A Dual-center, double blind randomized Study for a New Scientific Approach in

Assessment of Tender Joints in Inflammatory Arthritis Using the Smart JOINT ASSESSOR
GLOVE Device (Smart JAG Device)
Mohammad Faisal Khan 1, 2
Clinical Assistant Professor- University of Oklahoma, Health Sciences Center
1) Arthritis and Rheumatology Center of Oklahoma, PLLC
2) McBride Orthopedic Hospital Clinic

Objectives
Primary Objective Tender Joint Count Assessments are
significantly more accurate using the Smart JAG Device than
with conventional Joint Assessments.
Secondary Objective Establishing a high degree of consistency
over time to monitor therapeutic response and improved joint
Methods
function.
We present a smart hand held glove device for Tender Joint
Count Assessment.
The first of its kind that allows
standardizing a joint exam based on scientific rationale.

We examined 100 patients (2800 joints) with moderate to

severe inflammatory arthritis as defined by ACR criteria for their
respective disease states maintained on DMARD therapy. A
standardized 28 Joint Count was performed on all subjects.
Each subject underwent a Tender Joint Exam by a total of 4
different assessors that were blindly randomized to the device.
Two Joint Assessors performed the joint count using the device
and two performed without the device. All joint assessors were
blinded. Each joint count was performed after approximately 30
minute intervals. All assessors were blindly randomized to the
device. The device was programmed at 4kg pressure to beep
as a signal so that the same amount of pressure was applied
consistently throughout on all the joints measured. The device
beeped every time on reaching the desired pressure. This
smart device has the capability of connecting via wireless
connection to computer software with a built-in voice
recognition system. Tender Joints are captured based on voice
recognition of the Assessor in real time. The software has LED
mode feature for the hearing impaired. At the conclusion of the
Joint Assessment, this software is able to give a total Tender
Joint Count with memory capability that can be retrieved. It can
also calculate a CDAI and DAS-28 if needed.

Background

Blue- Joint under examination

Red-Tender Joint
Green- Non-tender Joint

Tender Joint Count (TJC) is a vital quality measure to assess the

progression of Inflammatory Arthritis both from a therapeutic
and a diagnostic standpoint. To date no scientific instruments
are available to validate and standardize a Joint Count and
these assessments remain largely subjective to the Joint
Assessor. Physician variability, depending upon the technique
and the force used in Tender joint count assessments, can
significantly impact the Disease Activity Scores. Both inter and
Results
intra-observer variability bias
in assessing Tender Joint Count
There
striking
difference
consistencies
can be was
pivotal
in impacting
the in
outcome
of a trial.between the 2
groups. We found only 4.5% discrepancy within the device users
as compared to 15% in non-device users. We performed a
paired t-test between the discrepancy measures from the 2
groups. We found strong statistical significance between the 2
groups. (p<9.8 x 10-8).There were no significant differences in
Conclusion
the overall mean tender joints
in either group.
The device measures tender joints with high accuracy and has
less discrepancy between different users. Can be used by other
health care personnel as joint assessors and has a high yield to
assess therapeutic efficacy over time. It is also much less time
consuming and standardizes tender joint exams by keeping the
pressure as constant with less inter and intra observer
variability.