scholarly journals EULAR Points to Consider for the use of imaging to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs)

2021 ◽  
pp. annrheumdis-2021-221261
Author(s):  
Christian Dejaco ◽  
Pedro M Machado ◽  
Francesco Carubbi ◽  
Philipp Bosch ◽  
Lene Terslev ◽  
...  
Keyword(s):  
Interventional Procedures ◽  
Healthcare Professionals ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
Fusion Imaging ◽  
Imaging Modalities ◽  
Imaging Method ◽  
Sacroiliac Joints ◽  
Level Of Agreement

ObjectivesTo develop evidence-based Points to Consider (PtC) for the use of imaging modalities to guide interventional procedures in patients with rheumatic and musculoskeletal diseases (RMDs).MethodsEuropean Alliance of Associations for Rheumatology (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound (US), fluoroscopy, MRI, CT and fusion imaging to guide interventional procedures. Based on evidence and expert opinion, the task force (25 participants consisting of physicians, healthcare professionals and patients from 11 countries) developed PtC, with consensus obtained through voting. The final level of agreement was provided anonymously.ResultsA total of three overarching principles and six specific PtC were formulated. The task force recommends preference of imaging over palpation to guide targeted interventional procedures at peripheral joints, periarticular musculoskeletal structures, nerves and the spine. While US is the favoured imaging technique for peripheral joints and nerves, the choice of the imaging method for the spine and sacroiliac joints has to be individualised according to the target, procedure, expertise, availability and radiation exposure. All imaging guided interventions should be performed by a trained specialist using appropriate operational procedures, settings and assistance by technical personnel.ConclusionThese are the first EULAR PtC to provide guidance on the role of imaging to guide interventional procedures in patients with RMDs.

scholarly journals EULAR points to consider for the development, evaluation and implementation of mobile health applications aiding self-management in people living with rheumatic and musculoskeletal diseases

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001014 ◽  
Author(s):  
Aurélie Najm ◽  
Elena Nikiphorou ◽  
Marie Kostine ◽  
Christophe Richez ◽  
John D Pauling ◽  
...  
Keyword(s):  
Mobile Health ◽  
Online Survey ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
Cost Benefit ◽  
Self Management ◽  
Mobile Health Applications ◽  
Development Evaluation ◽  
Level Of Agreement ◽  
Health Applications

BackgroundMobile health applications (apps) are available to enable people with rheumatic and musculoskeletal diseases (RMDs) to better self-manage their health. However, guidance on the development and evaluation of such apps is lacking.ObjectivesThe objective of this EULAR task force was to establish points to consider (PtC) for the development, evaluation and implementation of apps for self-management of RMDs.MethodsA systematic literature review of app content and development strategies was conducted, followed by patient focus group and an online survey. Based on this information and along with task force expert opinion, PtC were formulated in a face-to-face meeting by a multidisciplinary task force panel of experts, including two patient research partners. The level of agreement among the panel in regard to each PtC was established by anonymous online voting.ResultsThree overarching principles and 10 PtC were formulated. Three PtC are related to patient safety, considered as a critical issue by the panel. Three are related to relevance of the content and functionalities. The requirement for transparency around app development and funding sources, along with involvement of relevant health professionals, were also raised. Ease of app access across ages and abilities was highlighted, in addition to considering the cost benefit of apps from the outset. The level of agreement was from 8.8 to 9.9 out of 10.ConclusionThese EULAR PtC provide guidance on important aspects that should be considered for the development, evaluation and implementation of existing and new apps.

scholarly journals 2018 update of the EULAR recommendations for the role of the nurse in the management of chronic inflammatory arthritis

2019 ◽  
Vol 79 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Bianca Bech ◽  
Jette Primdahl ◽  
Astrid van Tubergen ◽  
Marieke Voshaar ◽  
Heidi A Zangi ◽  
...  
Keyword(s):  
Inflammatory Arthritis ◽  
Psychosocial Support ◽  
Task Force ◽  
Healthcare Team ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Chronic Inflammatory Arthritis ◽  
Eular Recommendations ◽  
Level Of Agreement

To update the European League Against Rheumatism (EULAR) recommendations for the role of the nurse in the management of chronic inflammatory arthritis (CIA) using the most up to date evidence. The EULAR standardised operating procedures were followed. A task force of rheumatologists, health professionals and patients, representing 17 European countries updated the recommendations, based on a systematic literature review and expert consensus. Higher level of evidence and new insights into nursing care for patients with CIA were added to the recommendation. Level of agreement was obtained by email voting. The search identified 2609 records, of which 51 (41 papers, 10 abstracts), mostly on rheumatoid arthritis, were included. Based on consensus, the task force formulated three overarching principles and eight recommendations. One recommendation remained unchanged, six were reworded, two were merged and one was reformulated as an overarching principle. Two additional overarching principles were formulated. The overarching principles emphasise the nurse’s role as part of a healthcare team, describe the importance of providing evidence-based care and endorse shared decision-making in the nursing consultation with the patient. The recommendations cover the contribution of rheumatology nursing in needs-based patient education, satisfaction with care, timely access to care, disease management, efficiency of care, psychosocial support and the promotion of self-management. The level of agreement among task force members was high (mean 9.7, range 9.6-10.0). The updated recommendations encompass three overarching principles and eight evidence-based and expert opinion-based recommendations for the role of the nurse in the management of CIA.

