scholarly journals POS0566 CATASTROPHIZING IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 518.1-518
Author(s):  
C. Traverson ◽  
B. Coste ◽  
E. Filhol ◽  
C. Daien ◽  
S. Laurent-Chabalier ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Linear Regression ◽  
Disease Activity ◽  
Pain Catastrophizing ◽  
Depression Score ◽  
Multivariate Linear Regression ◽  
Anxiety Score ◽  
Wilcoxon Test ◽  
Logistics Regression ◽  
High Level

Background:Catastrophizing is conceptualized as a negative cognitive–affective response to an anxiety-provoking stimulus, especially anticipated or actual pain. Catastrophizing can be assessed quickly using a validated questionnaire: the Pain Catastrophizing Scale (PCS)1. Catastrophizing plays a role in maintaining chronic pain and is associated with several pain-related outcomes in osteoarthritis and low back pain.Objectives:To assess the prevalence of catastrophizing and associated factors in rheumatoid arthritis (RA).Methods:We performed an observational, prospective, bi-centric study. All patients aged 18 or over with RA and fulfilling the ACR-EULAR 2010 criteria were consecutively included. Sociodemographic data, information on the disease and its treatments were collected as well as questionnaires for disease activity (DAS28), function (HAQ), quality of life (SF12, EQ5D), anxiety and depression (HADS, GAD7), fibromyalgia (FiRST), insomnia (ISI) and catastrophizing scores (PCS). Statistical analysis included the samples t-test, one-way variance analysis, the Spearman’s correlation test, the Chi2 test, Fisher’s exact test, the Wilcoxon test, multivariate linear regression (considering catastrophizing as a continuous variable) and multivariate logistics regression (considering catastrophizing as a categorical variable: PCS ≥ 20 = high level catastrophizing).Results:From September 2019 to March 2020, 201 patients with RA were included: 78.1% were women and the median age was 63.0 years. In all, 64.1% of patients were RF+, 65.7% ACPA+, and 46% had erosive disease. Median DAS28 CRP was 2.9 [2.1-4.0]. with 45% of patients in remission, 14.8% with low, 31.2% moderate and 9 % high activity. The majority of patients (92 %) had a disease lasting for more than 2 years.The prevalence of a PCS score ≥20 was 48.0% [41.0;54.9]. The median PCS score was 18 [7-28]. In multivariate logistics regression, high-level catastrophizing was significantly associated with DAS28-CRP (OR= 1.61 [1.18-2.20]), HADS anxiety score (OR=1.25 [1.11-1.40]) and the HADS depression score (OR=1.19 [1.07-1.33]). In multivariate linear regression, catastrophizing was significantly associated with the HADS anxiety score (p< 0.0001), HADS depression score (p=0.0055), HAQ (p=0.0015) and the ISI insomnia score (p=0.005).Conclusion:Almost half the patients with RA were high catastrophizers. Catastrophizing is linked to anxiety, depression, disease activity, function impairment and insomnia. It may be interesting to detect catastrophizing in order to improve the management of our patients.References:[1]Sullivan MJL. et al. Psychological Assessment. 1995;7(4):524–32Disclosure of Interests:None declared

scholarly journals POS1082 CATASTROPHIZING IN PATIENTS WITH PSORIATIC ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 820.2-820
Author(s):  
C. Gaujoux-Viala ◽  
B. Coste ◽  
C. Traverson ◽  
E. Filhol ◽  
S. Laurent-Chabalier ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Linear Regression ◽  
Pain Catastrophizing ◽  
Continuous Variable ◽  
Multivariate Linear Regression ◽  
Anxiety Score ◽  
Wilcoxon Test ◽  
Logistics Regression ◽  
Validated Questionnaire ◽  
High Level

