The Frequency of Diffuse Idiopathic Skeletal Hyperostosis (DISH) in Spondyloarthritis in Comparison to Age and Sex-Matched Controls and Impact of SpA on Onset Age of DISH
Notice bibliographique
Résumé
Objectives Although diffuse idiopathic skeletal hyperostosis (DISH) is classically defined in the thoracic spine and the elderly population, there are case reports on the overlap between cervical DISH and spondyloarthritis (SpA).[1] We aimed to compare the frequency of cervical DISH in SpA vs controls to see whether there is a true increased frequency and if the presence of SpA impacts the onset age of DISH. Methods The SpA population included patients who were diagnosed with axial or peripheral SpA, followed at the Arthritis Centre and had cervical spine x-rays for screening purposes between 2016-2020. The control group included patients who presented to the Emergency Department and had a cervical spine x-ray for any reason. Four control patients for each SpA patient were age- and sex-matched. An investigator meeting on the definitions took place before the study, followed by an agreement exercise. Two radiologists independently scored the radiographs for the confidence level for the presence of DISH on a scale between 0-5. The ICC of the 2 radiologists were 0,935. For the study, the radiographs were read by 1 of the 2 radiologists, who distributed the cases and controls equally among the 2 radiologists. The confidence of Grade 3 was considered as DISH positive. Results One-hundred-ninety-one SpA and 764 age- and sex-matched controls were included (Table). DISH was observed in 26 (13.6%) SpA patients and 108 (14.1%) controls, with similar frequencies (p=0.852). The age of DISH+ patients was statistically significantly lower in the SpA group than the control group (median (IQR); 54 (16) vs 59 (13); p=0.026). DISH was higher in males than females in both SpA (n:19/104 (18.3%) vs n:7/87 (8%); p=0.04) and control groups (n:74/416 (17.5%) vs n:35/348 (10.1%); p=0.003). There were 143 (74.9%) SpA patients with known HLA-B27 status. The frequency of DISH in HLA-B27(−) SpA patients was higher than HLA-B27(+) SpA patients numerically (n=14/65 (21.5%) vs n=8/78 (10.3%); p=0.063). Interestingly, HLA-B27 had different effects on the presence of DISH in subgroups: AxSpA patients (radiographic and non-radiographic combined) had more DISH if they were HLA-B27 positive (12.5% vs 8.7%), unlike the PsA, who had DISH exclusively if they were HLA-B27 negative (28.2% vs 0%). Table. Demographics and disease subgroups Conclusion The frequency of DISH in SpA patients is similar to the general population. However, SpA patients develop DISH at an earlier age. Our observation of the differential impact of HLA-B27 on axSpA vs PsA may signal the different mechanisms impacting the spine in both diseases. [1.] Kuperus JS. Rheumatology (Oxford) 2018;57(12):2120-8.
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 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 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 ».