scholarly journals 2019 EULAR points to consider for the assessment of competences in rheumatology specialty training

2020 ◽  
Vol 80 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Francisca Sivera ◽  
Alessia Alunno ◽  
Aurélie Najm ◽  
Tadej Avcin ◽  
Xenofon Baraliakos ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Training Programme ◽  
Assessment Practices ◽  
Specialty Training ◽  
Sufficient Time ◽  
Effective Implementation ◽  
European League Against Rheumatism ◽  
Training Programmes ◽  
Level Of Agreement

Background and aimStriving for harmonisation of specialty training and excellence of care in rheumatology, the European League Against Rheumatism (EULAR) established a task force to develop points to consider (PtCs) for the assessment of competences during rheumatology specialty training.MethodsA systematic literature review on the performance of methods for the assessment of competences in rheumatology specialty training was conducted. This was followed by focus groups in five selected countries to gather information on assessment practices and priorities. Combining the collected evidence with expert opinion, the PtCs were formulated by the multidisciplinary task force, including rheumatologists, medical educationalists, and people with rheumatic and musculoskeletal diseases. The level of agreement (LoA) for each PtC was anonymously voted online.ResultsFour overarching principles and 10 PtCs were formulated. The overarching principles highlighted the importance of assessments being closely linked to the rheumatology training programme and protecting sufficient time and resources to ensure effective implementation. In the PtCs, two were related to overall assessment strategy (PtCs 1 and 5); three focused on formative assessment and portfolio (PtCs 2–4); three focused on the assessment of knowledge, skills or professionalism (PtCs 6–8); one focused on trainees at risk of failure (PtC 9); and one focused on training the trainers (PtC 10). The LoA (0–10) ranged from 8.75 to 9.9.ConclusionThese EULAR PtCs provide European guidance on assessment methods throughout rheumatology training programmes. These can be used to benchmark current practices and to develop future strategies, thereby fostering continuous improvement in rheumatology learning and, ultimately, in patient care.

Echocardiography in the cath lab: Fusion imaging and use of intracardiac echocardiography

2021 ◽  
pp. 121-128
Author(s):  
Covadonga Fernández-Golfín ◽  
José Luis Zamorano
Keyword(s):  
Heart Disease ◽  
Structural Heart Disease ◽  
Transoesophageal Echocardiography ◽  
Fusion Imaging ◽  
Intracardiac Echocardiography ◽  
Imaging Modalities ◽  
Fusion System ◽  
Basic Principles ◽  
Fused Image

Structural heart disease interventions represent a new branch of percutaneous treatments rapidly expanding. Imaging, mainly transoesophageal echocardiography is essential to guide the procedures along with fluoroscopy. In the last year, fusion of both imaging modalities is available with dedicated software that allows the visualization of both echo and fluoro in a single fused image. These systems allow a better anatomic depiction of the different structures allowing safer and faster procedures with a better communication between the interventionalists and the imagers. In this chapter we will review the basic principles of these fusion system and main uses as well as the role of intracardiac echocardiography in the cath lab.

scholarly journals 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis

2018 ◽  
Vol 77 (9) ◽  
pp. 1251-1260 ◽  
Author(s):  
Anne-Kathrin Rausch Osthoff ◽  
Karin Niedermann ◽  
Jürgen Braun ◽  
Jo Adams ◽  
Nina Brodin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Inflammatory Arthritis ◽  
Musculoskeletal Diseases ◽  
Task Force ◽  
The Public ◽  
Knee Oa ◽  
Eular Recommendations ◽  
Patient Representatives ◽  
Research And Education ◽  
Level Of Agreement

Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed. A task force (TF) (including rheumatologists, other medical specialists and physicians, health professionals, patient-representatives, methodologists) from 16 countries met twice. In the first TF meeting, 13 research questions to support a systematic literature review (SLR) were identified and defined. In the second meeting, the SLR evidence was presented and discussed before the recommendations, research agenda and education agenda were formulated. The TF developed and agreed on four overarching principles and 10 recommendations for PA in people with iA and OA. The mean level of agreement between the TF members ranged between 9.8 and 8.8. Given the evidence for its effectiveness, feasibility and safety, PA is advocated as integral part of standard care throughout the course of these diseases. Finally, the TF agreed on related research and education agendas. Evidence and expert opinion inform these recommendations to provide guidance in the development, conduct and evaluation of PA-interventions and promotion in people with iA and OA. It is advised that these recommendations should be implemented considering individual needs and national health systems.

