Publications by authors named "Knitza Johannes"

Background: In recent years, health care has undergone a rapid and unprecedented digital transformation. In many fields of specialty care, such as rheumatology, this shift is driven by the growing number of patients and limited resources, leading to increased use of digital health technologies (DHTs) to maintain high-quality clinical care. Previous studies examined user acceptance of individual DHTs in rheumatology, such as telemedicine, video consultations, and mHealth.

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  • Spondyloarthritides (SpAs) are rheumatic diseases causing lower back pain and limited mobility, and access to physiotherapy is often a barrier to effective treatment.
  • A study compared the digital health application ViViRA with standard physiotherapy among SpAs patients, assessing pain, quality of life, and mobility over 12 weeks.
  • Results showed that the ViViRA group had better mobility improvements and lower pain intensity compared to the control group, indicating that digital health applications may be more effective than traditional physiotherapy for treating lower back pain in these patients.
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Background: The exponential growth of telehealth is revolutionizing health care delivery, but its evaluation has not matched the pace of its uptake. Various forms of assessment, from single-item to more extensive questionnaires, have been used to assess telehealth and digital therapeutics and their usability. The most frequently used questionnaire is the "Telehealth Usability Questionnaire" (TUQ).

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Background: The development and potential of artificial intelligence (AI) is remarkable. Its application in all medical disciplines, including rheumatology, is attracting attention. To what extent AI is already used in clinical routine in rheumatology is unknown.

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Background And Objective: Patient education is an integral component of the treatment of axial spondyloarthritis (axSpA). However, the validated tools currently available for assessing disease-related knowledge are outdated and, in the case of axSpA, only available in English. The aims of this work were therefore (1) to develop a German-language tool for assessing disease-specific knowledge among axSpA patients and (2) to assess this tool in a pilot study.

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Background: Therapeutic digital health applications (DiGAs) are expected to significantly enhance access to evidence-based care. Since 2020, German physicians and psychotherapists have been able to prescribe approved DiGAs, which are reimbursed by statutory health insurance. This study investigates the usage, knowledge and perception of DiGAs as well as the growing digitalization among internal medicine physicians in Germany.

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Rheumatology faces a critical shortage of health-care professionals, exacerbated by an ageing patient population and escalating costs, resulting in widening gaps in care. Exponential advances in digital health technologies (DHTs) in the past 5 years offer new opportunities to address these challenges and could contribute to overall improved health care. However, keeping pace with innovations and integrating them into clinical practice can be challenging.

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  • - The study focused on anti-synthetase syndrome (ASSD), a rare autoimmune disease, aiming to identify clinical and lab features for potential classification criteria.
  • - Researchers analyzed data from 948 ASSD patients and 1077 control subjects, finding that certain symptoms like arthritis and specific autoantibodies were more common in ASSD cases.
  • - The findings will assist clinicians in diagnosing ASSD and contribute to creating more standardized, data-driven classification criteria for the syndrome.
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Non-specific low back pain (NLBP) is prevalent among patients with rheumatic conditions. Digital health applications (DiGAs) provide reimbursed, personalized home treatment for patients, promising to overcome limitations of traditional healthcare systems. However, the adoption and effectiveness of back pain-specific DiGAs in rheumatology are not well understood.

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  • The study investigates how comorbidities impact the quality of life in patients with idiopathic inflammatory myopathies (IIMs) compared to other autoimmune diseases and healthy individuals, utilizing self-reported data from the COVAD-2 survey.
  • Results show IIM patients have significantly higher rates of comorbidities, basic multitasking, complex multitasking, and mental health disorders.
  • The presence of these conditions correlates with lower overall physical and mental health scores, suggesting the need for targeted management strategies for IIM patients based on identified clinical clusters.
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Background: Axial spondyloarthritis (AS) is a chronic inflammatory rheumatic disease characterized by potentially disabling inflammation of the spine and adjacent joints. Regular exercise is a cornerstone of treatment. However, patients with AS currently have little support.

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Digital health applications (DHAs) are revolutionising patient care by improving access to evidence-based therapy and promoting active self-management. The continuously growing number of DHAs enables patients to act more independently through digital support. The budget-neutral prescription and cost coverage by statutory health insurance companies reduce financial barriers for practitioners and patients.

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Cognitive behavioral therapy improves psychosocial outcomes in rheumatoid arthritis (RA), but access is limited. We conducted a randomized controlled trial to evaluate the efficacy of a cognitive-behavioral digital therapeutic, reclarit, on psychosocial outcomes in adult RA patients with impaired health-related quality of life. Participants were randomized to reclarit plus treatment as usual (TAU) or TAU plus educational and informational material (active control).

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Background: Emergency departments (EDs) are frequently overcrowded and increasingly used by nonurgent patients. Symptom checkers (SCs) offer on-demand access to disease suggestions and recommended actions, potentially improving overall patient flow. Contrary to the increasing use of SCs, there is a lack of supporting evidence based on direct patient use.

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  • Previous studies showed that telemedicine can enhance rheumatology care and is especially important amidst workforce shortages, with a surge in use during the COVID-19 pandemic.
  • This study focuses on identifying what motivates patients with rheumatoid arthritis (RA) to use telemedicine, using data from a German nationwide survey.
  • The analysis revealed 22 factors linked to patients' willingness to try telemedicine, narrowing down to 9 key determinants, which included a desire for telemedicine services.
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Background: The complex nature of rheumatic diseases poses considerable challenges for clinicians when developing individualized treatment plans. Large language models (LLMs) such as ChatGPT could enable treatment decision support.

Objective: To compare treatment plans generated by ChatGPT-3.

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  • The study investigates the diagnostic accuracy of two digital tools, an AI-based symptom checker (Ada) and a web-based self-referral tool (Rheport), for identifying inflammatory rheumatic diseases (IRDs) among patients at three rheumatology centers.
  • A total of 600 patients participated, with results showing that Rheport and Ada had varying levels of success in correctly identifying IRDs, achieving diagnostic accuracies of 52% and 58% respectively.
  • The tools notably had better performance in diagnosing rheumatoid arthritis compared to other IRDs, with Ada showing a higher sensitivity for this specific condition.
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Emerging digital technologies promise to improve breast cancer care, however lack of awareness among clinicians often prevents timely adoption. This study aims to investigate current awareness and intention-to-use of three technologies among breast cancer healthcare professionals (HCP): (1) digital health applications (DHA), (2) artificial intelligence (AI), and (3) blockchain technology (BC). A 22-item questionnaire was designed and administered before and after a 30 min educational presentation highlighting technology implementation examples.

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Purpose: This study investigated the concordance of five different publicly available Large Language Models (LLM) with the recommendations of a multidisciplinary tumor board regarding treatment recommendations for complex breast cancer patient profiles.

Methods: Five LLM, including three versions of ChatGPT (version 4 and 3.5, with data access until September 3021 and January 2022), Llama2, and Bard were prompted to produce treatment recommendations for 20 complex breast cancer patient profiles.

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Article Synopsis
  • A workforce shortage and rising cases of rheumatic diseases are putting pressure on outpatient care, prompting exploration of digital services to ease these challenges.
  • A study involving interviews with healthcare professionals in German rheumatology clinics reveals three main themes: the digital transformation of care, its impact on healthcare delivery, and the key factors for successful digitalization.
  • Findings show that while digital tools can enhance patient care efficiency and communication, they may also increase healthcare professionals' workloads due to higher patient accessibility and demand for services.
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