Myositis-Associated Autoantibodies in Patients With Juvenile Myositis Are Associated With Refractory Disease and Mortality.

OBJECTIVE: Myositis-associated autoantibodies (MAAs) have been associated with overlap myositis, certain disease manifestations such as interstitial lung disease (ILD), and worse prognosis in the idiopathic inflammatory myopathies. MAAs overall remain largely uncharacterized in patients with juvenile-onset myositis. Moreover, it is unknown whether the number of MAAs is associated with disease severity. METHODS: Patients with juvenile myositis in cross-sectional natural history studies who underwent testing for myositis autoantibodies were included. Demographics, myositis autoantibodies, clinical characteristics, medications received, and outcomes of those with and without MAAs were compared. Multivariable logistic regression was performed to determine whether the number of MAAs detected was associated with severe disease features. RESULTS: Among 551 patients, 36% had an MAA and 13% had more than one MAA. Among those who were MAA positive, there was a higher frequency of overlap myositis (18% vs 5.9%, P < 0.001). MAA positivity was associated with certain clinical features, including Raynaud phenomenon (odds ratio [OR] 2.44, 95% confidence interval [CI] 1.41-4.28) and ILD (OR 3.43, 95% CI 1.75-6.96), as well as a chronic disease course (OR 1.72, 95% CI 1.10-2.72) and mortality (OR 3.76, 95% CI 1.72-8.43). The number of MAAs was also associated with mortality (OR 1.83, 95% CI 1.16-2.86). CONCLUSION: MAAs were prevalent in a large cohort of patients with juvenile myositis. ILD, refractory disease, and mortality were associated with MAA positivity. Prospective studies are needed to determine whether early detection of MAAs may lead to improved outcomes for patients with juvenile myositis.

An evaluation of the risk factors associated with implementing projects of health information technology by fuzzy combined ANP-DEMATEL.

BACKGROUND: Application of a Clinical Information System (CIS) like Electronic Patient Record (EPR), PACS system and CPOE has turned into one of the most important criteria of priorities of health care systems. The aims of the clinical information system include improving the physicians' efficiency level, integrating the caring process, and expanding the fuzzy quality of the services offered to patients. Achievement of these benefits in reality is not an easy task, and there are lots of plans in this field which are doomed to failure. About 50% of the implementation plans of clinical information systems in health care organizations have failed, and this trend is significantly affecting industrial countries. Proper implementation of hospital information systems lies in identifying and assessing the relationships among the most important risk factors of fuzzy. The present study aimed to provide an applicable model for identifying, ranking and evaluating the risk factors associated with projects of clinical information technology in hospitals of Shiraz University of Medical Sciences. METHOD: This is an applied study which evaluates the risk factors associated with implementation of clinical information technology projects in hospitals of Shiraz Medical Sciences University. The participants consisted of professionals and senior experts of clinical information technology. Fuzzy logic was used in this study. We also applied ANP-DEMATEL combined model with fuzzy procedure to provide the analytic model of the study. RESULTS: According to the study findings, lack of top-executive supports, and unstable organizational environment were the two most important risk factors, while the main organizational factors and technology were also highly important. In addition, the factors associated with technology had the highest influence on the other studied risk factors. CONCLUSION: Hospital authorities can benefit from this proposed model to reduce the risk of implementing the projects of clinical information technology and improve the success coefficient of the risk of such projects.

Development of a model for predicting hospital beds shortage and optimal policies using system dynamics approach.

