Rheumatology Advances in Practice最新文献

{"title":"Right clinician, right place, right time: the role of the first contact practitioner from a rheumatology perspective.","authors":"William J Gregory","doi":"10.1093/rap/rkae032","DOIUrl":"https://doi.org/10.1093/rap/rkae032","url":null,"abstract":"","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae032"},"PeriodicalIF":3.1,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10948280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired health-related quality of life in idiopathic inflammatory myopathies: a cross-sectional analysis from the COVAD-2 e-survey.","authors":"Akira Yoshida, Yuan Li, Vahed Maroufy, Masataka Kuwana, Syahrul Sazliyana Shaharir, Ashima Makol, Parikshit Sen, James B Lilleker, Vishwesh Agarwal, Esha Kadam, Phonpen Akawatcharangura Goo, Jessica Day, Marcin Milchert, Yi-Ming Chen, Dzifa Dey, Tsvetelina Velikova, Sreoshy Saha, Abraham Edgar Gracia-Ramos, Ioannis Parodis, Elena Nikiphorou, Ai Lyn Tan, Arvind Nune, Lorenzo Cavagna, Carlos Enrique Toro Gutiérrez, Carlo Vinicio Caballero-Uribe, Miguel A Saavedra, Samuel Katsuyuki Shinjo, Nelly Ziade, Lina El Kibbi, Johannes Knitza, Oliver Distler, Hector Chinoy, Vikas Agarwal, Rohit Aggarwal, Latika Gupta","doi":"10.1093/rap/rkae028","DOIUrl":"10.1093/rap/rkae028","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate health-related quality of life in patients with idiopathic inflammatory myopathies (IIMs) compared with those with non-IIM autoimmune rheumatic diseases (AIRDs), non-rheumatic autoimmune diseases (nrAIDs) and without autoimmune diseases (controls) using Patient-Reported Outcome Measurement Information System (PROMIS) instrument data obtained from the second COVID-19 vaccination in autoimmune disease (COVAD-2) e-survey database.</p><p><strong>Methods: </strong>Demographics, diagnosis, comorbidities, disease activity, treatments and PROMIS instrument data were analysed. Primary outcomes were PROMIS Global Physical Health (GPH) and Global Mental Health (GMH) scores. Factors affecting GPH and GMH scores in IIMs were identified using multivariable regression analysis.</p><p><strong>Results: </strong>We analysed responses from 1582 IIM, 4700 non-IIM AIRD and 545 nrAID patients and 3675 controls gathered through 23 May 2022. The median GPH scores were the lowest in IIM and non-IIM AIRD patients {13 [interquartile range (IQR) 10-15] IIMs <i>vs</i> 13 [11-15] non-IIM AIRDs <i>vs</i> 15 [13-17] nrAIDs <i>vs</i> 17 [15-18] controls, <i>P</i> < 0.001}. The median GMH scores in IIM patients were also significantly lower compared with those without autoimmune diseases [13 (IQR 10-15) IIMs <i>vs</i> 15 (13-17) controls, <i>P</i> < 0.001]. Inclusion body myositis, comorbidities, active disease and glucocorticoid use were the determinants of lower GPH scores, whereas overlap myositis, interstitial lung disease, depression, active disease, lower PROMIS Physical Function 10a and higher PROMIS Fatigue 4a scores were associated with lower GMH scores in IIM patients.</p><p><strong>Conclusion: </strong>Both physical and mental health are significantly impaired in IIM patients, particularly in those with comorbidities and increased fatigue, emphasizing the importance of patient-reported experiences and optimized multidisciplinary care to enhance well-being in people with IIMs.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae028"},"PeriodicalIF":3.1,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10960935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and safety of eltrombopag in connective tissue disease patients with refractory immune thrombocytopenia: a retrospective study.","authors":"Xiangpin Jiang, Xiaoming Shu, Yongpeng Ge","doi":"10.1093/rap/rkae029","DOIUrl":"10.1093/rap/rkae029","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to investigate the safety and effectiveness of eltrombopag for adult patients with refractory immune thrombocytopenia (ITP) secondary to connective tissue disease (CTD).</p><p><strong>Methods: </strong>This is a single-centre, retrospective cohort and propensity score-matched study. Data from CTD-ITP patients treated with eltrombopag between January 2019 and January 2023 were retrospectively analysed. Baseline characteristics and follow-up information were recorded. CTD patients without ITP were matched to identify the risk factors associated with CTD-ITP performed by Logistic regression analysis.