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In wealthier countries, patients perceive worse impact of the disease although they have lower objectively assessed disease activity: results from the cross-sectional COMORA study.

Polina PutrikJosef S SmolenMonika HifingerAndras P KeszeiIhsane HmamouchiMaxime DougadosLaure GossecAnnelies Boonen
Published in: Annals of the rheumatic diseases (2015)
In patients with RA, important differences in physician-reported and patient-reported outcomes across countries were seen, with overall a paradox of worse physician-reported outcomes but better patient-reported outcomes in low-income countries, while results indicate that these outcomes in multinational studies should be interpreted with caution. Research on explanatory factors of this paradox should include non-disease driven cultural factors influencing health.
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