BACKGROUND: Policymakers use simulation-based models to improve system feedback and model the reality of the problems in the system. This study uses the system dynamics approach to provide a model for predicting hospital bed shortages and determine the optimal policy in Shiraz, Southern Iran. METHODS: This study was designed based on Sterman's system dynamic modeling (SDM) process. Firstly, we determined the main variables affecting bed distribution using a mixed qualitative and quantitative study which includes scoping review, expert panel, Delphi, and DANP. Then, dynamic hypotheses were designed. Subsequently, we held several expert panels for designing the causal and stock-flow models, formulating and testing a simulation model, as well as developing various scenarios and policies. RESULTS: Dynamic modeling process resulted in four scenarios. All of the scenarios predicted a shortage of national hospital beds over a 20-year time horizon. Then, four policies were developed based on the changes in the number of beds and capacity of home care services; finally, the optimal policy was determined. CONCLUSIONS: Due to the high cost of setting up hospital beds, developing and supporting cost-effective home care services, strengthening the insurance coverage of these services, and improving the quantity and quality of community care, considering the real needs of the community could be considered as an optimal option for the future of the city.

Phage display of environmental protein toxins and virulence factors reveals the prevalence, persistence, and genetics of antibody responses.

Microbial exposures are crucial environmental factors that impact healthspan by sculpting the immune system and microbiota. Antibody profiling via Phage ImmunoPrecipitation Sequencing (PhIP-Seq) provides a high-throughput, cost-effective approach for detecting exposure and response to microbial protein products. We designed and constructed a library of 95,601 56-amino acid peptide tiles spanning 14,430 proteins with "toxin" or "virulence factor" keyword annotations. We used PhIP-Seq to profile the antibodies of ∼1,000 individuals against this "ToxScan" library. In addition to enumerating immunodominant antibody epitopes, we studied the age-dependent stability of the ToxScan profile and used a genome-wide association study to find that the MHC-II locus modulates bacterial epitope selection. We detected previously described anti-flagellin antibody responses in a Crohn's disease cohort and identified an association between anti-flagellin antibodies and juvenile dermatomyositis. PhIP-Seq with the ToxScan library is thus an effective tool for studying the environmental determinants of health and disease at cohort scale.

Baseline factors associated with self-reported disease flares following COVID-19 vaccination among adults with systemic rheumatic disease: results from the COVID-19 global rheumatology alliance vaccine survey.

OBJECTIVE: To examine the frequency of, and risk factors for, disease flare following COVID-19 vaccination in patients with systemic rheumatic disease (SRD). METHODS: An international study was conducted from 2 April to 16 August 2021, using an online survey of 5619 adults with SRD for adverse events following COVID-19 vaccination, including flares of disease requiring a change in treatment. We examined risk factors identified a priori based on published associations with SRD activity and SARS-CoV-2 severity, including demographics, SRD type, comorbidities, vaccine type, cessation of immunosuppressive medications around vaccination and history of reactions to non-COVID-19 vaccines, using multivariable logistic regression. RESULTS: Flares requiring a change in treatment following COVID-19 vaccination were reported by 4.9% of patients. Compared with rheumatoid arthritis, certain SRD, including systemic lupus erythematosus (OR 1.51, 95% CI 1.03, 2.20), psoriatic arthritis (OR 1.95, 95% CI 1.20, 3.18) and polymyalgia rheumatica (OR 1.94, 95% CI 1.08, 2.48) were associated with higher odds of flare, while idiopathic inflammatory myopathies were associated with lower odds for flare (OR 0.54, 95% CI 0.31-0.96). The Oxford-AstraZeneca vaccine was associated with higher odds of flare relative to the Pfizer-BioNTech vaccine (OR 1.44, 95% CI 1.07, 1.95), as were a prior reaction to a non-COVID-19 vaccine (OR 2.50, 95% CI 1.76, 3.54) and female sex (OR 2.71, 95% CI 1.55, 4.72). CONCLUSION: SRD flares requiring changes in treatment following COVID-19 vaccination were uncommon in this large international study. Several potential risk factors, as well as differences by disease type, warrant further examination in prospective cohorts.

The Geospatial Distribution of Myositis and Its Phenotypes in the United States and Associations With Roadways: Findings From a National Myositis Patient Registry.