Background:Catastrophizing is a negative cognitivo-affective response to an anxiety-provoking stimulus, especially anticipated or actual pain. It can be quickly assessed using a validated questionnaire: the Pain Catastrophizing Scale (PCS)1. Catastrophizing plays a role in maintaining chronic pain and is associated with several pain-related outcomes in osteoarthritis and low back pain. To our knowledge, there are no data on catastrophizing in patients with psoriatic arthritis (PsA).Objectives:To assess the prevalence of catastrophizing and associated factors in PsA.Methods:We performed a bi-centric observational, prospective study. All patients aged 18 or over with PsA fulfilling the 2006 CASPAR criteria were consecutively included. Sociodemographic data, information on the disease and its treatments were collected as well as questionnaires for disease activity (BASDAI), function (HAQ, BASFI), quality of life (SF12, EQ5D), anxiety and depression (HADS, GAD7), fibromyalgia (FiRST), insomnia (ISI) and catastrophizing scores (PCS). Statistical analysis included samples T-test, one-way variance analysis, Spearman’s correlation coefficient, Chi2 test, Fisher’s exact test, Wilcoxon test, multivariate linear regression (considering catastrophizing as a continuous variable) and multivariate logistics regression (considering catastrophizing as a categorical variable: PCS ≥ 20 = high level catastrophizing).Results:From September 2019 to March 2020, 85 PsA patients were included: 54.1% were women, the median age was 54.0 years and 33 patients (39.8%) were professionally active. The majority of patients (88.2%) had a disease lasting for more than 2 years. Axial involvement was found for 39 patients (45.9%), almost all patients (98.8%) had peripheral involvement, 32 patients (37.7%) had enthesitic involvement and 14 patients (16.7%) had erosions. Median DAS28 CRP was 3.12 [2.13-4.46] and the median BASDAI score was 5.50 [4.30-6.70]. The prevalence of a PCS score ≥20 was 45.9% [35.3;56.5]. The median PCS score was 16 [6-29]. In multivariate logistics regression, high-level catastrophizing was significantly associated with the HADS anxiety score (OR=1.35 [1.15-1.61]) and pain VAS (OR=1.04 [1.02-1.06]). In multivariate linear regression, catastrophizing was significantly associated with the HADS anxiety score (p= 0.004), pain VAS (p=0.001), HADS depression score (p=0.018) and insomnia score (p=0.034).Conclusion:Almost half the patients with PsA were high catastrophizers. Catastrophizing is related to anxiety, pain, depression and insomnia. It may be interesting to detect catastrophizing in order to improve the care of our patients.References:[1]Sullivan MJL. et al. Psychological Assessment. 1995;7(4):524–32Disclosure of Interests:None declared.

scholarly journals POS1003 CATASTROPHIZING IN PATIENTS WITH SPONDYLOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 770.1-770
Author(s):  
B. Coste ◽  
C. Traverson ◽  
E. Filhol ◽  
C. Lukas ◽  
S. Laurent-Chabalier ◽  
...  
Keyword(s):  
Linear Regression ◽  
Disease Activity ◽  
Pain Catastrophizing ◽  
Continuous Variable ◽  
Multivariate Linear Regression ◽  
Wilcoxon Test ◽  
Logistics Regression ◽  
Validated Questionnaire ◽  
Asas Criteria ◽  
High Level