</p><p><strong>Results: </strong>Twenty patients were enrolled, including 5 systemic lupus erythematosus (SLE), 9 Sjögren's syndrome (SS) and 6 undifferentiated connective tissue disease (UCTD). Nineteen (95%) patients were female, and the median age was 59 years. Logistic regression analysis showed that anaemia (OR = 8.832, <i>P </i>=<i> </i>0.007) was associated with increased risk of ITP, while non-erosive arthritis (OR = 0.045, <i>P </i>=<i> </i>0.001) and interstitial lung disease (OR = 0.075, <i>P </i>=<i> </i>0.031) were associated with reduced risk. Fourteen patients (70%) achieved a complete response (CR) and one (5%) achieved a partial response (PR). The median response time was 14 days. The median platelet count was 8.5 × 10⁹/l at baseline of eltrombopag and increased to 122 × 10⁹/l after 4 weeks. No adverse events were observed.</p><p><strong>Conclusions: </strong>Eltrombopag appears to be effective, safe and well-tolerated in refractory ITP patients with CTD; larger studies are needed to confirm the generalizability of these findings.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae029"},"PeriodicalIF":3.1,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10942842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming provider barriers to therapeutic drug monitoring of tumour necrosis factor inhibitors for rheumatoid arthritis: a qualitative analysis.","authors":"Sean P Gavan, Katherine Payne, Anne Barton","doi":"10.1093/rap/rkae030","DOIUrl":"https://doi.org/10.1093/rap/rkae030","url":null,"abstract":"<p><strong>Objective: </strong>Therapeutic drug monitoring (TDM) of tumour necrosis factor-α inhibitors (TNFi), by measuring drug levels and/or anti-drug antibodies, is being considered by various international bodies to improve patient health outcomes and the value of care for people with rheumatoid arthritis. Rheumatology care providers may perceive barriers to adopting TNFi TDM within their own clinical practice, limiting the potential for patients and health care systems to benefit. This study aimed to explore the barriers perceived by rheumatologists that may reduce their uptake of TNFi TDM for rheumatoid arthritis.</p><p><strong>Method: </strong>Semi-structured one-to-one telephone interviews were performed with a convenience sample of senior rheumatologists with experience of managing people with rheumatoid arthritis. The interviews explored the rheumatologists' understanding of TDM and their beliefs about how it can be integrated into their own routine practice. Interviews were audio recorded, transcribed verbatim and anonymized. Transcripts were coded inductively and barriers to using TNFi TDM were identified by thematic framework analysis.</p><p><strong>Result: </strong>A sample of eleven senior rheumatologists were interviewed. The rheumatologists described five barriers to adopting TNFi TDM in routine practice: (i) observing clinical need; (ii) understanding how testing can improve practice; (iii) insufficient clinical evidence; (iv) insufficient resources to pay for testing; and (v) insufficient capability to deliver testing.</p><p><strong>Conclusion: </strong>Barriers to adopting TNFi TDM in routine care settings will restrict the ability for patients to benefit from effective monitoring strategies as they begin to emerge. Strategies to overcome these barriers are suggested which will require a coordinated response from stakeholders across health care systems.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae030"},"PeriodicalIF":3.1,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'What is my risk really?': a qualitative exploration of preventive interventions among individuals at risk of rheumatoid arthritis.","authors":"Lara S Chapman, Heidi J Siddle, Stefan Serban, Kulveer Mankia, Christopher M Rooney, Zhain Mustufvi, Simon Pini, Karen Vinall-Collier","doi":"10.1093/rap/rkae023","DOIUrl":"10.1093/rap/rkae023","url":null,"abstract":"<p><strong>Objectives: </strong>Intervention in the pre-arthritis phase of RA could prevent or delay the onset of disease. The primary aim of this study was to explore perspectives of being at risk and potential preventive interventions among individuals at risk of developing RA and to identify factors influencing their engagement with prevention. A secondary aim, established during the analytical process, was to understand and compare different approaches to health-related behaviours related to prevention of RA.