NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
SECTION 1 : PATIENT DETAILS & DEMOGRAPHICS
a source data provider (SDP) by the Registry manager and / or the steering committee for the purpose of reporting to central data coordinator.
admission OR the date Source Data Provider (SDP) was informed/ notify of this admission
rheumatologist based on patient's recollection or medical record
SECTION 1 : PATIENT DETAILS & DEMOGRAPHICS
Name of the patient as registered in the
MyKad or the applicable legal identification documents in CAPITAL LETTER and in FULLThis data element is collected for unique identification of patient records and records matching
The numbering of the individual MyKad utilizes a 12-digit numbering system (usual format: YYMMDD-BP-###G) known as the Identification Card number (IC) is issued to MyKad holders.
Specify document type (if To record what type of document was
2:Passport; 3:Birth certificate; 4:Mother's I/C; 5:Father's I/C; 6:Armed Force ID; 7:Work Permit; 8:Drivers License; 9:Hospital RN; 10:Date of Birth; 11:Lab number; 12:Patient ID; 13:Police ID Card; 14:Unregistered; 99:Others; 8888: Not available; 9999:Missing
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
where the patient resides / Patient's Current AddressSDP / Central registries carry out follow-up by contacting the patients by a letter or telephone calls to ascertain their vital status (especially for patients who are lost to follow up) . The most current reported address and telephone number are needed
The patient’s city (or township, or village)
02:Kedah Darul Aman03:Kelantan Darul Naim04:Melaka05:Negeri Sembilan Darul Khusus06:Pahang Darul Makmur07:Perak Darul Ridzuan08:Perlis Indera Kayangan09:Pulau Pinang10:Sabah11:Sarawak12:Selangor Darul Ehsan13:Terengganu Darul Iman14:Wilayah Persekutuan (Kuala Lumpur)15:Wilayah Persekutuan (Labuan)16:Wilayah Persekutuan (Putrajaya)9999:Missing
Note: 'Gender ' is not synonymous with 'Sex'. The terms ‘sex’ refers to biological differences between males and females, while the term gender refers to the social aspect of sex and expected and perceived behaviour associated with males and females - masculinity and femininity.
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
matrimony. Classify common law marriage as married. Includes married couples living together and not living together. Never Married: A person who has never been married or whose only marriages have been annulled. Widowed: A person who is no longer married because of the death of his/her spouse and has not remarried.
If date of birth is not known, provision
should be made to collect age (in years) and a date of birth derived from age. (if exact date is not known, please enter 01/07/yyyy)
calculated). Age is calculated as the Date of Notification / Date of Admission - Patient's Birth Date
class on the basis of certain distinctive
6:Melanau; 7:Murut; 8:Bajau; 9:Bidayuh; 10:Iban; 11:Orang Ulu; 13: Punjabi;99 Other Malaysian, specify; 88: Foreigner, specify country of origin; 8888:Not applicable/Unknown; 9999:Missing
include those of, inter alia, European, Middle Eastern, Cambodian, Thai and Vietnamese descent and some Portuguese.
Foreigner, specify country Patients who are not a the citizens of
Malaysia, specify the coutry of birth or origin
SECTION 2 : NEXT OF KIN, EDUCATION, OCCUPATION
Patient's closest living blood relative or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
kin. To enable the SDP / Central registries carry out follow-up by contacting the patients by a letter or telephone calls to ascertain their vital status (especially for patients who arelost to follow up)
The relationship to the patient. Indicate
2: Spouse; 3: Children; 4: Siblings; 5: Cousins; 99: Other, specify; 8888: Not available;9999: Missing
-Primary school consists of six years of
-Secondary schools offer education for a 8888:Not Availabletotal of five years, starting with Form 1
and finishing at Form 5. -Tertiary education including completed education in the public universities or attended private institutions of higher learning. This category also includes the pre- university - Form 6 or the matriculation . The category includes Postgraduate degrees-Nil if patient did not receive any formal education or completed primary education
2: Retired; 3:Retrenched; 4:Part-time; 5:Unemployed; 6: Homemaker;8888: Not available; 9999: Missing
unemployed or part-time was Due to disease
unemployed or part-time was Due to family circumstances
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
The International Standard Classification managers; of Occupations is an International
Labour Organization (ILO) classification
Legislators, senior government officials,
traditional chiefs and heads of villages,
managers, other department managers, 8:Skilled agricultural, general managers.
