Disease activity measurement in rheumatoid arthritis: comparison of 3 disease activity index tools at Kenyatta National Hospital

  • KM Ndirangu
  • GM Oyoo
  • KM Bhatt
  • CS Ilovi


Objectives: To compare the congruence of the Disease Activity Score with 28-joint count (DAS-28) with the Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) in measuring disease activity in Rheumatoid Arthritis (RA) patients at the Kenyatta National Hospital (KNH).
Design: Cross-sectional descriptive study.
Setting: Rheumatology Out-Patient Clinic (ROPC) at KNH.
Subjects: One hundred and four patients who fulfilled the 2012 American College of Rheumatology Classification Criteria for RA.
Results: DAS28, SDAI and CDAI were significantly correlated with each other on a group level (p < 0.001). Internal consistency was highest for CDAI (alpha = 0.705) and lowest for DAS28 (alpha = 0.67). Kappa statistics revealed substantial degree of agreement with respect to controlled, active, moderate and high disease activity categories according to the three scores.
Conclusion: Both SDAI and CDAI proved to be in congruence with DAS28 in daily clinical routine. SDAI and CDAI were found to be more stringent in defining remission.


Journal Identifiers

print ISSN: 2307-2482