scholarly journals Role of Fusion Imaging in Image-Guided Thermal Ablations

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 549
Author(s):  
Serena Carriero ◽  
Gianmarco Della Pepa ◽  
Lorenzo Monfardini ◽  
Renato Vitale ◽  
Duccio Rossi ◽  
...  
Keyword(s):  
Information Integration ◽  
Interventional Oncology ◽  
Imaging Technique ◽  
Fusion Imaging ◽  
Imaging Modalities ◽  
Ablation Therapy ◽  
Image Guided ◽  
Post Procedure ◽  
Ablation Success

Thermal ablation (TA) procedures are effective treatments for several kinds of cancers. In the recent years, several medical imaging advancements have improved the use of image-guided TA. Imaging technique plays a pivotal role in improving the ablation success, maximizing pre-procedure planning efficacy, intraprocedural targeting, post-procedure monitoring and assessing the achieved result. Fusion imaging (FI) techniques allow for information integration of different imaging modalities, improving all the ablation procedure steps. FI concedes exploitation of all imaging modalities’ strengths concurrently, eliminating or minimizing every single modality’s weaknesses. Our work aims to give an overview of FI, explain and analyze FI technical aspects and its clinical applications in ablation therapy and interventional oncology.

scholarly journals 2020 EULAR points to consider for the prevention, screening, assessment and management of non-adherence to treatment in people with rheumatic and musculoskeletal diseases for use in clinical practice

2020 ◽  
pp. annrheumdis-2020-218986
Author(s):  
Valentin Ritschl ◽  
Tanja A Stamm ◽  
Daniel Aletaha ◽  
Johannes W J Bijlsma ◽  
Peter Böhm ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Treatment Plan ◽  
Healthcare Providers ◽  
Structural Barriers ◽  
Adherence To Treatment ◽  
Patient Representatives ◽  
Screening Assessment ◽  
Free Environment ◽  
Level Of Agreement

BackgroundNon-adherence to treatment could preclude reaching an optimal outcome. Thirty to 80% of patients with rheumatic and musculoskeletal diseases (RMDs) do not adhere to the agreed treatment.ObjectivesThe objective was to establish points to consider (PtCs) for the prevention, screening, assessment and management of non-adherence to (non-)pharmacological treatments in people with RMDs.MethodsAn EULAR task force (TF) was established, and the EULAR standardised operating procedures for the development of PtCs were followed. The TF included healthcare providers (HCPs), comprising rheumatologists, nurses, pharmacists, psychologists, physiotherapists, occupational therapists and patient-representatives from 12 European countries. A review of systematic reviews was conducted in advance to support the TF in formulating the PtCs. The level of agreement among the TF was established by anonymous online voting.ResultsFour overarching principles and nine PtCs were formulated. The PtCs reflect the phases of action on non-adherence. HCPs should assess and discuss adherence with patients on a regular basis and support patients to treatment adherence. As adherence is an agreed behaviour, the treatment has to be tailored to the patients’ needs. The level of agreement ranged from 9.5 to 9.9 out of 10.ConclusionsThese PtCs can help HCPs to support people with RMDs to be more adherent to the agreed treatment plan. The basic scheme being prevent non-adherence by bonding with the patient and building trust, overcoming structural barriers, assessing in a blame-free environment and tailoring the solution to the problem.

scholarly journals EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice

2018 ◽  
Vol 77 (5) ◽  
pp. 636-643 ◽  
Author(s):  
Christian Dejaco ◽  
Sofia Ramiro ◽  
Christina Duftner ◽  
Florent L Besson ◽  
Thorsten A Bley ◽  
...  
Keyword(s):  
Structural Damage ◽  
Task Force ◽  
Aortic Aneurysms ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Imaging Modalities ◽  
Temporal Artery Biopsy ◽  
Close Monitoring ◽  
Eular Recommendations

