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DiRenzo D, Saygin D, de Groot I, Bingham Iii CO, Lundberg IE, Needham M, Park JK, Regardt M, Sarver C, Song YW, Maxwell L, Beaton D, de Visser M, Christopher-Stine L, Mecoli CA, Alexanderson H. Reliability and validity of PROMIS physical function, pain interference, and fatigue as patient reported outcome measures in adult idiopathic inflammatory myopathies: International study from the OMERACT myositis working group. Semin Arthritis Rheum 2023; 58:152111. [PMID: 36410180 PMCID: PMC10354786 DOI: 10.1016/j.semarthrit.2022.152111] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Pain interference, fatigue, and impaired physical function are common features of idiopathic inflammatory myopathies (IIM). The objective of this study was to evaluate the construct validity and test-retest reliability of the Patient Reported Outcome Information System (PROMIS) Pain Interference 6av1.0, Fatigue 7av1.0, and Physical Function 8bv2.0 instruments. METHODS Patient-Reported Outcome Measures (PROMs) were deployed to adult IIM patients from OMERACT Myositis Working Group (MWG) international clinic sites via two online surveys (2019, 2021). Internal consistency of each PROM was analyzed by Cronbach's α. Construct validity was determined by a priori hypotheses generated by the MWG with >75% agreement for each hypothesis and calculated with Pearson correlations. Test-retest reliability was assessed using intraclass correlation coefficient with PROMIS instruments administered at time zero and 7 days. RESULTS Surveys were sent to 368 participants in total; participants who completed each questionnaire varied (n=65 to 263). For construct validity, 10 out of 13 a priori hypotheses were met supporting construct validity of PROMIS instruments (Pain Interference 3/4, fatigue 4/4, and Physical Function 3/5). Test-retest reliability was strong for all PROMIS instruments. All PROMIS instruments demonstrated excellent internal consistency. None of the measures demonstrated any ceiling or floor effects except for a ceiling effect in the Pain Interference instrument. CONCLUSIONS This study presents test-retest reliability and construct validity evidence supporting PROMIS Pain Interference (6a v1.0), Fatigue (7a v1.0), and Physical Function (8b v2.0) using a large international cohort of patients with IIM. Internal consistency of these instruments was excellent. A ceiling effect was noted in the Pain Interference instrument.
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Affiliation(s)
- Dana DiRenzo
- Division of Rheumatology, Department of Medicine, University of Pennsylvania, USA
| | - Didem Saygin
- Division of Rheumatology, Department of Medicine, University of Chicago, USA
| | | | | | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University, Solna, Stockholm, Sweden
| | - Merrilee Needham
- Dept Neurology, Fiona Stanley Hospital, IIID Murdoch University and University of Notre Dame, Perth, Australia
| | - Jin Kyun Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Malin Regardt
- Occupational Therapist, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet and Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - Yeong Wook Song
- Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University
| | - Lara Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dorcas Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Marianne de Visser
- Department of Neurology, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, the Netherlands
| | | | - Christopher A Mecoli
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, USA.
| | - Helene Alexanderson
- Physiotherapist, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital and Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Maxwell LJ, Beaton DE, Boers M, D'Agostino MA, Conaghan PG, Grosskleg S, Shea BJ, Bingham Iii CO, Boonen A, Christensen R, Choy E, Doria AS, Hill CL, Hofstetter C, Kroon FP, Leung YY, Mackie S, Meara A, Touma Z, Tugwell P, Wells GA. The evolution of instrument selection for inclusion in core outcome sets at OMERACT: Filter 2.2. Semin Arthritis Rheum 2021; 51:1320-1330. [PMID: 34544617 DOI: 10.1016/j.semarthrit.2021.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION OMERACT uses an evidence-based framework known as the 'OMERACT Filter Instrument Selection Algorithm' (OFISA) to guide decisions in the assessment of outcome measurement instruments for inclusion in a core outcome set for interventional and observational clinical trials. METHODS A group of OMERACT imaging and patient-centered outcome methodologists worked with imaging outcome groups to facilitate the selection of imaging outcome measurement instruments using the OFISA approach. The lessons learned from this work influenced the evolution to Filter 2.2 and necessitated changes to OMERACT's documentation and processes. RESULTS OMERACT has revised documentation and processes to incorporate the evolution of instrument selection to Filter 2.2. These revisions include creation of a template for detailed definitions of the target domain which is a necessary first step for instrument selection, modifications to the Summary of Measurement Properties (SOMP) table to account for sources of variability, and development of standardized reporting tables for each measurement property. CONCLUSIONS OMERACT Filter 2.2 represents additional modifications of the OMERACT guide for working groups in their rigorous assessment of measurement properties of instruments of various types, including imaging outcome measurement instruments. Enhanced reporting aims to increase the transparency of the evidence base leading to judgements for the endorsement of instruments in core outcome sets.