Background:Catastrophizing is a negative cognitivo-affective response to an anxiety-provoking stimulus, especially anticipated or actual pain. It can be assessed quickly using a validated questionnaire: the Pain Catastrophizing Scale (PCS)1. Catastrophizing plays a role in maintaining chronic pain and is associated with several pain-related outcomes in osteoarthritis and low back pain. There is a lack of knowledge about catastrophizing in axial spondyloarthritis (AS) with only one study2 so far.Objectives:To assess the prevalence of catastrophizing and associated factors in spondyloarthritis.Methods:We performed an observational, prospective, bi-centric study. All patients aged 18 or over with AS fulfilling the 2009 Assessment in Spondyloarthritis International Society (ASAS) criteria were consecutively included. Sociodemographic data, information on the disease and its treatments were collected as well as questionnaires regarding disease activity (BASDAI), function (HAQ, BASFI), quality of life (SF12, EQ5D), anxiety and depression (HADS, GAD7), fibromyalgia (FiRST), insomnia (ISI) and catastrophizing scores (PCS). Statistical analysis included a samples t-test, one-way variance analysis, Spearman’s correlation coefficient, the Chi2 test, Fisher’s exact test, the Wilcoxon test, multivariate linear regression (considering catastrophizing as a continuous variable) and multivariate logistics regression (considering catastrophizing as a categorical variable: PCS ≥ 20 = high level catastrophizing).Results:From September 2019 to March 2020, 168 AS patients were included: 48.5% were women, the median age was 48.5 years and 100 patients (60.2%) were professionally active. Almost all patients (95.8%) had a disease lasting for more than 2 years; 110 (72%) were HLA-B27+; 84 (50%) had MRI sacroiliitis and 62 (37.6%) radiographic sacroiliitis. In all, 166 (98.8%) had axial involvement, 99 (58.9%) had peripheral involvement and 44 (26.2%) had enthesitic involvement. The median BASDAI score was 6.30 [Q1-Q3 4.65-6.30].The prevalence of a PCS score ≥20 was 45.5% [38.0;53.0]. The median PCS score was 18 [7-27]. In multivariate logistics regression, high-level catastrophizing was significantly associated with the HADS anxiety score (OR=1.54 [1.22-2.0]), HADS depression score (OR=1.25 [1.10-1.43]) and disease activity (BASDAI OR=1.14 [1.01-1.26]). In multivariate linear regression, catastrophizing was also significantly associated with anxiety (p<0.0001), depression (p<0.0001) and disease activity (p=0.0008).Conclusion:Almost half the patients with AS were high catastrophizers. Catastrophizing is linked to anxiety, depression, and disease activity. It may be interesting to detect catastrophizing in order to improve the management of our patients.References:[1]Sullivan MJL. et al. Psychological Assessment. 1995;7(4):524–32[2]Penhoat M. et al. Joint Bone Spine. 2014;81(3):235–9Disclosure of Interests:None declared.

scholarly journals Hazardous materials and CBRN incidents: Fundamentals of pre-hospital readiness in the State of Qatar

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Hassan Farhat ◽  
Padarath Gangaram ◽  
Nicholas Castle ◽  
Mohamed Chaker Khenissi ◽  
Sonia Bounouh ◽  
...  
Keyword(s):  
Linear Regression ◽  
Online Survey ◽  
Hazardous Materials ◽  
Multivariate Linear Regression ◽  
Wilcoxon Test ◽  
Training Module ◽  
Hospital Medical ◽  
Medical Response ◽  
Hospital Readiness ◽  
Non Parametric

Background: Hazardous Materials and Chemical/Biological/Radiological/Nuclear (HazMat-CBRN) incidents represent a serious threat to the population and the environment. They require a pre-hospital medical response system well equipped and supported with logistics and clinicians with appropriate knowledge and skills to prevent exposure and mitigate risks. Our aim is to determine if the Hamad Medical Corporation Ambulance Service (HMCAS) fulfils the pre-hospital readiness requirements for such incidents. Methods: This cross-sectional study was performed in HMCAS. An online survey assessed staff behaviour and knowledge in relation to HazMat-CBRN incidents. Responses were obtained on health risks and pre-hospital medical management of related threats in Qatar. Based on the results, a training module “HazMat Incident Management” was prepared with pre-/post-activity assessments. The results were explored using a multivariate linear regression and non-parametric Wilcoxon test for paired samples. Specialized Emergency Management (SEM) staff opinion about this training was assessed through an online survey. Both surveys’ validity and reliability tests were conducted. Ishikawa cause and effects diagram was built for the identification of the factors leading to a pre-hospital successful response to HazMat-CBRN incidents. Results: HMCAS has the proper logistics and plans to manage potential HazMat-CBRN incidents. The knowledge survey demonstrated that the pre-hospital medical staff information about this topic needs reinforcement. The multivariate linear regression and non-parametric Wilcoxon test demonstrated that this was obtained thanks to the implemented training module. The course satisfaction survey showed not only a big interest in this activity but also staff recommended more related topics. Earlier-RSDAT (Recognition, Safety, Decontamination, Antidot, Transport) is a tool proposed as a response acronym to build a successful risk-based response for HazMat CBRN incidents in pre-hospital setting. Conclusion: HMCAS fulfills the readiness requirements for safe and effective response to potential HazMat-CBRN incidents in Qatar. The RSDAT response matrix might help in mitigating pre-hospital response risks.

