Alternative Ways to Quantify Sustained Remission: Applying the Continuity Rewarded Score and Patient Vector Graph

Arthritis Care Res (Hoboken). 2015 Oct;67(10):1471-4. doi: 10.1002/acr.22565.

Abstract

Objective: Although the Computer Assisted Management in Early Rheumatoid Arthritis Trial-II (CAMERA-II) showed favorable clinical effects in the most intensive methotrexate (MTX)-based strategy with prednisone (MTX ± prednisone) compared to that with placebo (MTX + placebo), this beneficial difference was only seen in 1 of the 3 analyses of remission. Our objective was to investigate whether the Continuity Rewarded (ConRew) score and a simple sum score would better reveal differences regarding remission between the 2 treatment arms of CAMERA-II. Furthermore, we investigated whether the patient vector graph, which plots on patient level, would add visual information on remission compared to a conventional box plot only, which displays data on the group level.

Methods: The ConRew method, which awards continuous periods of remission with a higher score, was applied, in addition to a simple sum score of remission periods of 4 weeks. A patient vector graph was compared with box plots.

Results: Both the mean ± SD simple sum score and the ConRew score of remission were significantly higher (favorable) in the MTX + prednisone strategy group versus the MTX + placebo group, respectively: 9 ± 7 versus 12 ± 8; P = 0.003, and 23 ± 16 versus 17 ± 14; P = 0.004. The patient vector graphs show a visual pattern of more and longer periods of remission in the MTX + prednisone strategy and visually add information to the box plots.

Conclusion: The simple sum of remission periods, the ConRew score, and the patient vector graph add understanding and discrimination to the analysis of the remission outcome in CAMERA-II.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / physiopathology*
  • Data Display / statistics & numerical data*
  • Data Interpretation, Statistical
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Methotrexate / administration & dosage*
  • Middle Aged
  • Pain Measurement*
  • Prednisone / administration & dosage*
  • Prognosis
  • Remission Induction
  • Risk Assessment
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

Substances

  • Prednisone
  • Methotrexate