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Garrido-Castro JL, Curbelo R, Mazzucchelli R, Domínguez-González ME, Gonzalez-Navas C, Flores Robles BJ, Zarco P, Mulero J, Cea-Calvo L, Arteaga MJ, Font-Ugalde P, Carmona L, Collantes-Estevez E. High Reproducibility of an Automated Measurement of Mobility for Patients with Axial Spondyloarthritis. J Rheumatol 2018; 45:1383-1388. [PMID: 29907675 DOI: 10.3899/jrheum.170941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Conventional measures of spinal mobility used in the assessment of patients with axial spondyloarthritis (axSpA), such as the Bath Ankylosing Spondylitis Metrology Index and its components, are subject to interobserver variability. The University of Córdoba Ankylosing Spondylitis Metrology Index (UCOASMI) is a validated composite index based on a motion video-capture system, UCOTrack. Our objective was to assess its reproducibility in clinical practice settings. METHODS We carried out an observational study of repeated measures in 3 centers. Video-capture systems were installed and adapted to clinical rooms. Patients with axSpA and stable disease were selected by consecutive stratified sampling [disease duration, sex, and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)]. Intraobserver reliability of the UCOASMI and of conventional measures was tested 3-5 days apart. For interobserver reliability, 3 patients from each center were evaluated in the other centers, within 3-7 days. The intraclass correlation coefficients (ICC) were calculated. RESULTS Thirty patients were included (73% men, mean age 53 yrs, mean BASDAI 3.0). Interobserver and intraobserver ICC of the UCOASMI was 0.98. Conventional measurements showed lower but adequate reproducibility as well, except for interobserver reliability of lateral flexion (0.41), cervical rotation (0.61), and Schöber test (0.07), and intraobserver reliability of tragus-to-wall distance (0.30). CONCLUSION Reproducibility of the UCOASMI seems very high, and apparently more reliable than conventional measures of mobility.
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Affiliation(s)
- Juan L Garrido-Castro
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain. .,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba.
| | - Rafael Curbelo
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Ramón Mazzucchelli
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - María E Domínguez-González
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Cristina Gonzalez-Navas
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Bryan J Flores Robles
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Pedro Zarco
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Juan Mulero
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Luis Cea-Calvo
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - María J Arteaga
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Pilar Font-Ugalde
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Loreto Carmona
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
| | - Eduardo Collantes-Estevez
- From the Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC); Department of Rheumatology, Hospital Universitario Reina Sofía; Department of Medicine, Universidad de Córdoba, Córdoba; Instituto de Salud Musculoesquelética; Department of Rheumatology, Hospital Fundación Alcorcón, Alcorcón; Department of Rheumatology, Hospital Puerta de Hierro, Majadahonda; Medical Affairs, Merck Sharp & Dohme, Madrid, Spain.,J.L. Garrido-Castro, IE, PhD, IMIBIC; R. Curbelo, PT, PhD, Instituto de Salud Musculoesquelética; R. Mazzucchelli, MD, Department of Rheumatology, Hospital Fundación Alcorcón; M.E. Domínguez-González, RN, Department of Rheumatology, Hospital Fundación Alcorcón; C. Gonzalez-Navas, RN, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía; B.J. Flores Robles, MD, Department of Rheumatology, Hospital Puerta de Hierro; P. Zarco, MD, PhD, Department of Rheumatology, Hospital Fundación Alcorcón; J. Mulero, MD, PhD, Department of Rheumatology, Hospital Puerta de Hierro; L. Cea-Calvo, MD, Medical Affairs, Merck Sharp & Dohme; M.J. Arteaga, MD, Medical Affairs, Merck Sharp & Dohme; P. Font-Ugalde, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba; L. Carmona, MD, PhD, Instituto de Salud Musculoesquelética; E. Collantes-Estevez, MD, PhD, IMIBIC, and Department of Rheumatology, Hospital Universitario Reina Sofía, and Department of Medicine, Universidad de Córdoba
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