rheupp

Proposition Of A Triage System Based On Rapid3 Score For Rheumatoid Arthritis Patients In Brazil (PANLAR2025-1270)

Thu, 24 Apr 2025 05:32:50 GMT

Proposta de um Sistema de Triagem Baseado no Rapid3 Score para Pacientes com Artrite Reumatoide no Brasil

Conference: 27o Congresso Panamericano de Reumatologia At: Cidade do México, México

Ilka Benedet Lineburger; Claiton Viegas Brenol ; Vania Naomi Hirakata

Cross-cultural and clinical validation of the MDHAQ/RAPID3 of the MDHAQ/RAPID3 in electronic format for a Brazilian population of patients with rheumatoid arthritis

Tue, 22 Nov 2022 08:01:53 GMT

ABSTRACT

https://advancesinrheumatology.biomedcentral.com/articles/10.1186/s42358-022-00278-9

Background

Patients with rheumatologic diseases are monitored fundamentally through metric tools or index calculated from clinical data and patient exams, which allow us to assess the severity of the disease and guide the therapeutic decision. In rheumatoid arthritis (RA), for treatment to be optimized and considered effective, periodic assessment with composite disease activity index and a 'treat-to-target' approach is required. The Routine Assessment of Patient Index Data 3 (RAPID3) in the Multidimensional Health Assessment Questionnaire (MDHAQ) includes only three measures based on the central patient self-reported dataset and can be used in a 'treat-to-target' approach analogous to the Clinical Disease Activity Index (CDAI) and the Disease Activity Score 28-joints (DAS28). This tool, however, has not undergone cross-cultural or clinical validation in Brazil. In this research, we performed the MDHAQ cross-cultural and clinical validation for the Brazilian population of RA patients.

Methods

The Portuguese version of the MDHAQ was created identically in an electronic questionnaire and underwent a cross-cultural validation process with 38 participants. Test–retest was performed in 29 patients. Further, a clinical validation with 129 Rheumatoid Arthritis patients was performed. Electronic MDHAQ was answered through an online platform. We also collected socioeconomic data as well as other clinical (CDAI, SDAI, DAS28) and functional (HAQ) scores during the face-to-face assessment of patients.

Results

MDHAQ/RAPID3 maintained semantic, idiomatic, as well as conceptual and experience equivalence for the Brazilian population, with 92% acceptance of participants. It showed test–retest reliability, adequate internal consistency (Cronbach's α 0.85) and correlation of the scores obtained with adequate association with the DAS28 gold standard. RAPID3 also had high sensitivity (98%), adequate specificity (48%), high negative predictive value (92%) and negative post-test probability of 8%, attributes expected for a test tool for population screening.

Conclusion

The use of MDHAQ/RAPID3 associated with traditional clinical measures can adequately allow for remote follow-up based on the 'treat-to-target' approach with performance comparable to the gold standard DAS28, being a viable tool in the sample of Brazilian patients with RA in the current context of telehealth.

USABILITY AND ACCEPTANCE OF MDHAQ/RAPID3 IN ELECTRONIC FORMAT FOR BRAZILIAN PORTUGUESE PATIENTS (PANLAR2022-ABS-1429)

Fri, 12 Aug 2022 05:08:58 GMT

USABILIDADE E ACEITAÇÃO DO MDHAQ/RAPID3 EM FORMATO ELETRÔNICO PARA PACIENTES BRASILEIROS.

Conference: PANLAR Congress 2022 At: Miami, USA

Ilka Benedet Lineburger; Claiton Viegas Brenol ; Vania Naomi Hirakata

Objectives: The aim was to evaluate the usability and acceptance of a Multidimensional Health Assessment Questionnaire (MDHAQ/RAPID3) in electronic format for Brazilian Portuguese patients.

Methods: Participants were invited to answer an electronic questionnaire with reproduction of the MDHAQ items for consideration of conceptual equivalence, comprehension, and any cultural discrepancies or adaptations. The Portuguese version of the MDHAQ/RAPID3 was identically elaborated in an electronic format and underwent evaluation of its usability and acceptance by System Usability Scale (SUS) as part of the process of cross-cultural validation of the questionnaire for a Brazilian population of Rheumatoid Arthritis (RA) patients.

