Yun H, et al. - A total of 50,996 qualified individuals with 27,274 with longitudinal data from the ACR’s Rheumatology Informatics System for Effectiveness registry, were included in order to recognize which measurement tool(s) rheumatologists really used to assess RA patients’ disease activity, report RA medication use, treatment modifications and treatment response over time in association with disease activity, background RA therapies, and other factors, and evaluate how discordant disease activity measurement using various tools (eg, Clinical Disease Activity Index vs Routine Assessment of Patient Index Data with 3 measures) influenced RA treatment modifications. One- to two-thirds of individuals with RA, even when in moderate/high disease activity, could not modify their treatment. Multi-modal interventions focused both at individuals and providers are required to support shared decision making, goal-directed care, and to surmount obstacles to treatment escalation.