The effectiveness of the clinical self-assessment (MHAQ) compared with other clinical and laboratory tests used to monitor the activity of rheumatoid arthritis by consensus analysis

Disease activity in rheumatoid arthritis (RA) is difficult to measure objectively. Both clinical and laboratory measures were evaluated by the statistical method of consensus analysis. In the literature, laboratory tests as a group have proved more effective; however, studies did not include self- assessment questionnaires. We evaluated the effectiveness of a Modified Health Assessment Questionnaire (MHAQ) relative to other clinical and laboratory tests measuring disease activity in 100 patients with RA. Hemoglobin, hematocrit, mean corpuscular volume, fibrinogen level, Westergren erythrocyte sedimentation rate and C-reactive protein tests, along with tests of morning stiffness, visual analog pain scale, Ritchie index, total joint count, and MHAQ, were evaluated simultaneously. The erythrocyte sedimentation rate was confirmed as a highly effective test to follow disease activity. The MHAQ was the best clinical test; in the methotrexate-treated subgroup it ranked as highly as the most effective laboratory assays. MHAQ is a more effective tool than many laboratory tests currently ordered for monitoring RA disease activity and should be a part of the record of each visit of an arthritis patient.