Evidence map›Paper›PMID 26238974›Full record

Observational studyArthritis care & research2016

Effects of Achieving Target Measures in Rheumatoid Arthritis on Functional Status, Quality of Life, and Resource Utilization: Analysis of Clinical Practice Data.

Evo Alemao, Seongjung Joo, Hugh Kawabata, Maiwenn J Al, Paul D Allison, Maureen P M H Rutten-van Mölken, Michelle L Frits, Christine K Iannaccone, Nancy A Shadick, Michael E Weinblatt

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Arthritis care & research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 33 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Evo AlemaoBristol-Myers Squibb, Princeton, New Jersey.
Seongjung JooBristol-Myers Squibb, Hopewell, New Jersey.
Hugh KawabataBristol-Myers Squibb, Hopewell, New Jersey.
Maiwenn J AlInstitute of Health Policy and Management and Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands.
Paul D AllisonUniversity of Pennsylvania, Philadelphia.
Maureen P M H Rutten-van MölkenInstitute of Health Policy and Management and Institute for Medical Technology Assessment, Erasmus University, Rotterdam, The Netherlands.
Michelle L FritsBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Christine K IannacconeBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Nancy A ShadickBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Michael E WeinblattBrigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Bristol-Myers Squibb (United States) · USBrigham and Women's Hospital · USErasmus University Rotterdam · NLHarvard University · USUniversity of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate associations between achieving guideline-recommended targets of disease activity, defined by the Disease Activity Score in 28 joints using C-reactive protein level (DAS28-CRP) <2.6, the Simplified Disease Activity Index (SDAI) ≤3.3, or the Clinical Disease Activity Index (CDAI) ≤2.8, and other health outcomes in a longitudinal observational study.

methodsOther defined thresholds included low disease activity (LDA), moderate (MDA), or severe disease activity (SDA). To control for intraclass correlation and estimate effects of independent variables on outcomes of the modified Health Assessment Questionnaire (M-HAQ), the EuroQol 5-domain (EQ-5D; a quality-of-life measure), hospitalization, and durable medical equipment (DME) use, we employed mixed models for continuous outcomes and generalized estimating equations for binary outcomes.

resultsAmong 1,297 subjects, achievement (versus nonachievement) of recommended disease targets was associated with enhanced physical functioning and lower health resource utilization. After controlling for baseline covariates, achievement of disease targets (versus LDA) was associated with significantly enhanced physical functioning based on SDAI ≤3.3 (ΔM-HAQ -0.047; P = 0.0100) and CDAI ≤2.8 (-0.073; P = 0.0003) but not DAS28-CRP <2.6 (-0.022; P = 0.1735). Target attainment was associated with significantly improved EQ-5D (0.022-0.096; P < 0.0030 versus LDA, MDA, or SDA). Patients achieving guideline-recommended disease targets were 36-45% less likely to be hospitalized (P < 0.0500) and 23-45% less likely to utilize DME (P < 0.0100).

conclusionAttaining recommended target disease-activity measures was associated with enhanced physical functioning and health-related quality of life. Some health outcomes were similar in subjects attaining guideline targets versus LDA. Achieving LDA is a worthy clinical objective in some patients.

Indexed as

Health StatusPractice Patterns, Physicians'Quality of LifeAdultAgedArthritis, RheumatoidBiomarkersBostonC-Reactive ProteinDisability EvaluationFemaleGuideline AdherenceHealth ResourcesHumansInflammation MediatorsLongitudinal StudiesBiomarkersC-Reactive ProteinInflammation Mediators

Identifiers

PMID26238974
PMCPMC5067571
OpenAlexW2322227699

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.