scholarly journals POS1460-HPR MYRA TOUCH FOR DISEASE ACTIVITY EVALUATION IN RHEUMATOID ARTHRITIS: A COMPARISON OF PATIENT-REPORTED OUTCOMES WITH PHYSICIAN’S ASSESSMENT

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1015.1-1015
Author(s):  
L. H. Eow ◽  
J. Yew ◽  
K. H. Lee ◽  
S. Selvadurai ◽  
S. M. Liau ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Inflammatory Markers ◽  
Patient Reported Outcomes ◽  
Activity Index ◽  
Disease Assessment ◽  
Activity Measurement ◽  
Patient Reported ◽  
Rheumatology Unit ◽  
High Level

Background:Patient-reported outcomes (PROs) have become an essential component of patients’ assessment in the management of Rheumatoid Arthritis(RA).They have been reported to be at least as informative if not more than physician assessed outcomes.MyRA Touch was pioneered by the Rheumatology Unit of Hospital Tuanku Jaa’far in Seremban Malaysia in March 2018,to engage and empower all RA patients on their own disease activity monitoring. It is an electronic platform, designed to enhanced the application of electronic patient reported outcomes (ePROs) among RA patients where they examine and record their own painful and/or swollen joints for DAS28 calculation and report their health assessment through Routine Assessment of Patient Index Data with 3 Measures (RAPID 3).MyRA Touch is an applications (App) that is user friendly and available in four major spoken languages (English, Chinese, Malay and Tamil) with an animated version for patients who are illiterate.Objectives:The objectives of this study are to determine the correlation between:I)Patient-reported and physician reported DAS28 ESR/CRPII)RAPID3 and Clinical Disease activity Index (CDAI)III)RAPID3 and DAS28 ESR/CRP assessed by physician and patientIV)RAPID3 and inflammatory markers ESR/CRP.Methods:This was a cross-sectional study carried out in the Rheumatology Unit of Hospital Tuanku Jaa’far. All data entered through MyRA Touch App from April 2018 till April 2020 was analysed.Results:There were a total of 562 patients who entered the data in the App, 87.9% were women. The ethnic compositions of the study subjects comprised of Indians (36.7%) followed by the Malays (34.7%),Chinese (26.3%) and other ethnics (2.3%). About half of patients (59.8%) were in the 51-70 age group whereas 22.9%,1.8% and 15.5% were in the 31-50,18-30 and above 70 age groups respectively. The majority of our patients (96%) were literate. A total of 54.3% of them received secondary education, 27% primary, 12.2% tertiary and 6.6% did not receive any formal education.There was a high level of correlation between DAS28 ESR/CRP performed by patient and DAS28 ESR/CRP assessed by physician, (r=0.808 for DAS28 ESR and r=0.804 for DAS28 CRP). RAPID3 also showed high level of correlation with CDAI and DAS28 CRP assessed by patient (r=0.700 and r=0.718 respectively). There was a moderate correlation between DAS28 ESR/CRP done by physician with RAPID3 (r=0.656 and r=0.696 respectively).RAPID3 demonstrated little correlation with inflammatory markers ESR and CRP (r=0.141 and r=0.171 respectively).Conclusion:PROs via DAS 28 (ESR/CRP) and RAPID3 showed moderate to high correlation with disease activity assessed by physician. We can empower patients to perform their own disease assessment by using the MyRA Touch App before seeing their physician and the information provided in the App, can help to reduced consultation time. During the COVID-19 pandemic, telemedicine is very much encouraged. By using the MyRA Touch, patients can assess their own tender and swollen joint count on a homunculus, evaluate their own physical function, health and pain using the RAPID3 parameters. The information obtained from the PROs in the MyRA touch App enables the physician to make a more comprehensive virtual assessment of the patient’s condition which helps in treatment decision making. In conclusion, MyRA Touch is an useful tool for disease activity measurement by patient.References:[1]Jenny AA, Diana BC, Omar JC, et al. Usefulness of Patients-Reported Outcomes in Rheumatoid Arthritis Focus Group. Hindawi Publishing Corporation Arthritis, vol 2012,Article ID935187.[2]Ana MO, Clifton OB. Patient Reported Outcomes in Rheumatoid Arthritis Clinical Trials. Curr Rheumato Rep.2015 April;17(4):501.Disclosure of Interests:None declared

