{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T22:13:51Z","timestamp":1765232031026},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,2,4]],"date-time":"2013-02-04T00:00:00Z","timestamp":1359936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The Disease Activity Score in 28 joints (DAS28) is a key measure in clinical practice and clinical trials. There are at least five different versions of the \u2018Patient Global\u2019 Visual Analogue Scale (PG\u2010VAS) being used in the DAS28. The developers suggested that the PG\u2010VAS can be an assessment of global health or disease activity, but did not specify the wording of the question. There is no consensus on what the PG\u2010VAS is intended to capture, and the different words and phrases have not been evaluated. The aim of this study was to test if phrasing affects PG\u2010VAS scores and hence yields different results for the DAS28.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty patients with rheumatoid arthritis taking biologic agents in a rheumatology outpatient department completed a self\u2010administered questionnaire containing five versions of the 100\u2009mm PG\u2010VAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All PG\u2010VAS versions correlated strongly with each other (rho\u2009=\u20090.67\u20130.87, p\u2009&lt;\u20090.0001). However, individual scores for each PG\u2010VAS, when compared with the comparator on a Bland\u2013Altman chart had wide limits of agreement\u2014the largest being \u221242\u2009mm to +45\u2009mm. The five overall DAS28 scores were calculated for each patient using the five different PG\u2010VAS. The largest difference in DAS28 scores was 0.63.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Different phrasing of the PG\u2010VAS gives different DAS28 results. As the DAS28 is a key outcome measure, such differences have the potential to influence clinical decisions relating to eligibility for biologic agents and evaluation of new therapies. We urgently need to decide on the concept to be measured and the phrasing required to capture this. The PG\u2010VAS phrasing should then be standardized and validated. Copyright \u00a9 2013 John Wiley &amp; Sons, Ltd. 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