Can treatment expectations or treatment itself in patients with arthralgia suspicious for progression to rheumatoid arthritis improve illness perceptions?
Bibliographic record
Abstract
OBJECTIVES: Negative illness perceptions (IPs) are associated with poorer disease outcomes in rheumatoid arthritis (RA). Unfortunately, IPs are generally stable in established RA. We hypothesized that IPs, especially in the cognitive domain, are modifiable in arthralgia at risk of RA. We aimed to study if receiving DMARD treatment, or the offer of DMARD treatment associates with more positive IPs in patients with clinically suspect arthralgia (CSA). METHODS: The population studied were CSA patients to which a wait-and-see approach was adopted without offering DMARD treatment, or patients were offered DMARD treatment via the TREAT EARLIER trial and subsequently randomized to receive methotrexate or placebo. IPs were assessed using the Brief Illness Perception Questionnaire (BIPQ), covering cognitive, emotional and comprehensibility domains. The effect of DMARD treatment on IPs over time was studied by comparing the 2-year course of BIPQs of patients receiving methotrexate or placebo. The effect of offering DMARD treatment was examined by comparing the BIPQs of CSA patients in the trial with those undergoing a wait-and-see policy. RESULTS: In total, 375 CSA patients were studied, of which 236 of the TREAT EARLIER trial and 139 with a wait-and-see approach. Patients who received treatment showed sustained improvements in IPs over time compared with placebo in four cognitive domains: experience of physical complaints (P = 0.040), the illness's influence on life (P = 0.001), treatment effectiveness (P = 0.041) and disease duration (P = 0.045). Comparison at baseline showed that CSA patients to whom treatment was offered had more confidence in treatment (P < 0.001) and tended to have a deeper understanding of their disease (P = 0.054). CONCLUSION: Both the prospect of and DMARD treatment itself improved IPs in CSA, mainly in cognitive domains. These data suggest CSA as a suitable time period for influencing IPs, which may provide possibilities to improve disease outcomes in patients developing RA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".