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Affiliation(s)
- Lara J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Dorcas E Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Maarten Boers
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maria Antonietta D'Agostino
- Università Cattolica del Sacro Cuore, Rome, Italy; Rheumatology UOC, IRCSS, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy; Inserm U1173, Infection et inflammation, Laboratory of Excellence INFLAMEX, Université Paris-Saclay UVSQ, Montigny-le-Bretonneux, France
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, UK
| | | | - Beverley J Shea
- Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Clifton O Bingham Iii
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark
| | - Ernest Choy
- CREATE Centre and Section of Rheumatology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Andrea S Doria
- The Hospital for Sick Children, Medical Imaging Department, University of Toronto, Toronto, Canada
| | - Catherine L Hill
- Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | | | - Féline Pb Kroon
- Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ying Ying Leung
- Department of Rheumatology & Immunology, Singapore General Hospital; Duke-NUS Medical School, Singapore
| | - Sarah Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alexa Meara
- Division of Rheumatology and Immunology, Ohio State University, Wexner Medical Centre, Columbus, Ohio, United States
| | - Zahi Touma
- Division of Rheumatology, Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Peter Tugwell
- Division of Rheumatology, Department of Medicine, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - George A Wells
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
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DiRenzo DD, Craig ET, Bingham Iii CO, Bartlett SJ. Anxiety impacts rheumatoid arthritis symptoms and health-related quality of life even at low levels. Clin Exp Rheumatol 2020; 38:1176-1181. [PMID: 32141436 PMCID: PMC7483642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES We explored the burden of symptoms of anxiety and depression on health-related quality of life (HRQL) in patients with rheumatoid arthritis (RA). METHODS Adults with RA participating in an observational cohort completed PROMIS tests of depression, anxiety, fatigue, physical function (PF), pain interference (PI), sleep disturbance, and participation in social roles and activities at the baseline visit. Clinical measures of disease status were also obtained. We used ANOVA and partial correlation adjusting for the swollen joint count (SJC) to examine associations of anxiety and depression with other aspects of HRQL. Mild and moderate-severe anxiety were defined as T-scores ≥55.4 and ≥ 62.3 and mild and moderate-severe depression was defined as ≥52.5 and ≥58.6 based on previous validated clinical thresholds. Multivariable linear regression (MVR) was used to identify predictors of emotional distress with a subset analysis of those in remission/low disease activity. RESULTS Of 196 RA participants, 18% had mild anxiety, 9% had moderate-severe anxiety, 18% had mild depression, and 14% had moderate-severe depression symptoms. Anxiety and depression scores were associated with significantly worse mean scores across HRQL domains (p <0.05). In MVR, depression (β=0.75, p<0.001), PF (β=0.14, p=0.024) and fatigue (β=0.15, p=0.015) predicted higher anxiety levels, whereas only anxiety predicted higher depression levels (β=0.70, p=<0.001). In subset analysis, PF no longer predicted higher anxiety levels. CONCLUSIONS Emotional distress is common in RA, even when disease is well controlled, with considerable impacts on other aspects of HRQL even at mild levels.
