• Cecilie Lindström Egholm, Niels Steen Krogh, Theodore Pincus, Lene Dreyer, Torkell Ellingsen, Bente Glintborg, Marcin Ryszard Kowalski, Tove Lorenzen, Ole Rintek Madsen, Henrik Nordin, Claus Rasmussen, and Merete Lund Hetland.
• From the DANBIO Registry, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup Hospital, Glostrup; The Regional Research Unit, Region Zealand, Roskilde; Zitelab Aps, Frederiksberg; Department of Rheumatology C, Copenhagen University Hospital Gentofte, Hellerup; Department of Rheumatology, Odense University Hospital, Odense; Department of Rheumatology, Vendsyssel Hospital, Hjørring; Department of Rheumatology, Diagnostic Centre, Silkeborg Regional Hospital, Silkeborg; Department of Infectious Diseases and Rheumatology, Rigshospitalet, University Hospital of Copenhagen; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Division of Rheumatology, Rush University Medical Center, Chicago, Illinois, USA.C. Lindström Egholm, MPH, Research Consultant, DANBIO Registry, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Glostrup Hospital, and The Regional Research Unit, Region Zealand; N.S. Krogh, Master of Economics, CEO, Zitelab Aps; T. Pincus, MD, Division of Rheumatology, Rush University Medical Center; L. Dreyer, PhD, Chief Physician, Department of Rheumatology C, Copenhagen University Hospital Gentofte; T. Ellingsen, MD, PhD, Professor, Chief Physician, Department of Rheumatology, Odense University Hospital; B. Glintborg, MD, PhD, Department of Rheumatology C, Copenhagen University Hospital Gentofte; M.R. Kowalski, PhD, Consultant, Department of Rheumatology, Vendsyssel Hospital; T. Lorenzen, MD, Chief Physician, Department of Rheumatology, Diagnostic Centre, Silkeborg Regional Hospital; O.R. Madsen, PhD, DrMed, Consultant, Associate Professor, Department of Rheumatology C, Copenhagen University Hospital Gentofte; H. Nordin, MD, Consultant, Department of Infectious Diseases and Rheumatology, Rigshospitalet, University Hospital of Copenhagen; C. Rasmussen, MD, Chief Physician, Department of Rheumatology,
• J Rheumatol. 2015 Oct 1; 42 (10): 1781-5.

ObjectiveTo assess the frequency of discordance in patient's (PtGA) and physician's (PGA) global assessment, and to investigate whether higher discordance in female patients compared with male patients is associated with the physician's sex in patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA).MethodsPtGA, PGA, and other patient-related variables were retrieved from the Danish DANBIO registry, used nationwide to monitor patients with RA, axSpA, and PsA. A questionnaire was sent to all physicians registering in DANBIO (n = 265) regarding individual physician characteristics including sex and age. Discordance was defined as PtGA > 20 mm higher (or lower) than PGA. First encounters between patients and physicians were analyzed using descriptive statistics and mixed model regression analysis.ResultsNinety physicians (34%) returned the questionnaire and were pairwise matched with 10,282 first patient encounters (8300 patients with RA, 524 axSpA, and 1458 PsA). The frequency of discordant (PtGA > PGA) encounters (not including PGA > PtGA seen in < 2%) in RA, axSpA, and PsA was 49.0%, 48.3%, and 56.5%, respectively. Discordance was more common in female patients with high scores on functional disability, pain, and fatigue across the 3 diseases, whereas it was independent of the physician's sex.ConclusionIn this study on Danish patients with RA, axSpA, and PsA, the PtGA was > 20 mm higher than the PGA in about half of the encounters, and more common in female patients of both female and male physicians. This finding highlights one of the challenges in shared decision making.

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