{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:28:58Z","timestamp":1792632538699,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,11,11]],"date-time":"2019-11-11T00:00:00Z","timestamp":1573430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006518","name":"University of Nebraska Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006518","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006260","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["1U54\u2010GM\u2010115458"],"award-info":[{"award-number":["1U54\u2010GM\u2010115458"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["AR\u2010064172"],"award-info":[{"award-number":["AR\u2010064172"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["1U54\u2010GM\u2010115458"],"award-info":[{"award-number":["1U54\u2010GM\u2010115458"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To provide updated American College of Rheumatology (<jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content>) recommendations on rheumatoid arthritis (RA) disease activity measurements to facilitate a treat\u2010to\u2010target approach in routine clinical care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A working group conducted a systematic literature review from the time of the prior <jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content> recommendations literature search. Properties of disease activity measures were abstracted, and study quality was assessed using the Consensus\u2010Based Standards for the selection of Health Measurement Instruments 4\u2010point scoring method, allowing for overall level of evidence assessment. Measures that fulfilled a minimum standard were identified, and through a modified Delphi process preferred measures were selected for regular use in most clinic settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search identified 5,199 articles, of which 110 were included in the review. This search identified 46 <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> disease activity measures that contained patient, provider, laboratory, and\/or imaging data. Descriptions of the measures, properties, study quality, level of evidence, and feasibility were abstracted and scored. Following a modified Delphi process, 11 measures fulfilled a minimum standard for regular use in most clinic settings, and 5 measures were recommended: the Disease Activity Score in 28 Joints with Erythrocyte Sedimentation Rate or C\u2010Reactive Protein Level, Clinical Disease Activity Index, Simplified Disease Activity Index, Routine Assessment of Patient Index Data 3, and Patient Activity Scale\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We have updated prior <jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content> recommendations for preferred <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> disease activity measures, identifying 11 measures that met a minimum standard for regular use and 5 measures that were preferred for regular use in most clinic 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