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Affiliation(s)
| | - Ethan T Craig
- The Johns Hopkins University, Baltimore, MD; University of Pennsylvania, Philadelphia, PA; and Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | | | - Susan J Bartlett
- The Johns Hopkins University, Baltimore, MD, USA, and McGill University, Montreal, QC, Canada
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Albayda J, Christopher-Stine L, Bingham Iii CO, Paik JJ, Tiniakou E, Billings S, Uy OM, Burlina P. Pattern of muscle involvement in inclusion body myositis: a sonographic study. Clin Exp Rheumatol 2019; 37:518. [PMID: 31111821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 05/21/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Jemima Albayda
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
| | | | | | - Julie J Paik
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Eleni Tiniakou
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Seth Billings
- Johns Hopkins University, Applied Physics Laboratory, Laurel, MD, USA
| | - O Manny Uy
- Johns Hopkins University, Applied Physics Laboratory, Laurel, MD, USA
| | - Philippe Burlina
- Johns Hopkins University, Applied Physics Laboratory, Laurel, MD, USA
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Ramos-Casals M, Maria A, Suárez-Almazor ME, Lambotte O, Fisher BA, Hernández-Molina G, Guilpain P, Pundole X, Flores-Chávez A, Baldini C, Bingham Iii CO, Brito-Zerón P, Gottenberg JE, Kostine M, Radstake TRD, Schaeverbeke T, Schulze-Koops H, Calabrese L, Khamashta MA, Mariette X. Sicca/Sjögren's syndrome triggered by PD-1/PD-L1 checkpoint inhibitors. Data from the International ImmunoCancer Registry (ICIR). Clin Exp Rheumatol 2019; 37 Suppl 118:114-122. [PMID: 31464670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 07/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To analyse the worldwide occurrence of sicca/Sjögren's (SS) syndrome associated with the use of immune checkpoint inhibitors (ICI) in patients with cancer. METHODS The ImmunoCancer International Registry (ICIR) is a Big Data-Sharing multidisciplinary network composed by 40 specialists in Rheumatology, Internal Medicine, Immunology and Oncology from 18 countries focused on the clinical and basic research of the immune-related adverse events (irAEs) related to cancer immunotherapies. For this study, patients who were investigated for a clinical suspicion of SS after being exposed to ICI were included. RESULTS We identified 26 patients (11 women and 15 men, with a mean age at diagnosis of 63.57 years). Underlying cancer included lung (n=12), renal (n=7), melanoma (n=4), and other (n=3) neoplasia. Cancer immunotherapies consisted of monotherapy (77%) and combined regimens (23%). In those patients receiving monotherapy, all patients were treated with PD-1/PD-L1 inhibitors (nivolumab in 9, pembrolizumab in 7 and durvalumab in 4); no cases associated with CTLA-4 inhibitors were identified. The main SS-related features consisted of dry mouth in 25 (96%) patients, dry eye in 17 (65%), abnormal ocular tests in 10/16 (62%) and abnormal oral diagnostic tests in 12/14 (86%) patients. Minor salivary gland biopsy was carried out in 15 patients: histopathological findings consisted of mild chronic sialadenitis in 8 (53%) patients and focal lymphocytic sialadenitis in the remaining 7 (47%); a focus score was measured in 5 of the 6 patients (mean of 1.8, range 1-4). Immunological markers included positive ANA in 13/25 (52%), anti-Ro/ SS-A in 5/25 (20%), RF in 2/22 (9%), anti-La/SS-B in 2/25 (8%), low C3/C4 levels in 1/17 (6%) and positive cryoglobulins in 1/10 (10%). Classification criteria for SS were fulfilled by 10 (62%) out of 16 patients in whom the two key classificatory features were carried out. Among the 26 patients, there were only 3 (11%) who presented exclusively with sicca syndrome without organ-specific autoimmune manifestations. Therapeutic management included measures directed to treat sicca symptoms and therapies against autoimmune-mediated manifestations (glucocorticoids in 42%, second/third-line therapies in 31%); therapeutic response for systemic features was observed in 8/11 (73%). No patient died due to autoimmune involvement. CONCLUSIONS Patients with Sjögren's syndrome triggered by ICI display a very specific profile different from that reported in idiopathic primary SS, including more frequent occurrence in men, a higher mean age, a predominant immunonegative serological profile, and a notable development of organ-specific autoimmune involvement in spite of the poor immunological profile. The close association found between sicca/Sjögren's syndrome and primarily PD-1 blockade requires further specific investigation.