Background: Little is known about the spatial distribution of idiopathic inflammatory myopathies (IIM) in the United States (U.S.), or their geospatial associations. Methods: We studied a national myositis patient registry, with cases diagnosed in the contiguous U.S. from 1985-2011 and comprised of dermatomyositis (DM, n = 484), polymyositis (PM, n = 358), and inclusion body myositis (IBM, n = 318) patients. To assess the association of myositis prevalence with distance from roads, we employed log-Gaussian Cox process models, offset with population density. Results: The U.S. IIM case distribution demonstrated a higher concentration in the Northest. DM, IBM, and cases with lung disease were more common in the East, whereas PM cases were more common in the Southeast. One area in the West and one area in the South had a significant excess in cases of DM relative to PM and of cases with lung disease relative to those without lung disease, respectively. IIM cases tended to cluster, with between-points interactions more intense in the Northeast and less in the South. There was a trend of a higher prevalence of IIM and its major phenotypes among people living within 50 m of a roadway relative to living beyond 200 m. Demographic characteristics, rural-urban commuting area, and female percentage were significantly associated with the prevalence of IIM and with major phenotypes. Conclusions: Using a large U.S. database to evaluate the spatial distribution of IIM and its phenotypes, this study suggests clustering in some regions of the U.S. and a possible association of proximity to roadways.

Environmental factors associated with juvenile idiopathic inflammatory myopathy clinical and serologic phenotypes.

BACKGROUND: Environmental exposures have been associated with the juvenile idiopathic inflammatory myopathies (JIIM). We undertook a questionnaire-based study to evaluate patient-reported exposures as possible risk factors for JIIM. FINDINGS: One-hundred-seven patients with JIIM were enrolled in a myositis natural history protocol and completed environmental questionnaires. Frequencies of exposures in clinical and myositis-specific autoantibody (MSA) groups were examined. Patients with juvenile dermatomyositis (JDM) and juvenile connective tissue myositis (JCTM) more frequently received an immunization within 1 year of diagnosis compared to juvenile polymyositis (57.5 and 71.4% vs 0.0%, p ≤ 0.017). JCTM patients were more often underweight at diagnosis relative to JDM patients (42.9% vs 7.0%, p = 0.002). MSA-negative patients more frequently had gastroenteritis within a year of diagnosis compared to patients with anti-MDA5 autoantibodies (28.6% vs 0.0%, p = 0.032). Heavy exercise was more frequent in MSA-negative and anti-MDA5 groups compared to the anti-TIF-1 autoantibody group (42.9 and 35.3% vs. 9.0%, p ≤ 0.047). Medications received within 1 year of diagnosis were more frequent in MSA-negative patients relative to those with anti-MDA5 autoantibodies (92.9% vs. 52.8% p = 0.045). Being breastfed > 6 months was more frequent in MSA-negative patients (88.9%) compared to anti-TIF-1 and anti-MDA5 autoantibody groups (41.2 and 28.6%, p ≤ 0.036). CONCLUSIONS: Certain environmental exposures prior to diagnosis differed among clinical and serologic subgroups of JIIM, suggesting additional exposures to be explored as possible risk factors for JIIM phenotypes.

Risk assessment of probable human errors in the scaffold erection and dismantling procedure: a fuzzy approach.

Objectives. Despite widespread use of scaffolds on construction sites, they are the most common causes of accidents, injuries and fatalities in this sector. About 80-90% of all occupational accidents occur as a result of human factors. On construction sites, proper erection/dismantling of scaffold is possibly the most essential factor in preventing accidents as it is one of the factors reported to be highly statistically significant in correlation to a high overall scaffold safety rating. Therefore, analysis of human errors (HEs) caused by scaffolders is important to be implemented. The main objective of this study was to evaluate possible HEs during scaffold erection and dismantling (SE&D). Methods. Stages involved were identified using hierarchical task analysis (HTA). Risk values of HEs were then evaluated using the fuzzy analytical hierarchy process (FAHP). Results. Our findings indicate that the highest and lowest risk values were related to the errors of 'failure to reattach braces and connections prior to dismantling scaffolds' and 'insufficient preparation of the firm foundation', respectively. Conclusion. This study formulates a method to estimate the risk of potential HEs in SE&D.

