Objectives: To develop a web-based evidence-based decision aid to support shared decision-making in patients with axial spondyloarthritis (axSpA) who face a treatment decision to initiate or switch a biological or targeted synthetic disease modifying antirheumatic drug (b/tsDMARDs).
Methods: Through an iterative process, we systematically developed a decision aid based on evidence from the literature, explorative needs assessment interviews among patients and care providers, and input from experts of the SpA working group of the Dutch Society for Rheumatology and professionals on patient information employed at the Dutch Arthritis Society. The usability, ease of use and feasibility of the pilot version were tested among stakeholders and feedback was used to adapt the decision aid. Finally, a multifaceted strategy was used to introduce the decision aid in clinical practice.
Results: The decision aid consists of (1) consultation support instructions in the context of disease control and treatment needs, (2) an overview of available treatment options for axSpA, (3) detailed information on b/tsDMARDs and an interactive option grid that facilitates comparison of characteristics and (4) a final check supporting patients to deliberate on the decision to initiate or switch a b/tsDMARD. Rheumatologists introduced the decision aid in several Dutch rheumatology settings and the Dutch Arthritis Society posted it on their website, social media and in their monthly newsletter.
Conclusion: We developed an evidence-based decision aid to support axSpA patients who face a treatment decision to initiate or switch a b/tsDMARD and introduced this in clinical practice.
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http://dx.doi.org/10.1136/rmdopen-2023-003103 | DOI Listing |
Eur J Pain
February 2025
Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, SP, Brazil.
Background And Objective: Non-invasive neuromodulation techniques (NIN), such as transcranial Direct Current Stimulation (tDCS) and repetitive Transcranial Magnetic Stimulation (rTMS), have been extensively researched for their potential to alleviate pain by reversing neuroplastic changes associated with neuropathic pain (NP), a prevalent and complex condition. However, treating NP remains challenging due to the numerous variables involved, such as different techniques, dosages and aetiologies. It is necessary to provide insights for clinicians and public healthcare managers to support clinical decision-making.
View Article and Find Full Text PDFBiometrics
January 2025
Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
In the era of big data, increasing availability of data makes combining different data sources to obtain more accurate estimations a popular topic. However, the development of data integration is often hindered by the heterogeneity in data forms across studies. In this paper, we focus on a case in survival analysis where we have primary study data with a continuous time-to-event outcome and complete covariate measurements, while the data from an external study contain an outcome observed at regular intervals, and only a subset of covariates is measured.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Hepatobiliary Pancreatic Surgery Department, Huadu District People's Hospital of Guangzhou, Guangzhou, China.
Background: Sepsis is a life-threatening disease associated with a high mortality rate, emphasizing the need for the exploration of novel models to predict the prognosis of this patient population. This study compared the performance of traditional logistic regression and machine learning models in predicting adult sepsis mortality.
Objective: To develop an optimum model for predicting the mortality of adult sepsis patients based on comparing traditional logistic regression and machine learning methodology.
Front Vet Sci
January 2025
School of Veterinary Medicine, Veterinary Surgical and Radiological Sciences, University of California, Davis, Davis, CA, United States.
Oral lesions are common in dogs and cats, and determining the underlying etiology of these lesions can be challenging. A wide range of systemic ailments may lead to lesions in the oral cavity, including immune-mediated diseases, adverse drug reactions, viral and bacterial infections, and metabolic and autoimmune diseases. A complete history and thorough physical examination (including a fundic examination) should be obtained in affected patients.
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