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Affiliation(s)
- Manuel Ramos-Casals
- Department of Autoimmune Diseases, ICMiD, Barcelona; Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona; and Department of Medicine, University of Barcelona, Hospital Clínic, Barcelona, Spain.
| | - Alexandre Maria
- Department of Internal Medicine Multi-Organic Diseases, Local Referral Center for Autoimmune Diseases, Saint Eloi Hospital, Montpellier University Hospital, France
| | - María E Suárez-Almazor
- Section of Rheumatology and Clinical Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Olivier Lambotte
- APHP Médecine Interne/Immunologie Clinique, Hôpital Bicêtre, Paris, and Université Paris Sud - INSERM U1184 - CEA, Immunology of Viral Infections and Autoimmune Diseases, IDMIT Department, IBFJ, Fontenay-aux-Roses & Le Kremlin- Bicêtre, France
| | - Benjamin A Fisher
- Institute of Inflammation and Ageing, University of Birmingham; and National Institute of Health Research Birmingham Biomedical Research Centre and Department of Rheumatology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Gabriela Hernández-Molina
- Immunology and Rheumatology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Subirán, México City, Mexico
| | - Philippe Guilpain
- Department of Internal Medicine Multi-Organic Diseases, Local Referral Center for Autoimmune Diseases, Saint Eloi Hospital, Montpellier University Hospital, France
| | - Xerxes Pundole
- Section of Rheumatology and Clinical Immunology, Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Chiara Baldini
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Clifton O Bingham Iii
- Department of Rheumatology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pilar Brito-Zerón
- Department of Autoimmune Diseases, ICMiD, Barcelona, and Department of Internal Medicine, Hospital CIMA-Sanitas, Barcelona, Spain
| | - Jacques-Eric Gottenberg
- Dept. of Rheumatology, Strasbourg University Hospital, National Centre For Rare Systemic Autoimmune Diseases, CNRS, Institut de Biologie Moléculaire et Cellulaire, Immunologie, Immunopathologie et Chimie Thérapeutique, University of Strasbourg, France
| | - Marie Kostine
- Department of Rheumatology, Centre Hospitalier Universitaire, Bordeaux, France
| | - Timothy R D Radstake
- Department of Rheumatology/Clinical Immunology, University Medical Center Utrecht, The Netherlands
| | | | - Hendrik Schulze-Koops
- Department of Rheumatology/Clinical Immunology, Ludwig-Maximilians-University Munich, Germany
| | - Leonard Calabrese
- Department of Rheumatic/Immunologic Diseases, Cleveland Clinic University, Cleveland, OH, USA
| | | | - Xavier Mariette
- Center for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique – Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, Université Paris Sud, INSERM, Paris, France
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Bingham Iii CO, Gutierrez AK, Butanis A, Bykerk VP, Curtis JR, Leong A, Lyddiatt A, Nowell WB, Orbai AM, Bartlett SJ. PROMIS Fatigue short forms are reliable and valid in adults with rheumatoid arthritis. J Patient Rep Outcomes 2019; 3:14. [PMID: 30790155 PMCID: PMC6384289 DOI: 10.1186/s41687-019-0105-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 02/12/2019] [Indexed: 12/30/2022] Open
Abstract
Background Fatigue is prevalent and impactful in rheumatoid arthritis (RA). There is no standardized measure for its assessment nor data concerning the performance of PROMIS-Fatigue short forms (SFs) in people with RA. We evaluated the construct validity of 4-, 7-, and 8-item PROMIS-Fatigue SFs in RA patients across the range of disease activity. Methods Adult RA patients were recruited from an online patient community and an observational cohort from three academic medical centers. Measures included PROMIS-Fatigue SFs, other PROMIS measures, and other patient reported outcomes including RAND-36 Vitality, Fatigue NRS, and patient global assessment of disease activity. Other measures from the observational cohort included 28-joint swollen and tender joints, physician global assessment, and the composite RA clinical disease activity index (CDAI). Results Two-hundred online participants and 348 participants from the observational cohort were included. PROMIS Fatigue SF scores spanned the measurement continuum and correlated highly with each other (r’s ≥ 0.91) and other fatigue measures (r’s ≥ 0.85). PROMIS-Fatigue SF scores were highly and inversely associated with Physical Function and Participation (r’s − 0.77 to − 0.78), and moderately-highly and positively correlated with pain, sleep disturbance, anxiety, and depression (r’s 0.60 to 0.75). PROMIS-Fatigue SF scores showed dose-response relationships across fatigue severity descriptors and CDAI categories. Conclusions These results provide robust evidence supporting the construct validity of the 4, 7, and 8-item PROMIS-Fatigue SFs. They capture fatigue across the spectrum of RA disease activity in diverse groups of individuals and should be considered for use as patient-centered assessments of disease control and treatment efficacy.