Development of a scenario-based blood bank model to maximize reducing the blood wastage.

INTRODUCTION: Blood is a valuable as well as a perishable commodity that has a limited lifespan. So, keeping it in a blood bank requires careful attention and management. In this study, a management model has been designed for the blood bank that can cover all the requests sent through the hospital subunits in such a way that it has the least waste. MATERIALS AND METHODS: First, by examining the blood inventory system of a hospital, the number of inventories per month and the distribution of blood products in subunits of the hospital, and the amount of blood wastage every six months were estimated. Then, using ARENA simulation, all parts of the blood bank, including the request section, emergency blood section, donated blood section, and other sections were simulated. Finally, 10 scenarios were extracted by placing various parameters and the best scenarios were discussed and concluded. RESULTS AND DISCUSSION: The scenarios for the four blood groups included A, B, AB, and O were applied for six months in one year. The results showed that if the amount of blood injected into the blood bank is appropriate and at the right time, the amount of wastage can be reduced by up to 80% for most of the blood groups. CONCLUSION: The results of this study showed that if the system of receiving blood products built upon a precise management model is predetermined and placed with appropriate parameters, the amount of wastage will be reduced to the minimum possible number.

Association of anti-HSC70 autoantibodies with cutaneous ulceration and severe disease in juvenile dermatomyositis.

OBJECTIVES: JDM is an inflammatory myopathy characterized by prominent vasculopathy. AECAs are frequently detected in inflammatory and autoimmune diseases. We sought to determine whether AECAs correlate with clinical features of JDM, and thus serve as biomarkers to guide therapy or predict outcome. METHODS: Plasma samples from 63 patients with JDM, 49 patients with polyarticular JIA and 40 juvenile healthy controls were used to detect anti-heat shock cognate 71 kDa protein (HSC70) autoantibodies, a newly identified AECA, in ELISA assays. Clinical features were compared between JDM patients with and without anti-HSC70 autoantibodies. RESULTS: Anti-HSC70 autoantibodies were detected in 35% of patients with JDM, in 0% of patients with JIA (P < 0.0001) and in 0% of healthy donors (P < 0.0001). Both the presence of cutaneous ulcers (59% vs 17%, P < 0.002) and the use of wheelchairs and/or assistive devices (64% vs 27%, P < 0.007) were strongly associated with anti-HSC70 autoantibodies in JDM. High scores on the severity of myositis damage measures at the time of measurement of anti-HSC70 autoantibodies and an increased number of hospitalizations were also associated with anti-HSC70 autoantibodies. Intravenous immunoglobulin therapy was used more often in anti-HSC70 autoantibody-positive patients. CONCLUSION: Anti-HCS70 autoantibodies are detected frequently in children with JDM and are novel myositis-associated autoantibodies correlating with disease severity.

Occupational stressors among firefighters: application of multi-criteria decision making (MCDM)Techniques.

BACKGROUND: Firefighters are exposed to a wide range of occupational stressors due to the nature of their job. Multi-criteria decision-making technique (MCDM) is a method for identifying, evaluating, and preventing occupational stressors among firefighters. The purpose of this study was to identify and prioritize the occupational stressors among firefighters using the fuzzy delphi method (FDM) and fuzzy analytical hierarchy process (FAHP). METHODS: This qualitative-descriptive study was carried out in two stages. First, the most important occupational stressors of firefighters were identified and screened using a systematic review of scientific references and expert opinions based on the FDM. Then, all of the screened stressors were weighted and prioritized by the FAHP using the opinions of experts. All results were analyzed using Excel software. RESULTS: Among, the 52 occupational stressors of firefighters identified in the first stage, 27 stressors were selected to enter into the FAHP. The FAHP results showed that among the four main dimensions, the weight of managerial factors (0.358) was more than other dimensions. The overall result of the study, regardless of the stressors' main dimensions showed that the most important stressors among firefighters were financial strain due to inadequate pay, fear of explosion at incident scenes, toxic smoke, and gases produced at fires and lack of attention given to job safety by management, respectively. CONCLUSION: According to the results of the study, most occupational stressors of the firefighters are caused by organizational factors. Therefore, the implementation of management strategies to reduce the occupational stress of firefighters is recommended.

