The Validity and Sensitivity of Rheumatoid Arthritis Pain Scale on a Different Ethnic Group From Indian Rheumatoid Arthritis Patients

Objectives: This study aims to assess pain in rheumatoid arthritis (RA) patients by using Rheumatoid Arthritis Pain Scale (RAPS) and to find its correlation with Disease Activity Score 28 (DAS28) and Clinical Disease Activity Index (CDAI). Patients and methods: The study included 100 RA patients (23 males, 77 females; mean age 43.22 years; range, 19 to 72 years) who were subjected to RAPS questionnaire for pain assessment and DAS28 and CDAI for disease activity assessment. Spearman’s correlation coefficient was measured to assess the correlation of RAPS with DAS28 and CDAI. Cronbach’s alpha (α) was also measured for each scale to assess reliability. Results: The study group had a female to male ratio of 3.34:1. Mean values for RAPS, DAS28 and CDAI were 62.91, 5.59, and 25.24, respectively. RAPS was correlated with DAS28 and CDAI with correlation coefficients of 0.811 and 0.770, respectively. Cronbach’s α for RAPS, DAS28 and CDAI were 0.892, 0.814, and 0.833, respectively. Conclusion: Rheumatoid Arthritis Pain Scale had a strong positive correlation with disease activity measures of DAS28 and CDAI. RAPS also showed good correlation with core data set measures hence merits its place in clinical practice.


1. Bichile L. Clinical features and organ involvement in RA. In: Rao URK, Mahendranath KM, Misra R, Handa R, Chaturvedi V, Krishnamurthy V, editors. Manual of Rheumatology. 4th ed. Mumbai: Indian Rheumatology Association; 2014. p. 176-84.

2. Anderson KO, Bradley LA, Turner RA, Agudelo CA, Pisko EJ. Pain behavior of rheumatoid arthritis patients enrolled in experimental drug trials. Arthritis Care Res 1994;7:64-8.

3. Skevington SM. Psychological aspects of pain in rheumatoid arthritis: a review. Soc Sci Med 1986;23:567-75.

4. Buckelew SP, Parker JC. Coping with arthritis pain. A review of the literature. Arthritis Care Res 1989;2:136-45.

5. Anderson DL. Development of an instrument to measure pain in rheumatoid arthritis: Rheumatoid Arthritis Pain Scale (RAPS). Arthritis Rheum 2001;45:317-23.

6. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-24.

7. Pincus T, Sokka T. Quantitative clinical assessment in busy rheumatology settings: the value of short patient questionnaires. J Rheumatol 2008;35:1235-7.

8. Pisetsky DS, McCleane G. Pain in rheumatoid arthritis and osteoarthritis. In: Argoff CE, McCleane G, editors. Pain management secrets. 3rd ed. New York: Elsevier; 2009. p. 170-83.

9. Burckhardt CS, Jones KD. Adult measures of pain: The McGill Pain Questionnaire (MPQ), Rheumatoid Arthritis Pain Scale (RAPS), Short-Form McGill Pain Questionnaire (SF-MPQ), Verbal Descriptive Scale (VDS), Visual Analog Scale (VAS), and West Haven- Yale Multidisciplinary Pain Inventory (WHYMPI). Arthritis Rheum 2003;49:S96-104.

10. Sim, J and Waterfield, J. Validity, reliability and responsiveness in the assessment of pain. Physiotherapy Theory and Practice 1997;13:23-37.

11. Kianifard T, Kianyfard T, Chopra A. Validation and relevance of Rheumatoid Arthritis Pain Scale (RAPS) in Indian (Asian) patients suffering from rheumatoid arthritis. Clin Rheumatol 2016;35:63-71.

12. Leeb BF, Andel I, Sautner J, Nothnagl T, Rintelen B. The DAS28 in rheumatoid arthritis and fibromyalgia patients. Rheumatology (Oxford) 2004;43:1504-7.

Kaynak Göster

350 141