109. WHAT SERVICES DO RHEUMATOLOGY DEPARTMENTS OFFER AXIAL SPONDYLOARTHRITIS PATIENTS IN THE UK?
Notice bibliographique
Résumé
Background: There have been significant advances in the definition and management of axial spondyloarthritis (axSpA) during the last 5 years which should be reflected in patient care. We therefore explored the services offered to patients with axSpA by UK rheumatology departments. Methods: During February 2016, a validated web-based questionnaire was sent to 172 named NHS consultant rheumatologists at all acute trusts in the UK. The survey comprised 47 open and closed questions regarding professional views and service delivery relating to axSpA. Results: A total of 83 responses were received (response rate 48%). Eighty-eight percent of participants accepted the concept of axSpA, 7.2% rejected it and 4.8% were uncertain. Fifty-five percent would assign a diagnosis of axSpA to newly diagnosed patients. The term non-radiographic axSpA was used by the majority of respondents (72%) if the patient fulfilled the classification criteria. A majority of centres (57%) looked after between 100 and 499 patients, 13.3% >500, and 8.4% <100. The majority (61%) had at least one clinician with special interest in axSpA, 58% offered a dedicated axSpA clinic and 63% had an MDT with responsibility for axSpA. Patients were routinely reviewed 6-monthly by 61% of centres and annually by 22.9%. In 16 (19.3%) of centres there were combined clinics; 8 dermatology, 2 ophthalmology, 1 gastroenterology, 4 dermatology plus gastroenterology, and 1 dermatology plus ophthalmology. Metrology is routine practice in 96% of centres; in which, BASDAI (100%), BASFI (75%), BASMI (66%), WAPI (19%) were used; 66% of centres used at least 3 metrology tools simultaneously. The first-line investigation is MRI in 37%, X-ray in 22% and both in 34%. When requesting MRI scans, 53.3% ask for full spine, 9.1% sacroiliac joint, and 28.6% both, while 9.1% would request other sequences. Respondents reported that 30% (IQR 22–48%) of their axSpA patients were receiving anti-TNF therapy, however 39% reported restricted access. Seventy-nine percent treat non-radiographic axSpA with biologics; 97% treat MRI-positive patients, 25% MRI-negative/CRP-positive; only one centre would treat if MRI negative/CRP negative. The majority (75%) were confident using biosimilars; 57% reported experience using biosimilar Infliximab. Eighty-three percent of centres had access to specialized orthopaedic spinal surgery in a tertiary centre (59.4%), in the same trust (34.4%) or other centres (6.3%). The majority of centres (94%) have a patient advice line, aiming to respond within same (25%) or next working day (63%). Community clinics are offered by 36%. Fifty-five percent participate in axSpA research, 59% have dedicated databases or other computerized patient records and the majority (70%) contribute data to the BSRBR-AS.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».