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INFLAMMATORY ARTHRITIS DATA COLLECTION Version 1.0.0 Revised: April 27 th, 2018 www.ichom.org Notice: This work was conducted using resources from ICHOM, the International Consortium for Health Outcomes Measurement (www.ICHOM.org). The content is solely the responsibility of the authors and does not necessarily represent the official views of ICHOM. Conditions: Rheumatoid Arthritis | Psoriatic Arthritis | Ankylosing Spondylitis | Juvenile Idiopathic Arthritis This ODM-file contains Clinical Variables to be administered at baseline visit and (a large number of the variables) annually. The following scores are the ones that are integrated into the standard set. There are alternatives for each category: see questionnaire or data collection guide. PAIN: - Numerical Rating Scale (Adult/Paediatric) FATIGUE - Numerical rating Scale (Adult/Paediatric) ACTIVITY LIMITATION: - HAQ-II* (Adult): copyright FORWARD-The National Data Bank for Rheumatic Diseases, arthritis-research.org ; http://bit.ly/HAQIIIA ; Wolfe F, Michaud K, Pincus T. Development and validation of the health assessment questionnaire II: a revised version of the health assessment questionnaire. Arthritis & Rheumatism. 2004;50(10):3296-305. OVERALL EMOTIONAL AND PHYSICAL HEALTH IMPACT - Numerical rating scale (Adult/Paediatric) WORK/SCHOOL/HOUSEWORK ABILITY AND PRODUCTIVITY: - WPAI (Adult): reillyassociates.net/WPAI_General.html, they ask to inform them about publication or presentation of WPAI-data ICHOM was supported for the Inflammatory Arthritis Standard Set by Santeon, Arthritis Research UK, TiH Transparency in Healthcare, Maasstad Ziekenhuis, Karolinska Universitetssjukhuset and Sheba Academic Medical Center Hospital. Publication: Oude Voshaar MAH, Das Gupta Z, Bijlsma JWJ, et al. International Consortium for Health Outcome Measurement Set of Outcomes That Matter to People Living With Inflammatory Arthritis: Consensus From an International Working Group. Arthritis Care Res (Hoboken). 2019;71(12):1556‐1565. doi:10.1002/acr.23799 For this version of the standard set, semantic annotation with UMLS CUIs has been added.

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Versions (2) ▾
  1. 9/21/18
  2. 4/30/20
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ICHOM
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April 30, 2020

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ICHOM Inflammatory Arthritis

Baseline and Annual Clinical Form

Administrative Data
Baseline Condition Factors
Indicate whether the patient has hypertension and/or uses antihypertensive medication
Indicate whether the patient has had a myocardial infarction
Indicate whether the patient has had a stroke (excluding transient ischemic attacks)
Indicate whether the patient has any other heart disease
Indicate whether the patient has chronic lung disease
Indicate whether the patient has diabetes mellitus
Indicate whether the patient has any malignancies
Indicate whether the patient has depression
Indicate whether the patient has a fracture
Indicate whether the patient has stomach ulcers
Indicate whether the patient has stomach problems
Indicate whether the patient is obese
Indicate the current diagnosis/diagnoses of inflammatory arthritis 1 = Rheumatoid arthritis
Indicate the current diagnosis/diagnoses of inflammatory arthritis 2 = Spondyloarthritis
Indicate the current diagnosis/diagnoses of inflammatory arthritis 3 = Psoriatic arthritis
Indicate the current diagnosis/diagnoses of inflammatory arthritis 4 = Juvenile idiopathic arthritis
YYYY
Indicate the presence of rheumatoid factor
Indicate the presence of anti-citrullinated protein antibodies (ACPA)
Treatment-Specific
Has the patient suffered from any serious adverse events in the past 12 months?
Which serious adverse event(s) has the patient suffered from in the past 12 months? 1 = Death
Which serious adverse event(s) has the patient suffered from in the past 12 months? 2 = Life-threatening
Which serious adverse event(s) has the patient suffered from in the past 12 months? 3 = Hospitalization
Which serious adverse event(s) has the patient suffered from in the past 12 months? 4 = Disability or permanent damage
Which serious adverse event(s) has the patient suffered from in the past 12 months? 5 = Congenital anomaly/birth defect
Which serious adverse event(s) has the patient suffered from in the past 12 months? 6 = Required intervention to prevent permanent impairment or damage
Which serious adverse event(s) has the patient suffered from in the past 12 months? 7 = Other serious (important medical events)
What was the disease activity target?
Was the disease activity target reached?