265 Chiropractic and osteopathic knowledge and experience in treating patients with axial spondyloarthritis
Notice bibliographique
Résumé
Background: Chiropractors and osteopaths are important gatekeepers in the initial diagnosis and subsequent management of axial spondyloarthritis (axSpA). In view of recent significant advances in diagnosis and treatment, we sought to understand current knowledge and working practices among these important groups of healthcare professionals. Methods: In June 2018, a web-based questionnaire, comprising 30 open and closed questions relating to recognition of axSpA which included items on recognition of symptomology and onward referral processes was advertised via the Royal College of Chiropractors, Institute of Osteopathy and the National Ankylosing Spondylitis Society via online mechanisms including e-news and social media. Results: Three hundred and eighty-two completed responses were received; 237 chiropractors (62%) and 145 osteopaths (38%), 81% aged 30-59, 59% female; 63% practicing for >10 yrs. The majority (59%) were seeing between 1-5 back patients per day and 30% saw more than 5. All were familiar with the term ankylosing spondylitis (AS) and 99% were confident with their understanding of this. However only 63% were familiar with the term axSpA and 57% felt confident with this. For non-radiographic axSpA, 25% were aware of the term with 22% feeling confident with their understanding. Seventy-seven percent were confident with the concept of inflammatory back pain with the majority familiar with the characteristic features; including back pain onset <45 yrs (69%), insidious onset (78%), symptoms lasted >3 months (80%), pain improved by activity (55%), pain relieved by NSAIDs (77%); morning stiffness lasting >30 minutes (83%), alternating buttock pain (35%) Fifty-two percent considered localised spinal tenderness to be important. Regarding extra articular manifestations and peripheral musculoskeletal features, respondents routinely asked about a history of psoriasis (81%), inflammatory bowel disease (91%), acute anterior uveitis (AAU-49%), peripheral arthritis (71%), genitourinary/gut infection (56%), enthesitis (30%), and dactylitis (20%). Eighty-seven percent were aware of the association between axSpA and HLA-B27, 77% routinely asked about family history, and 56% routinely enquired about inflammatory markers. Only 29% recognised that axSpA was common in women. Forty percent recommend an X-ray (pelvic in 80%), and if normal 27% would recommend MRI sacroiliac joints and whole spine. Forty-four percent were aware of biologic therapies. On a weighted average, respondents indicated that their confidence in securing onward referral to rheumatology via the general practitioner (GP) was 3.2 out of 5 ; 43% were confident with the process. The principal perceived barrier to onward referral was reluctance by the GP to accept their findings. Conclusion: Overall knowledge of AS is good, however the term axSpA is poorly understood. Specific learning needs include sex preponderance, awareness of AAU and the availability of biological therapies. There is a lack of confidence in the onwards referral process to rheumatology via the GP. Disclosures: C. Yong: None. J. Hamilton: None. J. Benepal: None. K. Griffiths: None. Z. Clark: None. M. Rush: None. R. Sengupta: None. J. Martindale: None. K. Gaffney: None.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
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 source (Gemma direct ou Codex distillé), 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 ».