optical and electronic equipment operators, ship and aircraft controllers and technicians, safety and quality inspectors -Life science and health associate professionals, i.e - life science technicians and related associate professionals, modern health associate professionals (except nursing), nursing and midwifery associate professionals, traditional medicine practitioners and faith healers, teaching associate professionals, primary education teaching associate professionals, pre-primary education teaching associate professionals, special education teaching associate professionals, other teaching associate professionals -Other associate professionals, i.e - finance and sales associate professionals, business services agents and trade brokers, administrative associate professionals, customs, tax and related government associate professionals, police inspectors and detectives, social work associate professionals, artistic, entertainment and sports associate professionals, religious associate professionals.
Service workers, shop and market sales workers: Personal and protective services workers, i.e - travel attendants and related workers, housekeeping and restaurant services workers, personal care and related workers, other personal services workers, astrologers, fortune-tellers and related workers, protective services workers. -Models, salespersons and demonstrators, i.e - fashion and other models, shop salespersons and demonstrators, stall and market salespersons.
Craft and related trades workers: Extraction and building trades workers , i.e -miners, shotfirers, stone cutters and carvers, building frame and related trades workers, building finishers and related trades workers, painters, building structure cleaners and related trades workers -Metal, machinery and
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
related trades workers, i.e - metal moulders, welders, sheet-metal workers, structural- metal preparers, and related trades workers, blacksmiths, tool-makers and related trades workers, machinery mechanics and fitters, electrical and electronic equipment mechanics and fitters -Precision, handicraft, printing and related trades workers, i.e - precision workers in metal and related materials, potters, glass-makers and related trades workers, handicraft workers in wood,textile, leather and related materials, printing and related trades workers -Other craft and related trades workers, i.e - food processing and related trades workers, wood treaters, cabinet-makers and related trades workers, textile, garment and related trades workers, pelt, leather and shoemaking trades workers.
Elementary occupations: Sales and services elementary occupations, i.e-street vendors and related workers, shoe cleaning and other street services elementary occupations, domestic and related helpers, cleaners and launderers, building caretakers, window and related cleaners, messengers, porters, doorkeepers and related workers, garbage collectors and related labourers -Agricultural, fishery and related labourers, i.e agricultural, fishery and related labourers, labourers in mining, construction, manufacturing and transport, mining and construction labourers, manufacturing labourers, transport labourers and freight handlers.
Professionals: This category includes the following:- Physical, mathematical and engineering science professionals, i.e.- physicists, chemists and related professionals, mathematicians, statisticians and related professionals, computing professionals, architects, engineers and related professionals. -Life science and health professionals, i.e: life science professionals, health professionals (except nursing), nursing and midwifery professionals. -Teaching professionals – i.e- college, university and higher education teaching professionals, secondary education teaching professionals, primary and pre-primary education teaching professionals, special education teaching professionals, other teaching professionals. -And Other professionals, i.e - business professionals, legal professionals, archivists, librarians and related information professionals, social science and related professionals, writers and creative or performing artists, religious professionals.
Clerical workers: Office clerks, i.e - secretaries and keyboard-operating clerks, numerical clerks, material-
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
recording and transport clerks, library, mail and related clerks, other office clerks -Customer services clerks, i.e - cashiers, tellers and related clerks, client information clerks.
Skilled agricultural, fishery workers: Market-oriented skilled agricultural and fishery workers, i.e - market gardeners and crop growers, market-oriented animal producers and related workers, market-oriented crop and animal producers, forestry and related workers, fishery workers, hunters and trappers -Subsistence agricultural and fishery workers.