</p><p><strong>Methods: </strong>Anti-CCP-positive (CCP⁺) at-risk individuals with musculoskeletal symptoms but no synovitis participated in semi-structured interviews. Data were analysed using reflexive thematic analysis, followed by a secondary ideal-type analysis.</p><p><strong>Results: </strong>Nineteen CCP⁺ at-risk individuals (10 women; age range 35-70 years) participated. Three overarching themes were identified: being CCP⁺ at risk; aiming to prevent RA; and influencers of engagement. Participants described distress related to symptoms and uncertainty about disease progression. Many participants had concerns about medication side effects. In contrast, most participants expressed willingness to make lifestyle changes with the aim of preventing RA. Engagement with preventive measures was influenced by symptom severity, personal risk level, co-morbidities, experiences of taking other medications/supplements, knowledge of RA, risk factors and medications, and perceived effort. Three types of participants were identified from the data: proactive preventers, change considerers and fearful avoiders. Overall orientation to health behaviours also impacted the attitude towards preventing RA.</p><p><strong>Conclusion: </strong>Findings could inform recruitment and retention in RA prevention research and promote uptake of preventive interventions in clinical practice.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae023"},"PeriodicalIF":3.1,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10939459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterising polymyalgia rheumatica on whole-body ¹⁸F-FDG PET/CT: an atlas.","authors":"Claire E Owen, Aurora M T Poon, Bonnia Liu, David F L Liew, Lee Pheng Yap, Victor Yang, Jessica L Leung, Christopher R McMaster, Andrew M Scott, Russell R C Buchanan","doi":"10.1093/rap/rkae003","DOIUrl":"10.1093/rap/rkae003","url":null,"abstract":"<p><p>The impact of modern imaging in uncovering the underlying pathology of PMR cannot be understated. Long dismissed as an inflammatory syndrome with links to the large vessel vasculitis giant cell arteritis (GCA), a pathognomonic pattern of musculotendinous inflammation is now attributed to PMR and may be used to confirm its diagnosis. Among the available modalities, ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET/CT is increasingly recognized for its high sensitivity and specificity, as well as added ability to detect concomitant large vessel GCA and exclude other relevant differentials like infection and malignancy. This atlas provides a contemporary depiction of PMR's pathology and outlines how this knowledge translates into a pattern of findings on whole body ¹⁸F-FDG PET/CT that can reliably confirm its diagnosis.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 1","pages":"rkae003"},"PeriodicalIF":3.1,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10876394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139906364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coalition for Health and Gender Equity (CHANGE)-a protocol for a global cross-sectional survey of health and gender equity in rheumatology.","authors":"Tayyeba Khursheed, Pavel Ovseiko, Sarah Dyball, Ran Nakashima, Ana Maria Arredondo Gonzalez, Alejandra Babini, Asgar Ali Kalla, Catherine Hill, Debashish Danda, Dzifa Dey, Lisa Traboco, Elena Nikiphorou, Ghita Harifi, Humeira Badshah, Ihsane Hmamouchi, Joan Marie Von Feldt, Júlia Boechat Farani, Laura Andreoli, Mariana Peixoto Guimarães, Carlos Enrique Toro Gutiérrez, Cristiana Sieiro Santos, Christina Duftner, Deshire Alpizar Rodriguez, Nelly Ziadé, Penélope Esther Palominos, Syed Atiqul Haq, Wilson Bautista-Molano, Yoshiya Tanaka, Laure Gossec, Vikas Agarwal, Grace C Wright, Laura Coates, Latika Gupta","doi":"10.1093/rap/rkae021","DOIUrl":"10.1093/rap/rkae021","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aim of the CHANGE survey is to determine the current state of gender equity within rheumatology, and secondarily, to review the physician perspective on bullying, harassment and equipoise of opportunities within rheumatology.