scholarly journals OP0300 USE OF THERMOGRAPHY OF HANDS AND MACHINE LEARNING TO QUANTIFY JOINT INFLAMMATION AND ESTIMATE DAS28, CDAI, SDAI IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 184.1-184
Author(s):  
I. Morales-Ivorra ◽  
C. Gómez Vaquero ◽  
C. Moragues Pastor ◽  
J. M. Nolla ◽  
J. Narváez ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Machine Learning ◽  
Linear Regression ◽  
Disease Activity ◽  
Joint Inflammation ◽  
Training Dataset ◽  
Test Dataset ◽  
Thermal Images ◽  
Joint Assessment

Background:Disease activity scores such as DAS28, CDAI and SDAI are used in the follow-up of patients with rheumatoid arthritis (RA). These scores include variables obtained on physical examination such as the tender joint count (TJC) and the swollen joint count (SJC). In telematic consultations, it is not possible to determine these variables by physical joint assessment. Therefore, it is necessary to develop new tools that allow detecting joint inflammation in places close to the patient. Thermography is a safe and fast technique that measures heat through infrared imaging. Inflammation of the joints causes an increase in temperature and can therefore be detect by thermography. Machine learning methods are highly accurate in analyzing medical images automatically.Objectives:To develop an algorithm that, based on thermographic images of hands and machine learning, learn to quantify joint inflammation in patients with RA and estimate the DAS28, CDAI, SDAI by including the patient global health (PGH).Methods:Multicenter observational study conducted in the rheumatology and radiology service of two hospitals. Patients with RA, psoriatic arthritis (PA), undifferentiated arthritis (UA) and arthritis of hands secondary to other diseases (SA) that attended the follow-up visits were recruited. Companions of patients and healthcare professionals were also recruited as healthy subjects (HS). In all cases, a thermographic image of the hands was taken using a Flir One Pro or a Thermal Expert TE-Q1 camera connected to a smartphone. Ultrasound (US) of both hands was performed in patients with RA, PA, UA and SA. The degree of synovial hypertrophy (SH) and power doppler (PD) was assessed for each joint (score from 0 to 3). Machine learning was used to quantify joint inflammation (SH+PD) from the thermal images using US as ground truth. RA patients whose thermal image was taken with the Thermal Expert TE-Q1 camera were used to evaluate the performance (test dataset). The other participants were used as training dataset. The TJC, SJC, PGH, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were also assessed in the test dataset. A linear regression was used to estimate the DAS28, CDAI and SDAI with the resultant joint inflammation quantification from the thermal images and the PGH. Performance was evaluated by means of Pearson’s correlation coefficient. The study was approved by the Clinical Ethics and Research Committee of both centers.Results:The total number of recruited subjects was 521 (422 for the training and 99 for the testing dataset). In the training dataset, the thermography of 296 patients was taken with the Flir One Pro (163 RA, 17 PA, 22 UA, 12 SA and 82 HS) and 126 with the Thermal Expert TE-Q1 camera (6 RA without clinical data, 20 PA, 7 UA, 23 SA and 70 HS).We found higher correlations between joint inflammation variables (US and SJC) and thermography (0.48, p<0.01 for US and 0.48, p<0.01 for SJC) than between joint inflammation variables (US and SJC) and the PGH (0.29, p<0.01 for US and 0.35, p<0.01 for SJC). Thermography did not show statistically significant correlation with the PGH (0.14, p=0.164). The linear regression of thermography and the PGH showed strong correlation with the DAS28 (0.73, p<0.01), CDAI (0.84, p<0.01) and SDAI (0.82, p<0.01).Conclusion:Thermography of hands and machine learning can effectively quantify joint inflammation and can be used in combination with the PGH to estimate disease activity scores. These results open an opportunity to develop tools that facilitate telematic consultations in patients with RA.References:[1]Brenner M, Braun C, Oster M, Gulko PS. Thermal signature analysis as a novel method for evaluating inflammatory arthritis activity. Ann Rheum Dis. 2006;65(3):306-11[2]Lynch CJ, Liston C. New machine-learning technologies for computer-aided diagnosis. Nat Med. 2018;24(9):1304-1305[3]Tan YK, Hong C, Li H, Allen JC Jr, Thumboo J. Thermography in rheumatoid arthritis: a comparison with ultrasonography and clinical joint assessment. Clin Radiol. 2020;75(12):963Disclosure of Interests:None declared.

