Judgments of "current disease activity" made on "paper patients" (patient data presented on simple forms) reflect those made when seeing the real patients on whom the "paper patients" are based (R = 0.853) and furthermore are highly reproducible (R = 0.952). Judgments made on the same "paper patients" in a rheumatology department in the UK and one in Canada also correlate highly (R = 0.860) and this may reflect a common experience in the type of patients seen. Such general similarities between centers justify comparisons of more detailed analysis of clinical judgment using "paper patients".