Results: Thirty-eight participants were included in the analysis, with mean age of 56 years (±10), 13 years of education (±5.6) and 30 (78%) female gender. MDHAQ/RAPID3 maintained semantic, idiomatic, as well as conceptual and experience equivalence for the Brazilian population, with 92% acceptance from the participants. The usability of the questionnaire, estimated by the SUS, was considered "good" for most patients (61%) and relatives (50%) and "excellent" by nurses (42%), general practitioners (60%) and rheumatologists (80%). The mean was 70.6 (±14.0) among all participants, with a minimum score of 32.5 and a maximum of 100. There was no association between SUS evaluation and the participants’ level education (p = 0.092). Summing positive evaluation (good, excellent, and best imaginable) the participants judgment was good, ranging from 60 to 100%. Regarding acceptance, 92% of the participants considered the MDHAQ a good instrument for following their rheumatologic symptoms. Conclusions: Web-based patient assessments provide a rationale for further exploration of their use as cost-effective tools to monitor RA activity during outpatient visits and to optimize tight control strategies. MDHAQ/RAPID3 in electronic format may allow a shared dynamic between physicians and patients regarding decisions of their clinical follow-up, improving adherence to treatment and being an important source of monitoring of adverse effects and effectiveness of the therapeutic measures instituted.

Reference 1: Lewis JR, Sauro J (2009) The Factor Structure of the System Usability Scale. In: Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics). pp 94–103

Reference 2: Pincus T, Yazici Y, Bergman M. Development of a multi-dimensional health assessment questionnaire (MDHAQ) for the infrastructure of standard clinical care. Clin Exp Rheumatol. 2005 Sep-Oct;23(5 Suppl 39):S19-28. PMID: 16273781.

ASSOCIATED FACTORS OF FALL OR FRACTURE REPORTED BY RHEUMATOID ARTHRITIS PATIENTS IN ELECTRONIC MDHAQ DURING COVID-19 PANDEMIC (AB1533-HPR)

Sun, 22 May 2022 05:27:01 GMT

FATORES ASSOCIADOS DE QUEDA OU FRATURA RELATADOS POR PACIENTES COM ARTRITE REUMATOIDE NO MDHAQ ELETRÔNICO DURANTE A PANDEMIA DE COVID-19

Conference: EULAR 2022

Annals of the Rheumatic Diseases 81(Suppl 1):1868.2-1869 DOI: 10.1136/annrheumdis-2022-eular.5405

Ilka Benedet Lineburger; Claiton Viegas Brenol ; Vania Naomi Hirakata

Abstract

Background: The COVID-19 pandemic accelerated the use telemedicine for rheumatologic patients. Patient reported outcomes (PRO) can provide prioritization criteria for the form of face-to-face care in situations of social restriction, and optimization of early care by identifying high-risk patients.

Objectives: Our aim was to demonstrate the main associated factors for a fall or fracture reported by rheumatoid arthritis (RA) patients in an electronic MDHAQ (Multidimensional Health Assessment Questionnaire) during this period. Methods Patients with RA according to 2010 ACR/EULAR and access to digital platforms were enrolled in the study, from January to august 2021. A weblink was sent to MDHAQ in electronic platform. The study was approved by the ethics committee of Hospital de Clínicas de Porto Alegre – Brazil and all patients agreed with a Term of Informed Consent.

