{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:28:22Z","timestamp":1759422502238,"version":"3.40.5"},"reference-count":34,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T00:00:00Z","timestamp":1656288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Discordance between patient global assessment (PGA) and physician global assessment (PhGA) of rheumatoid arthritis (RA) disease activity is mainly determined by pain and functional disabilities. This study aimed to investigate the shift in PGA\u2010PhGA discordance and the variables associated with future positive discordance (PGA &gt; PhGA) based on the <jats:italic>NinJa<\/jats:italic> database in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined 7557 adults with RA registered in both <jats:italic>NinJa<\/jats:italic> 2014 and 2018, with a discordance cutoff of 3 on a 10\u2010cm scale. The affected joint distribution was investigated using the joint indices <jats:italic>x<\/jats:italic>, <jats:italic>y<\/jats:italic>, and <jats:italic>z<\/jats:italic>, which were calculated as indices for the upper joint, lower joint, and large joint involvement, respectively. The variables in <jats:italic>NinJa<\/jats:italic> 2014 that were associated with positive discordance in <jats:italic>NinJa<\/jats:italic> 2018 were examined using binary stepwise logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Due to the small number of patients with RA categorized as having negative discordance (PGA &lt; PhGA), we focused on patients with RA categorized as having either concordance or positive discordance. Logistic regression analysis revealed that positive discordance in <jats:italic>NinJa<\/jats:italic> 2018 was associated with age, pain, modified Health Assessment Questionnaire (mHAQ) score, corticosteroid use, and existent positive discordance and was inversely associated with C\u2010reactive protein (CRP) and <jats:italic>x<\/jats:italic> at baseline (<jats:italic>NinJa<\/jats:italic> 2014). The same findings were observed when patients with RA were divided based on the discordance status at baseline. Persistence (positive discordance to positive discordance) was associated with pain and mHAQ scores but inversely associated with CRP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Positive discordance may persist. Circumventing this requires adequate management of pain and functional impairment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.14374","type":"journal-article","created":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T07:14:28Z","timestamp":1656314068000},"page":"1020-1028","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical variables, including novel joint index, associated with future patient\u2010physician discordance in global assessment of rheumatoid arthritis (<scp>RA<\/scp>) disease activity based on a large <scp>RA<\/scp> database in Japan"],"prefix":"10.1111","volume":"25","author":[{"given":"Yusuke","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Department of Rheumatology Tokyo Medical University Hospital  Tokyo 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