ArticlePloS one2020
Discordance between the patient's and physician's global assessment in rheumatoid arthritis: Data from the REAL study-Brazil.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Remission definitions guiding immunosuppressive therapy in rheumatoid arthritis: which is best fitted for the purpose?RMD open · 2024Pooled it
- Understanding patient-reported disease burden in systemic sclerosis: key clinical and demographic features revealed by the EULAR Systemic Sclerosis Impact of Disease (ScleroID) Questionnaire.EULAR rheumatology open · 2026Article
- Disturbances in Central Sensitization Are Associated with Disease Severity and Alterations in Gene Expression Measured in the Peripheral Blood Mononuclear Cells of Patients with Rheumatoid Arthritis.International journal of molecular sciences · 2026Article
- Association between patient's psychological health and discordance in patient-physician assessment of psoriatic arthritis.Clinical rheumatology · 2025Article
- Prevalence and Factors Associated With Patient-Clinician Discordance Among Patients With Rheumatoid Arthritis Initiating Advanced Therapy.ACR open rheumatology · 2024Article
- Predictors of serious infections in rheumatoid arthritis-a prospective Brazilian cohort.Advances in rheumatology (London, England) · 2024Observational
- Reliability, validity, and simplification of the Chinese version of the Global Pain Scale in patients with rheumatoid arthritis.BMC nursing · 2024Article
- Review
- Disease activity and disease-related factors are drivers of patient global assessment in rheumatoid arthritis: a real-life cross-sectional study.Rheumatology international · 2023Article
- Profiling of plasma extracellular vesicles identifies proteins that strongly associate with patient's global assessment of disease activity in rheumatoid arthritis.Frontiers in medicine · 2023Article
- Neuronal CRMP2 phosphorylation inhibition by the flavonoid, naringenin, contributes to the reversal of spinal sensitization and arthritic pain improvement.Arthritis research & therapy · 2022Article
- Article
- Chronic Pain in Patients with Rheumatoid Arthritis.Current pain and headache reports · 2021Review
- Patient Reported Outcomes in Chronic Inflammatory Diseases: Current State, Limitations and Perspectives.Frontiers in immunology · 2021Review
- Pain Mechanism in Rheumatoid Arthritis: From Cytokines to Central Sensitization.Mediators of inflammation · 2020Review
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Authors and funding
26 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiscordance between patient's global assessment (PtGA) and physician's global assessment (PhGA) has been described in rheumatoid arthritis (RA). Understanding the reasons for this discrepancy is important in the context of treat-to-target treatment strategy.
objectiveTo assess the determinants of PtGA and PhGA and factors associated with discordance between them.
methodsThe REAL study included RA patients from Brazilian public health centers. Clinical, laboratory and outcomes measures were collected. PtGA and the PhGA were rated on a visual analog scale and analyzed. Three groups were defined: no discordance (difference between PtGA and PhGA within 3 cm), positive discordance (PtGA exceeding PhGA by >3 cm), and negative discordance (PtGA less than PhGA by >3 cm). Multivariate regression analysis was used to identify determinants of PtGA and PhGA and their discordance.
results1115 patients (89,4% female, mean age 56.7y and median disease duration of 12.7y) were enrolled. Two factors were associated with PtGA in the final multivariate model: one point increase in the pain scale leads to an increase of 0.62 in PtGA; one point increase in HAQ increases by 9,25 points the PtGA. The factors associated with PhGA were pain scale, number of tender and swollen joints (NTJ and NSJ), positive RF, ESR, HAQ-DI and use of corticosteroids. Discordance between patient and physician was found in 30.52%: positive discordance in 24.6% and negative discordance in 5.92%. An increase of one point in the NSJ was associated with a 12% increase in the chance of negative discordance. The chance of positive discordance increased by 90% and 2% for each unit increased in HAQ-DI and pain scale respectively. Finally, the chance of positive discordance decreased by 3% for each point increased in NTJ and by 15% for each point increased in NSJ.
conclusionIn one-third of the assessments, there was disagreement between PtGA and PhGA (a positive discordance was found in 80% of them). Pain and function were determinants for patients to estimate disease activity, while swollen joints was the main factor related to a worse physician's evaluation. These data show how different can be the perspectives of patients and assistants.
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