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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

    Disease Activity Score-28 for Rheumatoid Arthritis with CRP (DAS28-CRP)

    Describes severity of rheumatoid arthritis using clinical and laboratory data, specifically CRP.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with confirmed rheumatoid arthritis.

    • The DAS Scores indicate how active a patient’s rheumatoid arthritis (RA) is currently, and can be trended over time.
    • They were initially developed for comparing clinical trial results of RA drugs, but are now used as overall markers of disease activity.
    • Recently a “treat to target” approach has been recommended: that a DAS score be frequently calculated until a patient’s score suggests disease remission, or to a particular ESR or CRP level.
    • The DAS scores were simplified, previously using 44 joints for assessment, and now instead use 28.

    Points to Keep In Mind:

    • There is some degree of inter-rater variability in assessing the DAS scores, as different raters may classify a joint as swollen or tender to different degrees.
    • The feet are not assessed in the DAS28 scores, since foot joint pains may be unrelated to RA activity (since we walk on our feet). Foot assessment, however, should still be considered in the patient’s broader gestalt, and foot complaints should obviously be considered and managed appropriately in RA patients.

    Recently a “treat to target” approach has been recommended: that a DAS score be calculated at frequent intervals while therapies are being given, until a patient’s score suggests disease remission, or to a particular ESR or CRP level.

    joints
    joints
    mg/L
    0.0 - Very Well
    0
    0.5
    +0.5
    1.0
    +1
    1.5
    +1.5
    2.0
    +2
    2.5
    +2.5
    3.0
    +3
    3.5
    +3.5
    4.0
    +4
    4.5
    +4.5
    5.0
    +5
    5.5
    +5.5
    6.0
    +6
    6.5
    +6.5
    7.0
    +7
    7.5
    +7.5
    8.0
    +8
    8.5
    +8.5
    9.0
    +9
    9.5
    +9.5
    10.0 - Very Poor
    +10

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Jaap Fransen

    About the Creator

    Jaap Fransen, MD, is a senior researcher in rheumatology and professor of clinical research at the Radboud University Medical Center Nijmegen, the Netherlands. His research focuses on improving prognostication and treatment for rheumatic diseases including rheumatoid arthritis, psoriatic arthritis, gout and systemic sclerosis.

    To view Dr. Jaap Fransen's publications, visit PubMed

    Are you Dr. Jaap Fransen? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Jaap Fransen
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