Patient Activity Scale II (PAS II) for RA

PAS-II for RA Calculator
0-10
0-10
0-3
PAS II Score:
Quantifies severity of rheumatoid arthritis (RA) and has fewer questions than PAS.

Why Use

A fully patient-reported tool that integrates functional status and overall health perception. Helpful in tracking trends in RA disease activity over time and guiding clinical management. May be favored over the original PAS due to its simplicity and improved usability. Endorsed in the 2019 Update of the American College of Rheumatology Recommended Rheumatoid Arthritis Disease Activity Measures.

When to Use

Use during follow-up visits to assess current rheumatoid arthritis (RA) disease activity from the patient’s perspective. Appropriate in time-limited settings where a quick, patient-reported assessment is preferred.

Formula

PAS II = (A × 3.33 + B + C) / 3, where A = Health Assessment Questionnaire Disability Index II (HAQ-II), calculated by averaging selected points from table below. B = Pain Visual Analog Scale (ask patient to rate pain on a scale of 0-10, where 10 is the worst pain imaginable). C = Patient Global Assessment of Disease Activity (ask patient to rate how well they are doing in the past week considering all the ways their disease affects them on a scale of 0-10, where 10 is the worst). Variable Points Is the patient able to: Stand up from a straight chair Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Walk outdoors on flat ground Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Get on and off the toilet Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Reach and get down a 5-pound object (such as a bag of sugar) from just above the head Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Open car doors Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Do outside work (such as yard work) Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Wait in a line for 15 minutes Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Lift heavy objects Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Move heavy objects Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3 Go up 2 or more flights of stairs Without any difficulty 0 With some difficulty 1 With much difficulty 2 Unable 3

Pearls / Pitfalls

May overestimate disease activity in patients with chronic pain syndromes or functional limitations unrelated to RA. Combines the Health Assessment Questionnaire II (HAQ II), a visual analog scale (VAS) for pain, and a global assessment VAS (global assessment of disease severity).

Advice

Interpret results alongside clinical findings and laboratory data to guide treatment decisions. Use the score to support shared decision-making and discussions around treatment goals and symptom burden. If moderate or high activity is indicated, reassess the current RA treatment regimen and consider escalation of therapy. Evaluate for comorbid, noninflammatory conditions if scores remain persistently elevated. Repeat the score regularly to track treatment effectiveness and disease control.

More Information

Interpretation: PAS II Disease Activity 0.00-0.25 Remission 0.26-3.70 Low/minimal 3.71-7.99 Moderate 8.00-10.00 High/severe

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