Skip Navigation



Rheumatology Advance Access published online on August 17, 2004
Rheumatology, doi:10.1093/rheumatology/keh372
Rheumatology © British Society for Rheumatology 2004; all rights reserved
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
43/12/1519    most recent
keh372v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Bunn, D. K.
Right arrow Articles by Symmons, D. P. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Bunn, D. K.
Right arrow Articles by Symmons, D. P. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Received January 4, 2004
Accepted July 13, 2004

Original Papers

The NOAR Damaged Joint Count (NOAR-DJC): a clinical measure for assessing articular damage in patients with early inflammatory polyarthritis including rheumatoid arthritis

D. K. Bunn 1*, L. Shepstone 2, L. M. Galpin 1, N. J. Wiles 3, D. P. M. Symmons 4

1 Norfolk Arthritis Register, Norfolk and Norwich University Hospital, Norwich, UK
2 School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK
3 Division of Psychiatry, University of Bristol, Bristol, UK
4 ARC Epidemiology Unit, University of Manchester, Manchester, UK

* To whom correspondence should be addressed. E-mail: diane{at}fs1.ser.man.ac.uk.


  Abstract

Objectives. To evaluate the reliability and validity of the Norfolk Arthritis Register Damaged Joint Count (NOAR-DJC) in patients with early inflammatory polyarthritis (IP).

Methods. The NOAR-DJC examines deformity in 51 joints. Deformity is defined as inability to adopt the anatomical position, reduction in range of movement by at least one-third, and/or surgical alteration of the joint. Reliability was investigated by assessing intra- and inter-observer agreement in 40 and 32 patients, respectively. Validity was assessed by correlating the NOAR-DJC with the eroded joint count (criterion validity), the Health Assessment Questionnaire (HAQ) (convergent construct validity) and tender and swollen joint counts (divergent construct validity) and by discriminating between those who did and did not satisfy criteria for rheumatoid arthritis (discriminant validity).

Results. The intraclass correlation coefficient for the intra- and inter-rater studies were 0.88 [95% confidence interval (CI) 0.79, 0.94, P<0.00001] and 0.74 (95% CI 0.53, 0.86, P<0.00001), respectively. Correlations with eroded joint counts and HAQ scores after 5 yr follow-up were rs = 0.42 (95% CI 0.35, 0.49, P<0.01) and rs = 0.45 (95% CI 0.4, 0.5, P<0.01), respectively. Correlations with tender and swollen joint counts were weak (rs = 0.28 and rs = 0.33).

Conclusion. The NOAR-DJC is a quick, reliable and valid tool for assessing articular damage in patients with early IP.

Keywords: Inflammatory polyarthritis; NOAR; Damaged Joint Count; Clinical assessment.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Rheumatology (Oxford)Home page
C. Morgan, M. Lunt, D. Bunn, D. G. I. Scott, and D. P. M. Symmons
Five-year outcome of a primary-care-based inception cohort of patients with inflammatory polyarthritis plus psoriasis
Rheumatology, December 1, 2007; 46(12): 1819 - 1823.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.