Plant and machine operators and assemblers: Stationary-plant and related operators, i.e - mining- and mineral-processing-plant operators, metal-processing-plant operators, glass, ceramics and related plant operators, wood-processing- and papermaking-plant operators, chemical-processing-plant operators, power-production and related plant operators, automated-assembly-line and industrial-robot operators -Machine operators and assemblers, i.e - metal- and mineral-products machine operators, chemical-products machine operators, rubber- and plastic-products machine operators, wood-products machine operators, printing-, binding- and paper-products machine operators, textile-, fur- and leather-products machine operators, food and related products machine operators, assemblers, other machine operators and assemblers -Drivers and mobile-plant operators, i.e - locomotive-engine drivers and related workers, motor-vehicle drivers, agricultural and other mobile-plant operators, ships' deck crews and related workers.
Homemaker: Housewife (or househusband) or A homemaker is a person whose prime occupation is to care for their family and/or home.
Other Occupation: Other occupation if none of the specified categories are applicable.
Occupation – Unknown: Patient's occupation is not known or unknown or not available at the time of notification.
Other Occupation, specify Specify the occupation
2:Private Sector; 7777:Unknown; 8888:Not applicable; 9999:Missing
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
5:Above RM7000; 6: No Income; 7777: Unknown; 8888: Not Available;9999: Missing
Social welfare programs that are undertaken by governments Or non-governmental organizations (NGO's)
Arthritis: a chronic disease that is considered an autoimmune disease and is characterized especially by pain, stiffness, inflammation, swelling, and sometimes destruction of joints
Arthritis: Arthritis accompanied by inflammation, psoriasis of the skin or nails, and a negative test for rheumatoid factor
idiopathic arthritis (JIA): term used to
describe arthritis—inflammation of the synovium - with onset before 16 years of age.
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
maximal improvement. Criteria 1 through 4 must have been present for at least 6 weeks.
(not bony overgrowth alone) observed by a physician. The 14 possible areas are right or left PIP, MCP, wrist, elbow, knee, ankle and MTP joints. Criteria 1 through 4 must have been present for at least 6 weeks.
Criteria 1 through 4 must have been present for at least 6 weeks.
sides of the body (bilateral involvement of PIPs, MCPs, or MTPs is acceptable without absolute symmetry). Criteria 1 through 4 must have been present for at least 6 weeks.
prominences, or extensor surfaces, or in Unknown; 9999: Missingjuxtaarticular regions, observed by a physician
serum rheumatoid factor by any method Unknown; 9999: Missingfor which the result has been positive in <5% of normal control subjects
hand and wrist radiographs, which must include erosions or unequivocal bony decalcification localized in or most marked adjacent to the involved joints (osteoarthritis changes alone do not qualify)
diagnosis by medical practitioner as recorded in the case notes; if the day is not known, enter as 01/mm/yyyy
Date of onset of symptom if the day is not known, enter as
Date of onset of symptom Date first Disease Modifying Anti
Rheumatic Drug (DMARD). If the day is not known, enter as 01/mm/yyyy
2: No; 8888: Not available; 9999: Missing
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
hypertension. The patient have a diagnosis of hypertension documented by one of the following: a. Documented history of hypertension diagnosed and treated with medication, diet and/or exercise; b. Blood pressure >140 sys
hypercholesterolaemia diagnosed and or treated by a physician, and/or LDL Cholesterol > 4.1 mmol/L
Indicate if the patient has a history of
Diabetes mellitus: a variable disorder of carbohydrate metabolism caused by a combination of hereditary and environmental factors and usually characterized by inadequate secretion or utilization of insulin, by excessive urine production, by excessive amounts of sugar in the blood and urine, and by thirst, hunger, and loss of weight
Indicate if the patient has a history of
Ischaemic heart disease (IHD): 1) heart disease that causes narrowing of coronary arteries, leading to inadequate blood supply to the myocardium. 2) heart disease that occurs as a result of inadequate blood supply to the myocardium, as in myocardial infarction and angina pectoris.
Indicate if the patient has a history of
CVA = Cerbrovascular Accident. A loss of neurological function caused by an ischaemic event with residual symptoms at least 72 hours after onset.
is an ulcer (defined as mucosal erosions
equal to or greater than 0.5 cm) of an area of the gastrointestinal tract that is usually acidic and thus extremely painful.
that usually have the ability to spread, invade, and destroy tissue. Malignant cells tend to have fast, uncontrolled growth.