Achievement of Remission and Low Disease Activity Definitions in Patients with Rheumatoid Arthritis in Clinical Practice: Results from the NOR-DMARD Study

2016 ◽  
Vol 43 (4) ◽  
pp. 716-723 ◽  
Author(s):  
Till Uhlig ◽  
Elisabeth Lie ◽  
Vibeke Norvang ◽  
Åse Stavland Lexberg ◽  
Erik Rødevand ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Practice ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Joint Disease ◽  
Low Disease Activity ◽  
American College Of Rheumatology ◽  
Short Disease Duration ◽  
High Level

Objective.To examine the frequency of 6 definitions for remission and 4 definitions for low disease activity (LDA) after starting a disease-modifying antirheumatic drug (DMARD) in patients with rheumatoid arthritis (RA) in clinical practice, and to study whether predictors for achieving remission after 6 months are similar for these definitions.Methods.Remission and LDA were calculated according to the 28-joint Disease Activity Score (DAS28), the Clinical Disease Activity Index (CDAI), the Simplified Disease Activity Index (SDAI), the Routine Assessment of Patient Index Data (RAPID3), and both the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) Boolean remission definitions 3 and 6 months after 4992 DMARD prescriptions for patients enrolled in the NOR-DMARD, a 5-center Norwegian register. Prediction of remission after 6 months was also studied.Results.After 3 months, remission rates varied between definitions from 8.7% to 22.5% and for LDA from 35.5% to 42.7%, and increased slightly until 6 months of followup. DAS28 and RAPID3 gave the highest and ACR/EULAR, SDAI, and CDAI the lowest proportions for remission. Positive predictors for remission after 6 months were similar across the definitions and included lower age, male sex, short disease duration, high level of education, current nonsmoking, nonerosive disease, treatment with a biological DMARD, being DMARD-naive, good physical function, little fatigue, and LDA.Conclusion.In daily clinical practice, the DAS28 and RAPID3 definitions identified remission about twice as often as the ACR/EULAR Boolean, SDAI, and CDAI. Predictors of remission were similar across remission definitions. These findings provide additional evidence to follow treatment recommendations and treat RA early with a DMARD.

Importance of Obtaining Remission for Work Productivity and Activity of Patients with Rheumatoid Arthritis

2017 ◽  
Vol 44 (8) ◽  
pp. 1112-1117 ◽  
Author(s):  
Dam Kim ◽  
Yuko Kaneko ◽  
Tsutomu Takeuchi
Keyword(s):  
Rheumatoid Arthritis ◽  
Linear Regression ◽  
Disease Activity ◽  
Work Performance ◽  
Work Productivity ◽  
Regression Analyses ◽  
Clinical Factors ◽  
Activity Impairment ◽  
Low Disease Activity