Strategies for controlling violence against health care workers: Application of fuzzy analytical hierarchy process and fuzzy additive ratio assessment.

OBJECTIVE: The present study aimed to identify and prioritize control measures of violence against health care workers (HWs) using the fuzzy analytical hierarchy process (FAHP) and fuzzy additive ratio assessment (ARAS-F). BACKGROUND: Occupational violence is a pervasive problem in health care centres. Reducing violence against staff is one of the challenges for health care managers. METHOD: At the first stage, the most common criteria and control options for violence against HWs were identified and extracted using a review of previous studies. At the next stage, criteria for selection of control measures were prioritized using the FAHP. Finally, control measures of workplace violence were prioritized using the ARAS-F method. RESULTS: Results of the FAHP indicated that safety and efficiency were the most important criteria. Results of the ARAS-F also revealed that 'increasing number of security personnel' and 'training staff' were the best recommendations for controlling violence against HWs. CONCLUSION: Based on expert's opinions, administrative measures are the optimal ways to control violence at health centres; therefore, it is suggested that violence control programmes should be more focused on administrative measures. IMPLICATIONS FOR NURSING MANAGEMENT: These results could assist nursing management to take best strategies for controlling occupational violence based on multi-criteria decision-making methods.

Association of Ultraviolet Radiation Exposure With Dermatomyositis in a National Myositis Patient Registry.

OBJECTIVE: Dermatomyositis (DM) has been associated with geospatial differences in ultraviolet (UV) radiation, but the role of individual determinants of UV exposure prior to diagnosis is unknown. The objective was to examine the role of those individual determinants. METHODS: We analyzed questionnaire data from 1,350 adults in a US national myositis registry (638 with DM, 422 with polymyositis [PM], and 290 with inclusion body myositis [IBM] diagnosed at ages 18-65 years), examining the likelihood of DM compared with PM and IBM diagnosis, in relation to self-reported sunburn history and job- and hobby-related sun exposures in the year prior to diagnosis. We estimated odds ratios (ORs) and 95% confidence intervals (95% CIs) using logistic regression adjusted for age, skin tone, and sex, to determine the association of individual UV exposures with DM diagnosis. We also evaluated the proportion of DM by maximum daily ambient UV exposure, based on UVB erythemal irradiances for participant residence in the year prior to diagnosis. RESULTS: DM was associated with sunburn in the year before diagnosis (2 or more sunburns OR 1.77 [95% CI 1.28-2.43] versus PM/IBM; 1 sunburn OR 1.44 [95% CI 1.06-1.95]) and with having elevated job- or hobby-related sun exposure (high exposure OR 1.64 [95% CI 1.08-2.49] or moderate exposure OR 1.35 [95% CI 1.02-1.78] versus low or no exposure). Ambient UV intensity was associated with DM in females (ß = 3.97, P = 0.046), but not overall. CONCLUSION: Our findings suggest that high or moderate personal exposure to intense sunlight is associated with developing DM compared with other types of myositis. Prospective research on UV exposure as a modifiable risk factor for DM is warranted.

Evaluation of Respiratory Protection Program in Petrochemical Industries: Application of Analytic Hierarchy Process.

