OBJECTIVE: Few longitudinal data exist on the relationship between radiographic damage and self-reported functional disability and direct medical costs in @entity309 ( @entity309 ). We assessed these relationships. METHODS: One hundred thirty @entity1 with @entity309 (at time of the first available radiograph, mean age 56.6 yrs, 16.9% male, mean disease duration 16.8 yrs) were followed for up to 13.4 years. Semiannually, they reported on functional disability (0 = no difficulty, 3 = unable to do), global severity (0 = very well, 100 = very poor), @entity158 (0 = no @entity158 , 3 = severe @entity158 ), and health services utilization through completion of the Stanford @entity283 ( @entity283 ). Concurrent hand radiographs were scored for erosions and joint space narrowing using the Genant method and a single score summing both erosions and joint space narrowing for both hands was calculated (0 = no damage, 200 = maximum damage). The univariate association of functional disability, global severity, @entity158 , or direct medical costs with concurrent radiographic damage was assessed through Spearman correlations and @entity2357 models. The hierarchical models permit exploitation of the between- @entity1 and within- @entity1 variation present in our longitudinal data. RESULTS: At the time of the first available radiograph, mean (SD) levels of functional disability, global severity, and @entity158 were 1.3 (0.7), 39.4 (21.0), and 1.1 (0.7), respectively. At entry into the study, the average radiograph score was 49.7 and upon leaving the study it was 66.9. @entity1 were followed an average of 6.7 years, with radiograph scores increasing at an average rate of 2.5 units/yr. The Spearman correlation [95% confidence interval (CI)] between average per- @entity1 radiograph score and average per- @entity1 @entity283 disability index, average per- @entity1 global severity, average per- @entity1 @entity158 score, and average per- @entity1 direct medical costs was, respectively, 0.42 (0.26, 0.55), 0.23 (0.06, 0.39), 0.20 (0.03, 0.36), and 0.06 (-0.11, 0.23). The mean slope (95% CI) for disability on radiograph score was 0.0186 (0.0132, 0.0226), for severity on radiographs 0.1889 (0.1295, 0.2498), and for @entity158 on radiographs 0.0057 (0.0027, 0.0084). As an example, over 10 years, a 25 unit (i.e., 50%) increase in radiograph scores would, on average, be associated with a 0.46 unit (i.e., 35%) increase in disability, a 4.72 unit (12%) increase in global severity score, and a 0.14 unit (13%) increase in @entity158 , all expressed on the @entity283 scales. There was little association between radiograph score and direct medical costs. CONCLUSION: A clinically meaningful association exists between radiographic damage and self-reported functional disability, suggesting that interventions that slow radiographic progression may improve the @entity1 's health status. Such a relationship was not observed between radiographic damage and direct medical costs.

Radiographic damage in XXXX correlates with functional disability but not direct medical costs.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity283 :: ('OMIM:603663', 'Disease') :: ['HAQ', 'Health Assessment Questionnaire'] @entity2357 :: ('MESH:C537770', 'Disease') :: ['hierarchical regression'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity309 :: ('MESH:D001172', 'Disease') :: ['rheumatoid arthritis', 'RA']
@entity309 :: (MESH:D001172,Disease) :: ['rheumatoid arthritis']
