Work-Related Disability and Function in Systemic Lupus Erythematosus (SLE): Outcomes of an Exploratory Study from Different Canadian Centers
Bibliographic record
Abstract
Objectives Systemic lupus erythematosus (SLE) has a significant and long-lasting impact on work outcomes, is a source of long-lasting work disability, and presents challenges with participation in activities of daily living. This study aimed to create a functional profile for patients with SLE. A functional profile is defined as activities of daily living and those related to work functioning (activities of daily living). Methods A cross-sectional investigation was carried out across 6 Canadian facilities, comprising 6 academic institutions and 1 community-based facility. Clinical measurements were obtained, including the SLEDAI-2K and ACR/SLICC Damage Index (SDI) and patients’ medications. Patients completed the Work Role Functioning Questionnaire v2.0 (WRFQ), the World Health Organization—Disability (WHO-DAS) Assessment Schedule 2.0 (WHO-DAS), and the Beck Depression Inventory (BDI-II). Descriptive and inferential statistics were computed for the demographic, clinical, and functional outcomes. Univariate and multivariate regression analyses to study the association with WHO-DAS and WRF were performed. Results 404 patients were studied; mean age was 47.0±13.71 years and 91.8%% were female (64.7% White, 12.4% Black, 6.7% Chinese and 16.2% other races) with a mean SLE duration of 15.7 ±11.8 years. The total mean score for the WRFQ was 71.51.8±23.5. The WRFQ subscale mean scores were also reported for work scheduling demands (66.8±28.8), work output demands (71.1±25.6), physical demands (67.3±27.9), mental and social demands (74.4±22.8) and flexibility demands (75.0±24.7) (Figure 1). Comparison to the general working population). The WHO-DAS 2.0 total mean score was 25.1±9.71, representing approximately the 93.8th population percentile, meaning that only about 6.1% of the population scored higher (more disabled) than our sample. In the multivariate analysis, sex (Female), damage (SDI), prednisone dose, fatigue severity score, Work Role Functioning total scores, presence of fibromyalgia, Role Emotinal SF-36, depression and pain were associated with increased disability. Similarly, fatigue severity score, depression, and pain were associated with decreased WRF total scores. Conclusion This Canadian study confirmed that patients with SLE suffers from high level of disability and functional decline and as measured by WHO-DAS and WRF. Several factors were associated with disability and functional decline including accrued damage, presence of fatigue and fibromyalgia, depression, pain and prednisone dose. Developing the initial functional profile of work disability will facilitate a multidisciplinary approach to enhance the care and management of work disabilities and related functional outcomes. Supported by a CIORA grant. Best Abstract on Quality Care Initiatives in Rheumatology Award
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.006 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".