BACKGROUND: Respiratory protection equipment (RPE) is the last resort to control exposure to workplace air pollutants. A comprehensive respiratory protection program (RPP) ensures that RPE is selected, used, and cared properly. Therefore, RPP must be well integrated into the occupational health and safety requirements. In this study, we evaluated the implementation of RPP in Iranian petrochemical industries to identify the required solutions to improve the current status of respiratory protection. METHODS: This cross-sectional study was conducted among 24 petrochemical industries in Iran. The survey instrument was a checklist extracted from the Occupational Safety and Health Administration respiratory protection standard. An index, Respiratory Protection Program Index (RPPI), was developed and weighted by analytic hierarchy process to determine the compliance rate (CR) of provided respiratory protection measures with the RPP standard. Data analysis was performed using Excel 2010. RESULTS: The most important element of RPP, according to experts, was respiratory hazard evaluation. The average value of RPPI in the petrochemical plants was 49 ± 15%. The highest and lowest of CR among RPP elements were RPE selection and medical evaluation, respectively. CONCLUSION: None of studied petrochemical industries implemented RPP completely. This can lead to employees' overexposure to hazardous workplace air contaminants. Increasing awareness of employees and employers through training is suggested by this study to improve such conditions.

Occupational stress among nurses and pre-hospital emergency staff: application of fuzzy analytic hierarchy process (FAHP) method.

Healthcare professionals, especially nurses and pre-hospital emergency (PHE) staff, are influenced by many stressors due to their responsibility to provide comfort as well as care and treatment of patients. The aim of the present study was to identify and rank the occupational stressors in nurses and PHE staff using Fuzzy Analytic Hierarchy Process (FAHP) method. In this cross-sectional study, occupational stress factors in nurses and PHE staffs were identified and ranked by 30 experts, using FAHP method. Occupational stress factors were collected by General Health Questionnaire (GHQ), Job Stress Questionnaires as well as a literature review. Among the occupational stress factors in nurses, the highest scores were related to "Incompatibility between work schedule and life conditions" (0.03986) and "Being criticized by supervisors" (0.03723), respectively. The most common stress factors in PHE staff were related to "Care of patients with critical health conditions" (0.07258), "High number of missions" (0.07056), respectively. The overall results of this study showed that managerial factors and factors related to patient care are the most important causes of occupational stress among nurses and PHE staff. These factors should be considered in the implementation of control strategies for reducing and managing occupational stress.

Factors influencing decision making for healthcare services outsourcing: A review and Delphi study.

Background: Outsourcing is considered as one of the tools for organizational development and promotion of productivity by managers. In recent years, outsourcing of healthcare services has become significant. The aim of this study was to identify the most important factors influencing the decision making of outsourcing healthcare services. Methods: This study is a combined study. First, the literature was examined to identify the factors influencing decision making for outsourcing. Then, with the aim of consensus on the most important factors affecting the decision making of outsourcing in health services, the panel of experts and Delphi technique were used. Sampling was purposeful. Results: In the selected articles, a total of 180 factors were extracted. The members of the panel of experts from these 180 factors selected 29 sub-factors in the form of six main factors: strategy, quality, management, technology, performance feature, and economy, as the most important factors affecting the outsourcing of services. Finally, the results of Delphi showed that 22 sub-factors were more important in outsourcing decision making at healthcare services. Conclusion: The study showed that the decision making to outsource health services is a complex and multi-criteria decision. Therefore, when deciding to outsource healthcare services, attention should be paid to various factors, such as strategy, quality, management, technology, and economics.

Factors Influencing Laboratory Information System Effectiveness Through Strategic Planning in Shiraz Teaching Hospitals.

This study aimed to develop and test a research model that examined 7effective factors on the effectiveness of laboratory information system (LIS) through strategic planning. This research was carried out on total laboratory staff, information technology staff, and laboratory managers in Shiraz (a city in the south of Iran) teaching hospitals by structural equation modeling approach in 2015. The results revealed that there was no significant positive relationship between decisions based on cost-benefit analysis and LIS functionality with LIS effectiveness, but there was a significant positive relationship between other factors and LIS effectiveness. As expected, high levels of strategic information system planning result in increasing LIS effectiveness. The results also showed that the relationship between cost-benefit analysis, LIS functionality, end-user involvement, and information technology-business alignment with strategic information system planning was significant and positive.

