Towards a universal definition of disease activity score thresholds: the AS135 score

Abstract

BackgroundMany study groups have developed scores to re ect disease activity. The result of this fragmented process is a multitude of disease activity scores, even for a single disease. Design:To identify and standardize disease activity scores in rheumatology, we conducted a literature review on disease activity criteria using both a manual approach and in-house computer software (BIBOT) that applies natural language processing to automatically identify and interpret important words in abstracts published in English between 1.1.1975 and 31.12.2018. We selected activity scores with cut-off values divided into four classes (remission and low, moderate and high disease activity). We used a linear interpolation to map disease activity scores to our new score, the AS135, and developed a smartphone application to perform the conversion. ResultsA total of 108 activity criteria from various elds were identi ed, but it was in rheumatology that we found the most pronounced separation into four classes. We built the AS135 score modi cation for each selected score using a linear interpolation of the existing criteria. The score modi cation was de ned on the interval [0,10], and values of 1, 3 and 5 were used as thresholds. These arbitrary thresholds were then associated with the thresholds of the existing criteria, and an interpolation was calculated, allowing conversion of the existing criteria into the AS135 criterion.Finally, we created a mobile application. ConclusionWe developed an application for clinicians that enables the use of a single disease activity score for different in ammatory rheumatic diseases using an intuitive scale. Key MessagesWhat is already known about this subject? Scores re ecting disease activity are speci c for a single disease. The result of this fragmented process is a multitude of disease activity scores, even for a single disease.What does this study add?We have created a mobile application that allows any user to simply obtain the level of disease activity, regardless of the criterion used to describe it, since the application returns both the activity criterion value calculated from the physician's data and the transformed AS135 criterion value, as well as its interpretation in terms of the level of disease activity. How might this impact on clinical practice?