Características de los pacientes con espondiloartritis seguidos en unidades de reumatología en España. Estudio emAR II / Characteristics of patients with spondyloarthritis followed in rheumatology units in Spain. emAR II study

Objetivos. Describir las características clínicas y demográficas de los pacientes con espondiloartritis en España. Pacientes y métodos. Revisión de historias clínicas aleatorizadas de pacientes con espondiloartritis mayores de 16 años, con al menos una visita al reumatólogo en los 2 años anteriores. Se recogió información sobre datos sociodemográficos y clínicos (tiempo de duración de la enfermedad, categoría diagnóstica, actividad de la enfermedad, manifestaciones extrarticulares, y comorbilidad). Resultados. Se incluyeron 1.168 pacientes procedentes de 46 hospitales de toda España. El 68% eran varones con valores mediana de edad y tiempo de evolución de la enfermedad de 49,2 años (39,7-60,5) y de 105 meses (48,4-192,5), respectivamente. Los diagnósticos, por orden de frecuencia, fueron: espondilitis anquilosante (n = 629, 55,2%), artritis psoriásica (n = 253, 22,2%), espondiloartritis indiferenciada (n = 184, 16,1%), artritis asociada a enfermedad inflamatoria intestinal (n = 50, 4,4%) y artritis reactiva (n = 16, 1,4%). Las manifestaciones extrarticulares más comunes fueron: psoriasis (20,8%), uveítis anterior (19,4%) y entesitis (16,9%). Constaba la existencia de incapacidad laboral en el 8,3% de las historias clínicas. Constaban datos clínicos como el BASDAI solo en el 34% y la medida de metrología más utilizada, el test de Schöber, faltaba en el 37,7% de las historias. Conclusiones. Las características sociodemográficas y clínicas de los pacientes con espondiloartritis del estudio emAR II, no difieren de forma global de lo publicado previamente en otros estudios, excepto para el diagnóstico de formas indiferenciadas, que son más frecuentes en nuestros pacientes que en otras publicaciones. La calidad de los registros de actividad en las historias clínicas es mejorable (AU)

Objective. To describe the main demographic and clinical features of patients with spondyloarthropaties in Spain. Patients and methods. Review of randomized clinical charts of patients with spondyloarthropaties with at least one visit to the rheumatologist in the previous two years. Information was collected on demographic and clinical data (duration of illness, diagnostic category, disease activity, extrarticular manifestations, comorbidity and work disability). Results. 1,168 patients were included in the study. Their median age was 49.2 years (39.7-60.5), 68.0% were males, and median time of disease was 105.1 month (48.4-192.5). The diagnoses and clinical data such as the BASDAI were reported only in 34,0% of the patients. The most widely used measure of metrology, the Schober test, was missing in 37.7% of the clinical charts. The patients included had the following diagnoses: Ankylosing spondylitis (n = 629, 55.2%), Psoriatic arthritis (n= 253, 22.2%), Undifferentiated spondyloarthritis (n = 184, 16.1%), Arthritis associated to Inflammatory bowel disease (n= 50, 4.4%), and Reactive arthritis (n= 16, 1.4%). The most common extraarticular manifestations were psoriasis (20.8%), anterior uveitis (19.4%), and enthesitis (16.9%). Some kind of work disability was reported in 8.3% of the patients. Conclusions. Demographic and clinical characteristics of patients with spondyloarthropaties in Spain do not differ as a whole from other published studies, except for Undifferentiated Spondyloarthritis, which was more likely in our patients than in other studies. The quality of the records of activity in the clinical charts could be improved (AU)

Characteristics of patients with spondyloarthritis followed in rheumatology units in Spain. emAR II study.

OBJECTIVE: To describe the main demographic and clinical features of patients with spondyloarthropaties in Spain. PATIENTS AND METHODS: Review of randomized clinical charts of patients with spondyloarthropaties with at least one visit to the rheumatologist in the previous two years. Information was collected on demographic and clinical data (duration of illness, diagnostic category, disease activity, extrarticular manifestations, comorbidity and work disability). RESULTS: 1,168 patients were included in the study. Their median age was 49.2 years (39.7-60.5), 68.0% were males, and median time of disease was 105.1 month (48.4-192.5). The diagnoses and clinical data such as the BASDAI were reported only in 34,0% of the patients. The most widely used measure of metrology, the Schober test, was missing in 37.7% of the clinical charts. The patients included had the following diagnoses: Ankylosing spondylitis (n = 629, 55.2%), Psoriatic arthritis (n= 253, 22.2%), Undifferentiated spondyloarthritis (n = 184, 16.1%), Arthritis associated to Inflammatory bowel disease (n= 50, 4.4%), and Reactive arthritis (n= 16, 1.4%). The most common extraarticular manifestations were psoriasis (20.8%), anterior uveitis (19.4%), and enthesitis (16.9%). Some kind of work disability was reported in 8.3% of the patients. CONCLUSIONS: Demographic and clinical characteristics of patients with spondyloarthropaties in Spain do not differ as a whole from other published studies, except for Undifferentiated Spondyloarthritis, which was more likely in our patients than in other studies. The quality of the records of activity in the clinical charts could be improved.

Sensibilidad al cambio de las medidas de desenlace / Responsiveness of outcome measures

En la investigación médica, y en especial en el ámbito de la reumatología, hay gran interés sobre el concepto de sensibilidad al cambio de un instrumento de medida como posible reflejo de modificaciones en la situación clínica del paciente. Sin embargo, la terminología de este concepto y su metodología de análisis están rodeadas de confusión y falta de consenso. Se presenta un trabajo de revisión sobre el concepto y el análisis de la sensibilidad al cambio teniendo en cuenta tanto las características de la sensibilidad como el tipo de diseño y cambio previsible en la muestra en estudio (AU)

In medical research, particularly in the field of rheumatology, there is great interest about the concept of responsiveness of outcome measures as a sign of changes in the patient´s health status. However, the terminology sorrounding this concept and the methods of analysis are confusing and lacking in consensus. We present a review about the concept and analysis of responsiveness taking into account both, the characteristics of the responsiveness and the type of design and predictable change in the sample being studied (AU)