Extended report included a formal examination to count the number of swollen and tender joints, report of radiographic erosions, erythrocyte sedimentation rate (ESR) and rheumatoid factor (RF) positivity according to local reference values. Physicians reported the use of disease-modifying antirheumatic drugs (DMARD), including: (1) the interval between the first symptoms and the start of the first DMARD; (2) the number of DMARD ever used; (3) the use of methotrexate, oral glucocorticoids, biological agents and other DMARD and (4) the start and stop dates for each DMARD used. The total duration of DMARD therapy as a percentage of disease duration was computed. Patient self-report questionnaire measures Patients completed a 4-page self-report questionnaire, which included demographic data, physical function, pain, global estimate and psychological distress. Demographic data included date of birth, gender, years of formal education, race and smoking status, as well as weight and height, to calculate body mass index (BMI). A standard health assessment questionnaire (HAQ)14 assesses physical function in activities of daily living with four response categories: 0, without any difficulty; 1, with some difficulty; 2, with much difficulty; 3, unable to do. Visual analogue scales (0 = best to 10 = worst) were completed for pain and patient estimate of his/her global health (GH). Psychological distress was assessed as the capacity to cope with stress, anxiety and depression, queried and calculated in the HAQ format for psychological HAQ scored 0–3.15 Disease activity score The DAS2812 is the most widely used overall measure for RA disease activity, comprising two physical examination mea- sures, a swollen 28-joint count (SJC28) and a tender 28-joint count (TJC28); one laboratory measure, ESR; and one patient self-report measure, a global estimate of health status (GH). DAS28 ranges from 0 to 9.1 (low–high), calculated from the Table 1 Comparison of patient characteristics, RA disease activity measures and treatment-related variables in the QUEST–RA study in ‘‘high GDP’’ and ‘‘low GDP’’ countries N Patient characteristics Female, % Age, years, mean Education, years, median Smoking now, % BMI, mean Disease duration, years, mean Disease activity measures DAS28 (0–9.1), mean Physician SJC (0–28), median TJC (0–28), median Physician global (0–10), median Patient self-report HAQ physical function (0–3) median Pain VAS (0–10), median Patient global VAS (0–10), median Psychological HAQ (0–3), mean Laboratory/imaging ESR, median RF-positive, % Erosive disease, % In patients with disease duration (2 years In patients with disease duration >10 years Treatment-related variables Patients taking DMARD ever, % Delay to start a DMARD, months, median No of DMARD ever taken, mean Methotrexate ever, % of patients Methotrexate now, % of patients Prednisone ever, % of patients Prednisone now, % of patients Biologicals ever, % of patients Biologicals now, % of patients Any DMARD, % of disease duration Methotrexate, % of disease duration Biologicals, % of disease duration Total 6004 79% 56 11 17% 26 11 4.2 2 4 2.4 0.88 4.1 4.2 0.82 22 74% 63% 97% 9 2.7 85% 63% 71% 49% 23% 18% 72% 31% 3.9% ‘‘High GDP’’ countries 3719 ‘‘Low GDP’’ countries 2285 75% 58 11 19% 26 11 3.7 1 2 1.7 0.75 3.3 3.2 0.7 18 72% 58% 23% 79% 97% 9 2.8 86% 63% 66% 42% 31% 25% 75% 32% 5.6% 86% 54 11 14% 26 11 5.1 4 8 3.7 1.3 4.9 4.9 1.3 30 76% 72% 40% 84% 97% 9 2.5 84% 62% 80% 60% 9.4% 7.5% 67% 30% 1.8% p Value* ,0.001 ,0.001 0.16 ,0.001 0.63 0.038 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 ,0.001 0.001 ,0.001 ,0.001 0.001 0.75 0.063 ,0.001 ,0.001 0.36 ,0.001 ,0.001 ,0.001 ,0.001 0.085 0.18 0.001 *Unadjusted p values are presented. BMI, body mass index; DAS28, disease activity score in 28 joints; DMARD, disease-modifying antirheumatic drug; ESR, erythrocyte sedimentation rate; GDP, gross domestic product; HAQ, health assessment questionnaire; RA, rheumatoid arthritis; RF, rheumatoid factor; SJC, swollen joint count; TJC, tender joint count; VAS, visual analogue scale. Ann Rheum Dis 2009;68:1666–1672. doi:10.1136/ard.2009.109983 1667