A study published in BMC Rheumatology found disease-specific distress to be a pivotal entity experienced by rheumatoid arthritis patients. The 39-item RADS showed acceptable first phase content and face validity in individuals suffering from rheumatoid arthritis. Researchers undertook this five-phased qualitative research study to assess whether disease-specific distress is experienced by individuals with rheumatoid arthritis.

This study comprised of secondary data assessment of 61 interviews of individuals having rheumatic disease (Phase 1), substantiation of findings using a patient and public involvement group of rheumatoid arthritis people (n = 4) (Phase 2), item generation for a patient-reported outcome measure (PROM) (Phase 3) and establishment of content and face validity of the PROM via patient and public involvement group (n = 4) and individual cognitive interviews (n = 9) of people with rheumatoid arthritis respectively (Phase 4 and 5).

For people having long-term rheumatic diseases, including rheumatoid arthritis, and caretakers, the final PROM was presented. Notably, 5 themes of rheumatic disease distress arose from Phase 1, which was validated in the phase 2 patient and public involvement group. Following phases 3–5, the RADS was formed of thirty-nine items and three supplementary questions. 

The recruited subjects reported the content of RADS to be relevant and clear. Furthermore, the disease-specific distress was noted to be a valid concept in rheumatoid arthritis, distinct from other entities such as anxiety or clinical depression. However, additional psychometric testing is warranted.