2:Lymphoma; 8888:Not available; 9999:Missing
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Uterus/Ovary, Bladder, Skin or Unknown) 3:Colon;
4:Liver; 5:ENT; 6:Uterus/Ovary; 7:Bladder; 8:Skin; 7777:Unknown; 9999:Missing
Indicate if the patient has a history of
Hepatitis B: hepatitis caused by a double-stranded DNA virus (species Hepatitis B virus of the genus Orthohepadnavirus, family Hepadnaviridae) that tends to persist in the blood serum and is transmitted especially by contact with infected blood (as by transfusion or by sharing contaminated needles in illicit intravenous drug use) or by contact with other infected bodily fluids
Indicate if the patient has a history of
Hepatitis C: hepatitis caused by a single-stranded RNA virus of the family Flaviviridae (species Hepatitis C virus of the genus Hepacivirus) that tends to persist in the blood serum and is usually transmitted by infected blood (as by injection of an illicit drug, blood transfusion, or exposure to blood or blood products)
Fatty liver (also known as steatorrhoeic
hepatosis or steatosis hepatitis) is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis.
Indicate if the patient has a history of
Osteoporosis: a condition that is characterized by decrease in bone mass with decreased density and enlargement of bone spaces producing porosity and brittleness
Indicate if the patient has a history of TB
(Tuberculosis): a condition that is deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Indicate if there is extra-articular features 1: Yes;
2: No; 8888: Not available; 9999: Missing
normal whether a natural response (as to infection) or artificially induced for therapeutic reasons; 2) an abnormal bodily state characterized by increased production of heat, accelerated heart action and pulse, and systemic debility with weakness, loss of appetite, and thirst
complications as documented by ophthalmologist
Sicca - Eye / Oral Cavity / Indicates dryness of eye, oral cavity or
2:Oral Cavity; 3:Both; 8888:Not available; 9999:Missing
lymph into a pleural cavity or an exudate in a pleural cavity
known as diffuse parenchymal lung disease (DPLD), refers to a group of lung diseases (including idiopathic pulmonary fibrosis), affecting the alveolar epithelium, pulmonary capillary endothelium, basement membrane, perivascular and perilymphatic tissues.
which result in compression of the nerve. It may result from direct external nerve compression or structural abnormality. It may result in neurologic impairment
Inflammation of small vessels of the skin
recurrent spasm of the capillaries and especially those of the fingers and toes upon exposure to cold, that is characterized by pallor, cyanosis, and redness in succession usually accompanied by pain, and that in severe cases progresses to local gangrene
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
arthritis, neutropenia, and splenomegaly and often by weight loss, anemia, lymphadenopathy, and pigment spots on the skin
deposition of amyloid in organs or tissues of the body
Neurological deficit of the cervical cord
Date of clinical examination of the joint
Indicate if joint assessment on the right
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
Indicate if joint assessment on the left
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
Indicate if joint assessment on the right
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Indicate if joint assessment on the left
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on the right
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
Indicate if joint assessment on the left
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
Indicate if joint assessment on left wrist
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on right IPI1
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left IPI1
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Indicate if joint assessment on left PIP2
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left PIP3
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left PIP4
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Joints are classified as either swollen or
Indicate if joint assessment on left PIP5
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left DIP2
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left DIP3
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left DIP4
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left DIP5
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on right hip
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or 1: Yes; 2: No; 8888: Not
Indicate if joint assessment on left hip is
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left knee
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left ankle
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left MTP1
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left MTP2
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Indicate if joint assessment on left MTP3
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left MTP4
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left MTP5
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on right IP1
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Joints are classified as either swollen or
Indicate if joint assessment on left IP1 is
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left PIP2
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left PIP3
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left PIP4
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
Indicate if joint assessment on left PIP5
and joint manipulation on physical examination. Joints are classified as tender or non-tender.