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Affiliation(s)
- Clifton O Bingham Iii
- Johns Hopkins Medicine, Division of Rheumatology, Mason F Lord Center Tower, 5200 Eastern Ave #434A, Baltimore, MD, 21224, USA.
| | - Anna Kristina Gutierrez
- Johns Hopkins Medicine, Division of Rheumatology, Mason F Lord Tower, 5200 Eastern Avenue, Rm 4100, Baltimore, MD, 21224, USA
| | - Alessandra Butanis
- Johns Hopkins Medicine, Division of Rheumatology, Mason F Lord Tower, 5200 Eastern Avenue, Rm 4100, Baltimore, MD, 21224, USA
| | - Vivian P Bykerk
- Hospital for Special Surgery, Weill Cornell Medical College, 525 East 71st St, 7th floor, New York, NY, 10021, USA
| | - Jeffrey R Curtis
- Division of Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amye Leong
- Healthy Motivation, Santa Barbara, CA, USA
| | | | | | - Ana Maria Orbai
- Johns Hopkins Medicine, Division of Rheumatology, Mason F Lord Tower, 5200 Eastern Avenue, Rm 4100, Baltimore, MD, 21224, USA
| | - Susan J Bartlett
- Johns Hopkins Medicine, Division of Rheumatology, Mason F Lord Tower, 5200 Eastern Avenue, Rm 4100, Baltimore, MD, 21224, USA.,Center for Health Outcomes Research, McGill University, 5252 de Maisonneuve West, #3D-57, Montreal, QC, H4A 3S5, Canada
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Albayda J, Christopher-Stine L, Bingham Iii CO, Paik JJ, Tiniakou E, Billings S, Uy OM, Burlina P. Pattern of muscle involvement in inclusion body myositis: a sonographic study. Clin Exp Rheumatol 2018; 36:996-1002. [PMID: 29745890 PMCID: PMC6558657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Imaging plays a role in myositis assessment by detecting muscle changes indicative of pathology. This study was conducted to determine the ultrasonographic pattern of muscle involvement in patients with inclusion body myositis (IBM) through an assessment of muscle echointensity. METHODS Sixty-two individuals were consecutively studied, 18 with IBM, 16 with polymyositis or dermatomyositis and 28 normal controls. Standardised scans were completed bilaterally for the deltoids, biceps, flexor digitorum profundus (FDP), flexor carpi ulnaris, rectus femoris, tibialis anterior and gastrocnemius assessing for muscle echointensity changes. RESULTS Patients with IBM had a markedly increased muscle echointensity when compared with comparator groups for all muscles studied. This was most discriminating at the FDP, gastrocnemius and rectus femoris. Asymmetry between sides and a heterogeneously increased echointensity were also seen. CONCLUSIONS Ultrasonography can aid in the assessment of IBM by displaying an increased echointensity in characteristically involved muscles, particularly when combined with assessments for asymmetry and echotexture.
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Affiliation(s)
- Jemima Albayda
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA.
| | | | | | - Julie J Paik
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Eleni Tiniakou
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Seth Billings
- Johns Hopkins University, Applied Physics Laboratory, Laurel, MD, USA
| | - O Manny Uy
- Johns Hopkins University, Applied Physics Laboratory, Laurel, MD, USA
| | - Philippe Burlina
- Johns Hopkins University, Applied Physics Laboratory, Laurel, MD, USA
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