利用自然语言处理技术探索在西班牙真实世界条件下接受治疗的轴性脊柱关节炎和银屑病关节炎患者的特征和管理方法:SpAINET 研究。

IF 3.4 2区 医学 Q2 RHEUMATOLOGY
Therapeutic Advances in Musculoskeletal Disease Pub Date : 2023-12-24 eCollection Date: 2023-01-01 DOI:10.1177/1759720X231220818
Diego Benavent, Santiago Muñoz-Fernández, Isabel De la Morena, Antonio Fernández-Nebro, Judith Marín-Corral, Eva Castillo Rosa, Miren Taberna, Cristina Sanabra, Carlos Sastre
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引用次数: 0

摘要

背景:脊柱关节炎(SpA)是一组相关但表型不同的炎症性疾病,包括轴性脊柱关节炎(axSpA)和银屑病关节炎(PsA)。现实世界中有关这些患者的特征和管理的信息仍然很少:目的:利用电子健康记录(EHR)中的自然语言处理(NLP)技术,探讨axSpA和PsA患者的特征和管理[疾病活动评估和使用赛库单抗(SEC)或其他生物性改变病情抗风湿药(bDMARDs)治疗]:全国性、多中心、观察性和回顾性研究:我们分析了三家医院电子病历中的自由文本和结构化临床信息。纳入了2018年至2021年期间所有患有axSpA、PsA或未分类SpA的成年患者,这些患者在开始使用SEC或其他bDMARDs时至少随访了三个月。临床变量采用基于系统化医学术语-临床术语(SNOMED CT)术语的EHRead®技术提取:在887,735名患者中,纳入了758名,其中328名患有axSpA[58.5%为男性;平均(标清)年龄为50.7(12.7)岁],365名患有PsA[54.8%为女性,53.9(12.4)岁],65名未分类SpA。axSpA和PsA患者确诊后的平均(标清)时间分别为36.8(61.0)个月和24.1(35.2)个月。只有 116 名 axSpA 患者(35.3%)在开始使用 bDMARD 时有强直性脊柱炎疾病活动度评分 (ASDAS) 或巴斯强直性脊柱炎疾病活动度指数 (BASDAI),其中 61 人的疾病处于活动期。只有61名PsA患者(16.7%)在开始使用bDMARD时获得了PSoriatic关节炎疾病活动度(DAPSA)或疾病评估评分--28个关节(DAS-28)值,其中23人的疾病处于活动期。axSpA和PsA患者分别有68人(20.7%)和59人(18%)有关节压痛计数或关节肿胀计数评估,PsA患者分别有115人(31.5%)和119人(32.6%)有关节压痛计数或关节肿胀计数评估。63名(19.2%)axSpA患者和63名(17.3%)PsA患者使用了SEC:研究表明,约有三分之一的axSpA患者和六分之一的PsA患者分别使用ASDAS/BASDAI或DAPSA/DAS-28对疾病活动性进行评估,这表明这些患者的管理工作有待改进。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Using natural language processing to explore characteristics and management of patients with axial spondyloarthritis and psoriatic arthritis treated under real-world conditions in Spain: SpAINET study.

Background: Spondyloarthritis (SpA) is a group of related but phenotypically distinct inflammatory disorders that include axial SpA (axSpA) and psoriatic arthritis (PsA). Information on the characteristics and management of these patients in the real world remains scarce.

Objectives: To explore the characteristics and management [disease activity assessment and treatment with secukinumab (SEC) or other biologic disease-modifying antirheumatic drugs (bDMARDs)] of axSpA and PsA patients using natural language processing (NLP) in Electronic Health Records (EHRs).

Design: National, multicenter, observational, and retrospective study.

Methods: We analyzed free-text and structured clinical information from EHR at three hospitals. All adult patients with axSpA, PsA or non-classified SpA from 2018 to 2021 with minimum follow-up of three months were included when starting SEC or other bDMARDs. Clinical variables were extracted using EHRead® technology based on Systemized Nomenclature of Medicine-Clinical Terms (SNOMED CT) terminology.

Results: Out of 887,735 patients, 758 were included, of which 328 had axSpA [58.5% male; mean (SD) age of 50.7 (12.7) years], 365 PsA [54.8% female, 53.9 (12.4) years], and 65 non-classified SpA. Mean (SD) time since diagnosis was 36.8 (61.0) and 24.1 (35.2) months for axSpA and PsA, respectively. Only 116 axSpA patients (35.3%) had available Ankylosing Spondylitis Disease Activity Score (ASDAS) or Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) at bDMARD onset, of which 61 presented active disease. Disease Activity in PSoriatic Arthritis (DAPSA) or Disease Assessment Score - 28 joints (DAS-28) values at bDMARD onset were available for only 61 PsA (16.7%) patients, with 23 of them having active disease. The number of patients with available tender joint count or swollen joint count assessment was 68 (20.7%) and 59 (18%) for axSpA, and 115 (31.5%) and 119 (32.6%) for PsA, respectively. SEC was used in 63 (19.2%) axSpA patients and in 63 (17.3%) PsA patients.

Conclusion: Using NLP, the study showed that around one-third of axSpA and one-sixth of PsA patients have disease activity assessments with ASDAS/BASDAI or DAPSA/DAS-28, respectively, highlighting an area of improvement in these patients' management.

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来源期刊
CiteScore
6.80
自引率
4.80%
发文量
132
审稿时长
18 weeks
期刊介绍: Therapeutic Advances in Musculoskeletal Disease delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of musculoskeletal disease.
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