Results: A total of 129 RA patients completed the electronic MDHAQ, mean age was 60 years (S.D. 14) and 83% were female. The mean DAS28, SDAI and HAQ were 3.8 (S.D. 1.6), 14.2 (S.D. 11.0) and 1.2 (S.D. 0.7). Of those 129 patients, 14 reported a fall or fracture in the last 6 months of response and only 16 patients were physically active. Relevant symptoms known as factors associated with risk of fall and its prevalence in this study were: pain (82%), followed by articular pain (68%), fatigue (43%), muscle weakness (37%) and weight gain (22%). Among patients who reported a fall or fracture, 83% had a RADAI ≥ 16 and mean FAST3 (Fibromyalgia Assessment Screening Test) index of 19 (IC95 % 17-21). FAST3 based on MDHAQ and independent RADAI showed positively association with a reported fall or fracture for these patients, with a p value of 0.023 and 0.025, respectively. Other factors, such as high disease activity based on DAS28 or MDHAQ, obesity and age were not statistically significant with the reported episode. Conclusion: Maintaining PRO is aligned with patient-centered care, allowing relevant data source and identification of high-risk patients - in our study: patients in pain, sedentary and in major risk of fracture. Also, use of combined in like FAST3 or independent articular pain scores such as RADAI, might be helpful to identify those high-risk patients in need for orientation for reinforcement of physical activity, prioritization for in person visits and early clinical adjustments.

References:

[1]PINCUS, T.; YAZICI, Y.; BERGMAN, M. Development of a multi-dimensional health assessment questionnaire (MDHAQ) for the infrastructure of standard clinical care. Clinical and Experimental Rheumatology , v. 23, n. 5 SUPPL. 39, 2005.

[2]ENGLAND, B. R. et al. Brief Report: Adaptation of American College of Rheumatology Rheumatoid Arthritis Disease Activity and Functional Status Measures for Telehealth Visits. Arthritis Care & Research , p. 0–2, 2020.

[3]IKEDA, K. et al. Securely collecting multidimensional health information from patients with rheumatoid arthritis using smart device technology: Beneficial effect for physicians and patients. Musculoskeletal Care , v. 16, n. 4, p. 494–499, 2018.

Acknowledgements: Rheumatology Service of Hospital de Clínicas de Porto Alegre

Disclosure of Interests: None declared

PREVALENCE OF SYMPTOMS REPORTED BY RHEUMATOID ARTHRITIS PATIENTS AT ELECTRONIC PLATFORM DURING COVID-19 PANDEMIC (Abstract no.662)

Wed, 20 Apr 2022 11:12:42 GMT

Conference: PAIN IN EUROPE XII: TARGETING PAIN AND ITS COMORBIDITIES IN THE DIGITAL AGE At: Dublin, Ireland - April, 2022.

Ilka Benedet Lineburger; Claiton Viegas Brenol ; Édila Pinheiro ; Alice Silveira Goularte ; Vania Naomi Hirakata

Background and aims : The COVID-19 pandemic accelerated the use telemedicine for rheumatologic patients. Patient reported outcomes (PRO) can provide prioritization criteria for the form of face-to-face care in situations of social restriction, and optimization of early care by identifying high-risk patients. Our aim was to demonstrate the prevalence of symptoms during this period for rheumatoid arthritis (RA) patients.

Methods: Patients with RA according to 2010 ACR/EULAR and access to digital platforms were enrolled in the study, from January to august 2021. A weblink was sent to a PRO elaborated in electronic platform. The study was approved by the ethics committee of Hospital de Clínicas de Porto Alegre – Brazil and all patients agreed with a Term of Informed Consent.

Results: A total of 129 RA patients completed the PRO, mean age was 60 years (S.D. 14) and 83% were female. The mean DAS28, SDAI and HAQ were 3.8 (S.D. 1.6), 14.2 (S.D. 11.0) and 1.2 (S.D. 0.7). Nearly 50% reported anxiety and 27% depression. Pain (VAS ≥ 5) was a common symptom for 82% of patients, followed by articular pain (68%), headache (53%), memory difficulties (50%), sleep problems (46%), fatigue (43%), muscle weakness (37%) and weight gain (22%). Only 16 patients were physically active and 104 sedentary in the last 6 months of response. Markedly, 14 patients reported a fall or fracture in the same period.

Conclusions: Maintaining PRO is aligned with patient-centered care, allowing relevant data source and identification of high- risk patients - in our study: patients in pain, sedentary and in major risk of fracture.