Table 3 Strategies to Manipulate the DAS28 Assessment Reported by the Sample

1

Measure disease activity using a different instrument (such as RAPID3) and convert to DAS28 scores.

2

Claim the patient has psoriatic arthritis because fewer active joints are required to prescribe anti-TNF therapy compared with RA.

3

Only perform one DAS28 assessment.

4

Stop a patient’s steroids to increase their DAS28 score.

5

Perform a DAS28 assessment when the patient has a flare in disease activity.

6

Increase the frequency of DAS28 assessments to increase the likelihood of measuring two scores greater than 5.1.