Understanding patient and physician global assessments in rheumatoid arthritis: A meta-epidemiological study of core outcome set performance
Pooled result · Treatment effect on global assessment (SMD vs placebo)Result — go to the resultΔSMDGlobal −0.09 95% CI −0.12 to −0.05Authors' conclusion
Targeted therapies show larger improvements in physician-assessed outcomes than on patient-reported outcomes, largely driven by SJC. Pain remains a distinct determinant of patient assessments
Study context
- Population
- RA patients in double-blind randomised controlled trials (RCTs) comparing targeted therapies with placebo73 double-blind RCTs (165 comparisons)
- Participants
- 33,956 patients
- Comparison
- Physician global assessment vs patient global assessment improvements with targeted therapies vs placebo
- Outcome
- Agreement between physician and patient global assessments: ΔSMD Global (SMD physician global assessment − SMD patient global assessment)
Methodological detailsmultivariate meta-analysis, multiple imputation, meta-regression
- Multivariate meta-analysis
- Multiple imputation
- Meta-regression
Pooled result
As reported in the abstract
Treatment effect on global assessment (SMD vs placebo)
ΔSMDGlobal
−0.09
95% CI −0.12 to −0.05
By group
Physician global assessment
−0.60
SMD · 95% CI −0.65–-0.55
Patient global assessment
−0.50
SMD · 95% CI −0.54–-0.46
Physician global assessmentvs Patient global assessment
ΔSMDGlobal −0.09 (95% CI −0.12 to −0.05)
Further pooled results
Domain-level predictors (univariable meta-regression)
- Disability, Tender joint count (TJC) and Swollen joint count (SJC) strongest associations of both assessments
- SJC the only domain significantly associated with ΔSMDGlobal
- Pain independently associated only with patient global assessment
Original publication
Understanding patient and physician global assessments in rheumatoid arthritis: A meta-epidemiological study of core outcome set performance. Semin Arthritis Rheum. Published 14 June 2026. doi:10.
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