Objective.To identify the factors relevant to work and activity impairment in patients with rheumatoid arthritis.Methods.In total, 1274 consecutive patients were included. Work and activity impairment were measured by the Work Productivity and Activity Impairment questionnaire, and related clinical factors were examined.Results.Work and activity impairment was reported by 67.4% of the patients. Multivariable linear regression analyses revealed pain and non-remission to be associated with activity impairment and presenteeism. Patients in remission had significantly less activity impairment and presenteeism than those with low disease activity.Conclusion.Remission achievement is essential for ensuring work performance and activity.

scholarly journals Health Literacy Predicts the Discrepancy Between Patient and Provider Global Assessments of Rheumatoid Arthritis Activity at a Public Urban Rheumatology Clinic

2010 ◽  
Vol 37 (5) ◽  
pp. 961-966 ◽  
Author(s):  
JOEL M. HIRSH ◽  
DENNIS J. BOYLE ◽  
DAVID H. COLLIER ◽  
ABBEY J. OXENFELD ◽  
LIRON CAPLAN
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Literacy ◽  
Linear Regression ◽  
Disease Activity ◽  
Functional Health ◽  
Common Finding ◽  
Absolute Difference ◽  
Cross Sectional ◽  
English Speaking ◽  
The Absolute

Objective.Numerous studies report that significant discordance exists between patient and provider [physician] measures of rheumatoid arthritis (RA). We examined whether health literacy explains this discordance.Methods.We recruited English-speaking adult patients with RA for this cross-sectional study. Subjects completed 2 versions of patient global assessments of disease activity (PTGA), using standard terminology from the Multi-Dimensional Health Assessment Questionnaire (MDHAQ) and the 28-joint count Disease Activity Score 28 (DAS28). The provider global assessment (MDGA) was also obtained. The discrepancy between PTGA and MDGA was calculated as the absolute difference between these assessments. We used validated instruments [Short Test of Functional Health Literacy in Adults (S-TOFHLA) and Rapid Estimate of Adult Literacy in Medicine (REALM)] and linear regression to determine whether health literacy predicts disease measure discrepancy.Results.The study included 110 subjects. Limited health literacy was a common finding by both the REALM and S-TOFHLA. PTGA and MDGA showed fair to good correlation (r = 0.66–0.68), although both versions of the PTGA were significantly higher than MDGA by the t-test (p < 0.001). The S-TOFHLA and REALM both were associated with the absolute difference between the MDGA and PTGA by linear regression, and results remained statistically significant in multivariate analysis.Conclusion.Health literacy was independently associated with the extent of discrepancy between PTGA and MDGA in English-speaking patients with RA at an urban clinic. This finding should influence our interpretation of disease measures.

Are Baseline High Molecular Weight Adiponectin Levels Associated with Radiographic Progression in Rheumatoid Arthritis and Osteoarthritis?

2014 ◽  
Vol 41 (5) ◽  
pp. 853-857 ◽  
Author(s):  
Inge R. Klein-Wieringa ◽  
Stefan N. Andersen ◽  
Linda Herb-van Toorn ◽  
Joanneke C. Kwekkeboom ◽  
Anette H.M. van der Helm-van Mil ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Molecular Weight ◽  
Linear Regression ◽  
High Molecular Weight ◽  
Radiographic Progression ◽  
Multivariate Linear Regression ◽  
Hand Osteoarthritis ◽  
High Molecular Weight Adiponectin ◽  
Differential Effects ◽  
Total Adiponectin

Objective.To investigate whether high molecular weight adiponectin (hmwAPN) mediates the associations of total adiponectin (totAPN) with radiographic progression in rheumatoid arthritis (RA) and hand osteoarthritis (HOA).Methods.Associations between baseline hmwAPN or totAPN levels with radiographic progression were determined using multivariate linear regression or generalized estimated equations.Results.In patients with RA, totAPN associated positively, whereas in patients with HOA it associated negatively with radiographic progression. In contrast, hmwAPN did not associate significantly with radiographic progression in either cohort.Conclusion.Our data indicate that the differential effects associated between totAPN and radiographic progression in either RA or HOA are not mediated by hmwAPN.

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