The performativity of numbers in illness management: The case of Swedish Rheumatology

- Little is known about how numbers perform in illness management.
- We show how numbers perform differently for physicians and patients.
- Numbers constructed the disease across time and framed action.
- Interaction between numbers, physicians and patients produced tension and alignment.
- We contribute a new model of the dynamic performativity in illness management.

While there is a proliferation of numerical data in healthcare, little attention has been paid to the role of numbers in constituting the healthcare reality they are intended to depict. This study explores the performativity of numbers in the microlevel management of rheumatoid disease. We draw on a study of patients' and physicians' use of the numbers in the Swedish Rheumatology Quality Registry, conducted between 2009 and 2014. We show how the numbers performed by constructing the disease across time, and by framing action. The numerical performances influenced patients and physicians in different ways, challenging the former to quantify embodied disease and the latter to subsume the disease into one of many possible trajectory standards. Based on our findings, we provide a model of the dynamic performativity of numbers in the on-going management of illness. The model conceptualises how numbers generate new possibilities; by creating tension and alignment they may open up new avenues for communication between patients and physicians.