Factors Associated with Physical and Social Functioning among People with Systemic Sclerosis: A Set of SPIN Cohort Cross-sectional Studies
Bibliographic record
Abstract
Background: Individuals with systemic sclerosis (SSc) face many challenges that negatively impact their physical function and ability to fulfill social roles and participate in social activities. There is limited evidence on the degree to which individuals with SSc have impaired physical function compared to the general population, how satisfied they are with their abilities to successfully undertake social roles and activities, and factors associated with physical and social function. Our objectives were to (1) compare physical function levels and satisfaction with social roles and activities in a large multinational SSc cohort to general population normative data and (2) identify factors associated with these outcomes. Methods: Participants in the Scleroderma Patient-centered Intervention Network Cohort completed the PROMIS-29v2 Physical Function and Social Roles and Activities domain questionnaires as part of their baseline cohort assessment. Multivariable linear regressions were used to assess associations of sociodemographic, lifestyle, and physician-reported disease-related variables with physical function and ability to fulfill social roles.Results: Among 2,385 participants with a mean age of 54.9 (standard deviation [SD] 12.6) years, 87% were female, and 83% were White. The mean physical function T-score (43.7, SD = 8.9) was approximately 2/3 of a standard deviation (SD) below the US general population (mean = 50, SD = 10), whereas the mean Satisfaction with Social Roles and Activities T-score (48.1, SD = 9.9) was 1/5 of a SD below the US general population mean. Multivariable analysis factors independently associated with physical function were older age (-0.74 points per SD years, 95% CI -0.78, -1.08), female sex (-1.35 points, -2.37, -0.34), fewer years of education (-0.41 points per SD in years, -0.75, -0.07), being single, divorced, or widowed (-0.76 points, -1.48, -0.03), smoking (-3.14 points, -4.42, -1.85), alcohol consumption (0.79 points per SD drinks per week, 0.45, 1.14), body mass index (BMI; -1.41 points per SD, -1.75, -1.07), diffuse subtype (-1.43 points, -2.23, -0.62), gastrointestinal involvement (-2.58 points, -3.53, -1.62), digital ulcers (-1.96 points, -2.94, -0.98), moderate (-1.94 points, -2.94, -0.93) and severe (-1.76 points, -3.24, -0.28) small joint contractures, moderate (-2.10 points, -3.44, -0.76) and severe (-2.54 points, -4.64, -0.44) large joint contractures, interstitial lung disease (ILD; -1.52 points, -2.27, -0.77), pulmonary arterial hypertension (PAH; -3.72 points, -4.91, -2.52), rheumatoid arthritis (RA; -2.10 points, -3.64, -0.56) and idiopathic inflammatory myositis (-2.10 points, -3.63, -0.56). Multivariate analyses factors independently associated with satisfaction with social roles and activities were years of education (0.54 points per SD, 0.14, 0.93); self-reported race or ethnicity other than White (-1.13 points, -2.18, -0.08); living in Canada (-1.33 points, -2.40, -0.26) or the United Kingdom (-2.49 points, -3.92, -1.06); BMI (-1.08 points per SD, -1.47, -0.69); gastrointestinal involvement (-3.16 points, -4.27, -2.05); digital ulcers (-1.90 points, -3.05, -0.76); moderate (-1.62 points, -2.78, -0.45) or severe (-2.26 points, -3.99, -0.52) small joint contractures; ILD (-1.11 points, -1.97, -0.25); PAH (-2.69 points, -4.08, -1.30); RA (-2.51 points, -4.28, -0.73); and Sjogren’s syndrome (-2.42 points, -3.96, -0.88).Conclusion: Physical function is impaired for many individuals with SSc. This does not appear to translate to lower satisfaction with social roles and activities. Multiple disease factors were associated with both outcomes. While many people with SSc may adapt to cope with challenges inherent in living with a chronic and burdensome disease, research is needed to better understand factors that influence physical and social function and to develop strategies that target specific factors to improve function
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| 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".