</p><p><strong>Methods: </strong>The CHANGE e-survey is a cross-sectional self-reported questionnaire adapted from EULAR's gender equity in academic rheumatology task force. The survey was launched in January 2023; it is available in six languages and distributed widely via rheumatology organizations and social media. Eligible participants include rheumatologist physicians and rheumatology health-care professionals. Survey responses will undergo descriptive analysis and inter-group comparison aiming to explore gender-based discrimination using logistic regression, with subgroup analyses for country/continent variations.</p><p><strong>Conclusion: </strong>This e-survey represents a comprehensive global initiative led by an international consortium, aimed at exploring and investigating the gender-related disparities and obstacles encountered by rheumatologists and rheumatology health-care professionals across diverse communities and health-care environments. By pursuing this initiative, we aim to take the broader rheumatology community a step closer to understanding the underlying origins of inequities and their determinants. Such insights are pivotal in identifying viable interventions and strategies to foster gender equity within the field. Ultimately, our collective objective is to ensure equitable access to opportunities for every individual, irrespective of gender, thereby promoting inclusivity and fairness across the entire spectrum of professional practice and career development.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 2","pages":"rkae021"},"PeriodicalIF":3.1,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10980588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psoriatic arthritis: the role of self-reported non-adherence, non-trough drug levels, immunogenicity and conventional synthetic DMARD co-therapy in adalimumab and etanercept response.","authors":"Philippa D K Curry, Andrew P Morris, Meghna Jani, Hector Chinoy, Anne Barton, James Bluett","doi":"10.1093/rap/rkae014","DOIUrl":"10.1093/rap/rkae014","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess the relationship between self-reported non-adherence, non-trough drug levels, immunogenicity and conventional synthetic DMARD (csDMARD) co-therapy in TNF inhibitor (TNF-i) drug response in PsA.</p><p><strong>Methods: </strong>Serum samples and adherence questionnaires were collected at baseline, 3, 6 and 12 months for PsA patients prescribed TNF-i. Non-trough adalimumab (ADL) and etanercept (ETN) drug levels were measured at 3 and 6 months using commercially available ELISAs. Clinical response was assessed using PsA response criteria (PsARC) and change in 28-joint DAS (ΔDAS28) between baseline and 3, 6 and 12 months.</p><p><strong>Results: </strong>In 244 PsA patients (52.5% ADL and 47.5% ETN), self-reported non-adherence was associated with PsARC non-response over 12 months using generalized estimating equation (GEE) modelling (<i>P </i>= 0.037). However, there was no significant difference between non-trough ADL or ETN drug levels based on self-reported non-adherence. Higher ETN levels at 3 months were associated with PsARC response at 3 (<i>P </i>= 0.015), 6 (<i>P </i>= 0.037) and 12 months (<i>P </i>= 0.015) and over 12 months using GEE modelling (<i>P </i>= 0.026). Increased ADL drug levels at 3 months were associated with greater ΔDAS28 at 3 months (<i>P </i>= 0.019). ADL anti-drug antibody-positive status was significantly associated with lower 3- and 6-month ADL levels (<i>P </i>< 0.001) and ΔDAS28 and PsARC response at 3, 6 and 12 months. Meanwhile, MTX co-therapy was associated with a reduction in immunogenicity at 3 and 6 months (<i>P </i>= 0.008 and <i>P </i>= 0.024).</p><p><strong>Conclusion: </strong>Although both were associated with reduced response, the objectively measured non-trough drug levels showed more significant associations with drug response than self-reported non-adherence measures.