To develop evidence-based recommendations for the use of imaging modalities in primary large vessel vasculitis (LVV) including giant cell arteritis (GCA) and Takayasu arteritis (TAK). European League Against Rheumatism (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound, MRI, CT and [18F]-fluorodeoxyglucose positron emission tomography (PET) in LVV. Based on evidence and expert opinion, the task force consisting of 20 physicians, healthcare professionals and patients from 10 EULAR countries developed recommendations, with consensus obtained through voting. The final level of agreement was voted anonymously. A total of 12 recommendations have been formulated. The task force recommends an early imaging test in patients with suspected LVV, with ultrasound and MRI being the first choices in GCA and TAK, respectively. CT or PET may be used alternatively. In case the diagnosis is still in question after clinical examination and imaging, additional investigations including temporal artery biopsy and/or additional imaging are required. In patients with a suspected flare, imaging might help to better assess disease activity. The frequency and choice of imaging modalities for long-term monitoring of structural damage remains an individual decision; close monitoring for aortic aneurysms should be conducted in patients at risk for this complication. All imaging should be performed by a trained specialist using appropriate operational procedures and settings. These are the first EULAR recommendations providing up-to-date guidance for the role of imaging in the diagnosis and monitoring of patients with (suspected) LVV.

scholarly journals Multidisciplinary team intervention to reduce the nocebo effect when switching from the originator infliximab to a biosimilar

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001396
Author(s):  
Juliette Petit ◽  
Marie Antignac ◽  
Rose-Marie Poilverd ◽  
Régine Baratto ◽  
Sylvie Darthout ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Healthcare Professionals ◽  
Musculoskeletal Diseases ◽  
Retention Rate ◽  
Nocebo Effect ◽  
Historical Cohort ◽  
Tailored Communication ◽  
Secondary Outcomes ◽  
Patient Representative

ObjectivesTo evaluate an intervention to reduce the nocebo effect (NE) when switching from the originator infliximab (OI) to the infliximab biosimilar SB2 in chronic inflammatory rheumatic disease (CIRD).MethodsAn intervention was built with healthcare professionals (HPs) and a patient representative, based on a systematic review of interventions reducing the NE in musculoskeletal diseases and semi-directed questioning of five patients. Our strategy consisted of training HPs, switch information given by the nurses, a consistent vocabulary. All CIRD patients switched from OI to SB2 were included for the intervention. The primary outcome was the SB2 retention rate (RR) at 34 weeks. Secondary outcomes were the SB2 RR at 12 months, discontinuation rates due to a possible NE and comparison with a historical cohort of CIRD patients receiving the OI and 6 published European cohorts.Results45 patients were included from March 2018 (rheumatoid arthritis, n=17, spondylarthritis, n=28). After 34 weeks, the SB2 RR was 91.2%, similar to the historical cohort RR (p=0.41) but higher than the 3 European cohort RRs (p<0.05). At 12 months, the SB2 RR was 84.5% vs 88.4% for the historical cohort (p=0.52). SB2 discontinuation due to a possible NE was 6.6% after 12 months.ConclusionsA tailored communication with a prominent role of nurses reduced the NE in non-medical switches from the OI to SB2 as compared to published results. The RR was similar to the historical cohort RR. The methodology used to construct this intervention may help improve the outcomes of switches with upcoming biosimilars.

scholarly journals Gastrointestinal Ultrasound in Functional Disorders of the Gastrointestinal Tract - EFSUMB Consensus Statement

2021 ◽  
Vol 07 (01) ◽  
pp. E14-E24
Author(s):  
Giovanni Maconi ◽  
Trygve Hausken ◽  
Christoph F. Dietrich ◽  
Nadia Pallotta ◽  
Ioan Sporea ◽  
...  
Keyword(s):  
Task Force ◽  
Gastrointestinal Diseases ◽  
Response To Therapy ◽  
Diagnostic Tools ◽  
European Federation ◽  
Imaging Method ◽  
Functional Disorders ◽  
Abdominal Symptoms ◽  
Gastrointestinal Ultrasound

AbstractAbdominal ultrasonography and intestinal ultrasonography are widely used as first diagnostic tools for investigating patients with abdominal symptoms, mainly for excluding organic diseases. However, gastrointestinal ultrasound (GIUS), as a real-time diagnostic imaging method, can also provide information on motility, flow, perfusion, peristalsis, and organ filling and emptying, with high temporal and spatial resolution. Thanks to its noninvasiveness and high repeatability, GIUS can investigate functional gastrointestinal processes and functional gastrointestinal diseases (FGID) by studying their behavior over time and their response to therapy and providing insight into their pathophysiologic mechanisms. The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has established a Task Force Group consisting of GIUS experts, which developed clinical recommendations and guidelines on the role of GIUS in several acute and chronic gastrointestinal diseases. This review is dedicated to the role of GIUS in assisting the diagnosis of FGID and particularly in investigating patients with symptoms of functional disorders, such as dysphagia, reflux disorders, dyspepsia, abdominal pain, bloating, and altered bowel habits. The available scientific evidence of GIUS in detecting, assessing, and investigating FGID are reported here, while highlighting sonographic findings and its usefulness in a clinical setting, defining the actual and potential role of GIUS in the management of patients, and providing information regarding future applications and research.

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