. The survey included 58 factors related to the decision to escalate care in RA. Participants answered 24 choice tasks. In each task, participants were asked to choose the most important factor from a set of 5. We used hierarchical Bayes modeling to generate the mean relative importance score (RIS) for each factor.
resultsFor rheumatologists, the 5 most influential factors were number of swollen joints (mean ± SD RIS 5.2 ± 0.4), DAS28 score (mean ± SD RIS 5.2 ± 0.5), physician global assessment of disease activity (mean ± SD RIS 5.2 ± 0.6), worsening erosions over the last year (mean ± SD RIS 5.2 ± 0.5), and RA disease activity now compared to 3 months ago (mean ± SD RIS 5.1 ± 0.6). For patients, the 5 most important factors were current level of physical functioning (mean ± SD RIS 4.3 ± 1.1), motivation to get better (mean ± SD RIS 3.5 ± 1.4), trust in their rheumatologist (mean ± SD RIS 3.5 ± 1.6), satisfaction with current disease-modifying antirheumatic drugs (mean ± SD RIS 3.4 ± 1.4), and current number of painful joints (mean ± SD RIS 3.4 ± 1.4).
conclusionFactors influencing the decision to escalate care differ between rheumatologists and patients. Better communication between patients and their physicians may improve treatment planning in RA patients with active disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.