Respiratory Protection Program Compliance in Iranian Hospitals: Application of Fuzzy Analytical Hierarchy Process.

In hospitals, health care workers (HCWs) are exposed to a wide range of respiratory hazards, which requires using respiratory protective equipment and implementing Respiratory Protection Programs (RPPs). The aim of this cross-sectional study was to investigate RPP implementation in 36 teaching hospitals located in the Fars province of Iran. A researcher-developed checklist, including nine components of the RPP standard, was completed by industrial hygienists in the study hospitals. The Fuzzy Analytical Hierarchy Process (FAHP) was used to determine the weight coefficient of RPP components. Finally, a Respiratory Protection Program Index (RPPI) was developed to calculate hospital compliance with RPP. The results showed that RPP were not fully implemented in the studied hospitals, and the highest and lowest RPPI scores were related to training and fit testing, respectively. To promote the implementation of RPP, significant efforts are required for all components, especially fit testing and worker evaluation.

Effective factors on not using the N95 respirators among health care workers: Application of Fuzzy Delphi and Fuzzy Analytic Hierarchy Process (FAHP).

Using respiratory protective equipment (RPE) including N95 respirators is one of the most important ways to protect health care workers (HCWs) against respiratory hazards. The aim of this study was to identify and prioritize the problems and obstacles in using N95 respirators among HCWs in Iran. In this cross-sectional study, problems and obstacles in using N95 respirators were identified and ranked by experts, using Fuzzy Delphi and Fuzzy Analytic Hierarchy Process (FAHP). Additionally, HCWs were asked to give their opinions about obstacles in using N95 respirators in order to form an opinion. Of 15 important obstacles in using N95 respirators identified by Fuzzy Delphi method, 6 factors were entered into the FAHP model: heat around the face, inaccessibility to respirator, difficulty breathing, pressure on the nose, trouble communicating with patients and colleagues, and no one does it. Identified problems and obstacles in using N95 respirators could be controlled during the selection of respirators, as well as by training and administrative measures.

Predictors of Reduced Health-Related Quality of Life in Adult Patients With Idiopathic Inflammatory Myopathies.

OBJECTIVE: Extensive studies on health-related quality of life (HRQoL) in idiopathic inflammatory myopathies (IIMs) are lacking. Our objective was to document HRQoL and to identify factors associated with a reduced HRQoL in patients with IIM. METHODS: A total of 1,715 patients (median age 49.9 years, 70% female, 87% white) who met probable or definite Bohan and Peter criteria or Griggs criteria for myositis were included from the Myovision registry. HRQoL was ascertained using the Short Form 12 (SF-12) health survey questionnaire. HRQoL physical component summary (PCS) and mental component summary (MCS) scores in relation to different patient and disease characteristics were compared to scores from matched normative data from the US general population and rheumatoid arthritis (RA) patients. Bivariate and multiple linear regression analyses were performed to assess the association between HRQoL and patient and disease parameters. RESULTS: The mean SF-12 summary scores were significantly lower in IIM patients than in the normative and RA populations. A diagnosis of inclusion body myositis, older age, patient-reported negative effect of disease on work, presence of another co-occurring autoimmune disease, polypharmacy, and IIM-associated lung disease and joint involvement were significantly associated with lower PCS scores. Lower MCS scores were associated with joint involvement and a negative effect of disease on work. CONCLUSION: In this large study of patient-reported outcomes in IIM, an association was found between multiple disease characteristics and reduced HRQoL, mostly in the physical domain. In the US, the HRQoL of IIM patients was found to be lower than that of the general population and RA patients.