Joints are classified as either swollen or
activities; 3:Limited in vocational activities; 4:Wheel-chair or bedridden; 8888:Not available; 9999: Missing
SECTION 2. INVESTIGATIONS (AT NOTIFICATION)
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
Indicate if results for C-reactive protein
CCP) Antibodies (at any time) categorize 7777:Unknown; as Positive, Negative or Unknown
Citrullinated Peptide (anti-CCP) Antibodies is unknown
(usually 100 mm) measure of the patient's general health for the past 1 week
physician’s assessment of the patient’s current disease activity
The patient’s overall assessment of how
assessment of RA Activity the arthritis is doing. An anchored,
horizontal, visual analogue scale (usually 100 mm) is provided.
(usually 100 mm) of the patient’s current level of pain
Auto calculated Tender joint count of 28
Auto calculated Swollen joint count. ACR
swollen joint count, an assessment of 28 or more joints. Joints are classified as either swollen or not swollen.
x SQRT (Tender Joint Count) + 0.28 x SQRT(Swollen Joint count) + 0.70 x Ln(ESR) + 0.014 x General Health Assessment]
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
tender joint count, an assessment of 28 or more joints. The joint count should be done by scoring several different aspects of tenderness, as assessed by pressure and joint manipulation on physical examination. The information on various types of tenderness should then be collapsed into a single tender-versus-nontender dichotomy
Auto calculated Swollen joint count. ACR
swollen joint count, an assessment of 28 or more joints. Joints are classified as either swollen or not swollen.
Auto calculated - DAS 28 Score = [0.56 x
sqrt (Tender Joint Count) + 0.28 x sqrt(Swollen Joint Count) + 0.36 x ln(CRP+1) + 0.014 x General Health Assessment + 0.96]
medication administered medication administered to the patient
2: Steroids IM; 3: Steroids IV; 4: MTX; 5: SSZ; 6: Azathioprine;7: Hydroxychloroquine (HCQ); 8: Leflunomide; 9: Penicillamine; 10: Mycophenolate; 11: Cyclosporine; 12: Cyclophosphamide; 13: Infliximab; 14: Etanercept; 15: Adalimumab; 16: Rituximab; 17:NSAIDS; 18:Cox2 Inh; 19:Opioid; 99:Others, specify; 8888:Not available; 9999:Missing
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
administered either p.r.n. or "now" as at
the date of notification or date of follow
any of the practices (as acupuncture) of
utilized by mainstream medical practitioners
at specific points especially to cure disease or relieve pain
the surgical immobilization of a joint so
surgical removal of a synovial membrane 1: Yes; 2: No; 8888: Not
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
was discharged from the hospital. This is intended to capture.the total length of stay in your hospital regardless of the medical service managing the patient
Indicate if the reason for admission into
hospital was due to RA flare: Periods of increased disease activity; alternate with periods of relative remission, during which the swelling, pain, difficulty sleeping, and weakness fade or disappear.
Indicate if the reason for admission into
hospital was due to infections:Any systemic or organ infection (i.e. sepsis, sternal or wound, subacute bacterial endocarditis, cellulites)
Indicate if the reason for admission into
hospital was due to ischaemic heart disease, heart failure, valvular and inflammation of the heart
Indicate if the reason for admission into
hospital was due to drug allergy or side effects
Indicate if the reason for admission into
hospital was for joint replacement or surgery
Status Assessment should be recorded:-- at a review point e.g. Joint assessment performed -at a follow-up visit
Indicate if the Date of Follow up is not
NATIONAL INFLAMMATORY ARTHRITIS REGISTRY
2: Month 6; 3:Month 12; 99:Others; 8888:Not available; 9999:Missing
An indicator of the patient's vital status
at follow-up. categorize as Alive, Death,
4:Transfer to a new centre;8888:Not Available;9999:Missing
An indicator if patient is in remission,
activity (defined as DAS Score >3.2 to
patient's vital status at follow-up is Alive.
(>5.1);7777:Unknown; 8888:Not Available; 9999:Missing
i.e. the first significant abnormal event.
Specification if cause of death is RA or
none of the specified categories are applicable.
Mental Illness…What is it? How Does It Relate To The Revised RCF Regulations? “I wander”…”Do some of the residents in my assisted living community qualify as having a “serious mental illness” according to the RCF regulations” ? Mrs. Jones moved in six months ago to my facility and she has been taking the anti-depressant medication Lexapro for her depression