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 1","pages":"rkae014"},"PeriodicalIF":3.1,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10898332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anxiety and depression in patients with giant cell arteritis.","authors":"Joana Martins-Martinho, André Ponte, Eduardo Dourado, Nikita Khmelinskii, Sofia C Barreira, Ana R Cruz-Machado, Carla Macieira, Vítor Teixeira, Ana M Rodrigues, Diogo Telles-Correia, João E Fonseca, Cristina Ponte","doi":"10.1093/rap/rkae013","DOIUrl":"10.1093/rap/rkae013","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the prevalence of anxiety and depression in patients with GCA with that in the general population, using the Hospital Anxiety and Depression Scale (HADS), and to identify independent predictors of these psychiatric manifestations in patients with GCA.</p><p><strong>Methods: </strong>We conducted a cross-sectional study including all patients diagnosed with GCA followed during 1 year in a vasculitis outpatient clinic. The HADS and 36-item Short Form (SF-36) questionnaires were prospectively collected. Patients' HADS results were compared with an age- and gender-matched control group. HADS anxiety (HADS-A) and HADS depression (HADS-D) scores between 8 and 10 defined possible anxiety and depression and ≥11 defined probable anxiety and depression, respectively.</p><p><strong>Results: </strong>We included 72 patients and 288 controls. Compared with controls, patients with GCA had a statistically significant higher prevalence of HADS-A ≥8 (48.6% <i>vs</i> 26.4%), HADS-A ≥11 (30.6% <i>vs</i> 12.2%) and HADS-D ≥11 (33.3% <i>vs</i> 18.1%). GCA was an independent predictor of HADS-A ≥8 [odds ratio (OR) 3.3 (95% CI 1.9, 5.9)], HADS-A ≥11 [OR 3.8 (95% CI 2.0, 7.4)] and HADS-D ≥11 [OR 2.6 (95% CI 1.4, 4.7)]. Among patients with GCA, a negative correlation was observed between HADS-A/D and SF-36 mental health scores (<i>r</i> = -0.780 and <i>r</i> = -0.742, respectively). Glucocorticoid therapy was a predictor of HADS-A ≥8 [OR 10.4 (95% CI 1.2, 94.2)] and older age of HADS-D ≥8 [OR 1.2 (95% CI 1.1, 1.3)] and HADS-D ≥11 [OR 1.1 (95% CI 1.0, 1.2)].</p><p><strong>Conclusions: </strong>Compared with the general population, patients with GCA have a higher prevalence of anxiety and depression and GCA is an independent predictor of these symptoms. Glucocorticoid treatment and older age are predictors of anxiety and depression, respectively, in patients with GCA.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 1","pages":"rkae013"},"PeriodicalIF":3.1,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10879746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond pGALS: the need for a multifaceted musculoskeletal decision-making tool ('pGALSplus') in community-based clinical practice.","authors":"Vicky Mercer, Nicola Smith, Sharmila Jandial, Michela Guglieri, Simon A Jones, Helen E Foster","doi":"10.1093/rap/rkae004","DOIUrl":"10.1093/rap/rkae004","url":null,"abstract":"<p><p>Musculoskeletal (MSK) problems in children are common, and health-care professionals must identify those requiring onward referral. Paediatric gait, arms, legs and spine (pGALS) is an MSK assessment to discern abnormal joints. We aimed to identify MSK assessments to add to pGALS (pGALSplus) to facilitate decision-making in the context of exemplar conditions representing a spectrum of MSK presentations, namely JIA, mucopolysaccharidoses, muscular dystrophy and developmental co-ordination disorder. A literature review identified 35 relevant articles that focused on clinical assessments [including questionnaire(s), physical examination and functional tests] used by health-care professionals in the context of the exemplar conditions. We provide a description of these assessments and the rationale regarding how they, or components of such tools, might be useful within pGALSplus. This process provides a foundation for further work to develop and validate pGALSplus.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 1","pages":"rkae004"},"PeriodicalIF":2.1,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10822673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139570767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}