It's Not All About the Journal Impact Factor.

We read with great interest the recent Panorama article that discussed the rise in the Journal Impact Factor (JIF) of rheumatology journals and the potential effect of the coronavirus disease 19 (COVID-19) pandemic in this rise.1 Although there has definitely been a rise in the JIF of journals following the COVID-19 pandemic, there are concerns about some aspects of the paper that we wish to discuss in this letter.2.

Metaverse: Evolving role in healthcare delivery and implications.

Metaverse, or the immersive internet, is touted as the next considerable technology-led disruption on the horizon, which can potentially disrupt clinician-patient interactions, patient experience, innovation and research and development processes. Metaverse is still in the evolution phase, and its firm definition framework is a work in progress. Surgical training allows the trainees to mimic procedures and simulate cross-collaborations within time and space, shortening the learning cycles. Similarly, patient experiences can be built by creating unique experiences replicating the real world without constraints. At the same time, the care providers can foster greater empathy while serving the patients with regular or special specific needs per disease conditions.

Awareness, perspectives and satisfaction levels among patients with psoriatic arthritis: a multicentric cross-sectional survey.

Perception of the disease and its management impacts patients with Psoriatic arthritis (PsA) to a great degree. Studies examining patients' viewpoints and perception of their disease and its management are scarce. This multicentric cross-sectional survey was undertaken to understand the perspectives of patients with PsA. A survey questionnaire with items on demographics, awareness about their disease, treatment, physical therapy, quality of life and satisfaction with the care received was designed. After internal and external validation, a pilot survey was conducted, and the questionnaire was finalized. The final survey (with translations in local languages) was carried out at 17 centres across India. There were 262 respondents (56% males) with mean age of 45.14 ± 12.89 years. In 40%, the time lag between onset of symptoms and medical assessment for it was more than a year. In most of the patients, the diagnosis of PsA was made by a rheumatologist. Over 83% of patients were consulting their rheumatologist periodically as advised and fully compliant with the treatment. Lack of time and cost of therapy were the most common reasons for non-adherence to therapy. Eighty-eight patients (34%) were not fully satisfied with their current treatment. Over two-third of patients had never seen a physiotherapist due to barriers including a lack of time, pain, and fatigue. The daily activities and employment status were affected in nearly 50% of patients with PsA. The current survey has identified a gap in patients' awareness levels and helps healthcare providers in understanding the varied perceptions of patients with PsA. Addressing these issues in a systematic manner would potentially improve the treatment approaches, outcomes, and patient satisfaction levels.

Ocular Manifestations of Spondyloarthritis.

Introduction: Ocular manifestations are seen in several autoimmune disorders including spondyloarthritis (SpAs). Though acute anterior uveitis (AAU) is the hallmark of SpAs, episcleritis and scleritis are also seen. Genetic and geographical factors impact the prevalence of AAU; however, available evidence support that HLA-B27 positivity is closely associated with it. Objective: The current narrative review is focused on clinical features of AAU and its management. Methods: For the purpose of this narrative review; literature search covered MEDLINE, Google scholar and EMBASE databases and included articles published in English language from January 1980 till April 2022 using the following keywords: "Ankylosing spondylitis", "Spondyloarthritis", "Eye manifestations", "Ocular", "Uveitis" and "Arthritis". Conclusion: Patients with SpA may suffer from different ocular complications with uveitis being the most common one. Biological therapy is a promising medical strategy enabling in achieving therapeutic goals with minimal adverse effects. An effective management strategy for patients with AAU associated with SpA could be formulated by the collaboration between ophthalmologists and rheumatologists.

Musculoskeletal care - at the confluence of data science, sensors, engineering, and computation.

Data has always been integral to modern medicine in almost all aspects of patient care and the recent proliferation of data has opened up innumerable opportunities for all the stakeholders in trying to improve the quality of care and health outcomes including quality of life and rehabilitation. Greater usage and adoption of digital technologies have led to the convergence of health data in different forms - clinical, self-reported, electronic health records social media, etc. The application and utilization of patient data set continue to get broadened each day with greater availability and access. These are empowering newer cutting-edge solutions such as connected care and artificial intelligence, 3D printing and real-life mimicking prosthetics. The availability of data at micro and macro levels has the potential to act as a catalyst for personalized care based on behavioral, cultural, genetic, and psychological needs for patients with musculoskeletal disorders. Realistic algorithms coupled with biomarkers which can identify relevant interventions and alert the care providers regarding any deterioration. Although in the nascent stage currently, 3D printing, exoskeletons, and virtual rehabilitation hold tremendous potential of cost-effective, precise interventions for the patients.

Harnessing of real-world data and real-world evidence using digital tools: utility and potential models in rheumatology practice.

The diversity of diseases in rheumatology and variability in disease prevalence necessitates greater data parity in disease presentation, treatment responses including adverse events to drugs and various comorbidities. Randomized controlled trials are the gold standard for drug development and performance evaluation. However, when the drug is applied outside the controlled environment, the outcomes may differ in patient populations. In this context, the need to understand the macro and micro changes involved in disease evolution and progression becomes important and so is the need for harvesting and harnessing the real-world data from various resources to use them in generating real-world evidence. Digital tools with potential relevance to rheumatology can potentially be leveraged to obtain greater patient insights, greater information on disease progression and disease micro processes and even in the early diagnosis of diseases. Since the patients spend only a minuscule portion of their time in hospital or in a clinic, using modern digital tools to generate realistic, bias-proof, real-world data in a non-invasive patient-friendly manner becomes critical. In this review we have appraised different digital mediums and mechanisms for collecting real-world data and proposed digital care models for generating real-world evidence in rheumatology.

Clinical inertia in rheumatology practice.

Several professional medical learned societies and organisations have recommended guidelines for management of various chronic diseases geared to achieve optimal control over the diseases and improve the quality of care. However, the data from around the world suggest that a majority of patients are not achieving those treatment targets. This has been well documented in diseases such as diabetes, hypertension, dyslipidaemia and rheumatoid arthritis, and clinical inertia is thought to be a major factor responsible. In this article, we have discussed clinical inertia in rheumatology practice, which has relevance to several other chronic non-communicable diseases as well.