Loreto Carmona

Instituto de Salud Musculoesquelética

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Estíbaliz Loza

Instituto de Salud Musculoesquelética

Laure Gossec

Institut Pierre Louis d‘Épidémiologie et de Santé Publique

Juan J. Gómez‐Reino

Hospital Clínico Universitario de Valencia

María Jesús García de Yébenes

Instituto de Salud Musculoesquelética

Pedro Machado

University College London

Teresa Otón

Instituto de Salud Musculoesquelética

Elsa F Mateus

Portuguese League Against Epilepsy

Kimme L Hyrich

University of Manchester

M.Á. Descalzo

World Health Organization Regional Office for the Americas

Isidoro González‐Álvaro

Hospital Universitario de La Princesa

Cooperative Institutions

Center for Rheumatology

418

Digital Research Alliance of Canada

258

Psoriasis Association

248

University of Washington

131

Institute for Health Metrics and Evaluation

118

Universidad Autónoma de Madrid

103

Inserm

102

University College London

101

Hospital Universitario de La Princesa

Université Paris Cité

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FRI0106 Results of a systematic literature review of prognostic factors in rheumatoid arthritis as a basis for a prospective rheumatologists survey

Annals of the Rheumatic Diseases (2017)

Loreto Carmona Teresa Otón A Royo JL Baquero Sean Lujan

Background

Selecting the most appropriate therapy for each patient with rheumatoid arthritis (RA) is crucial in order to prevent joint damage, particularly in patients with rapidly progressing disease. The literature on prognostic factors is tremendous, being practical to summarize which factors are most strongly associated with a particular outcome and what is the utility that rheumatologists assign to these factors.

Objectives

To identify well established factors predicting long-term outcomes in RA, as the basis for a survey.

Methods

The identification of the factors was performed via an overview of systematic reviews studying prognostic factors in RA, followed by scoping reviews for individual factors. All searches were conducted in PubMed. In order to be included in the overview, the study had to be a systematic review of prognostic factors of any of the following outcomes: disability, mortality, remission, response to treatment, or radiological damage. All factors identified, in positive or negative association with the selected outcomes, were compiled in a matrix of factors * outcomes. Subsequent scoping literature reviews were performed for each combination of the matrix.

Results

The overview of systematic reviews allowed the identification of 36 prognostic factors (see Table 1). After a round of discussions, we decided to remove all factors depending on treatment or study methodology for the scoping reviews, considering that they could not properly be considered prognostic factors but modifiers. Following the scoping reviews, we obtained a list of studies of prognostic factors, with methodological characteristics and 27 reviews of specific prognostic factors and outcomes. With this information, a survey addressed to practicing rheumatologists was developed to test how often they use the various factors to make long-term predictions, and how strong they think the association with outcome is.

Conclusions

We have analyzed and compiled a summary of prognostic factors published in RA and their predictability of long-term outcomes. This may act as a reference for cross-factor comparison and evidence-based risk assimilation and serve as a basis of surveying the value of such factors.

Acknowledgements

This study was funded by Bristol-Myers Squibb.

Disclosure of Interest

L. Carmona Grant/research support from: BMS, T. Otόn Grant/research support from: BMS, A. Royo Employee of: BMS, J. L. Baquero Grant/research support from: BMS, S. Luján: None declared, S. Muñoz-Fernández Grant/research support from: BMS

Identification

10.1136/annrheumdis-2017-eular.4765

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SISTEMA DE CLASSIFICAÇÃO DE PACIENTES: APLICAÇÃO DE UM INSTRUMENTO VALIDADO CLASSIFICATION SYSTEM OF PATIENTS: APPLICATION OF A VALIDATED TOOL SISTEMA DE CLASIFICACIÓN DE PACIENTES: APLICACIÓN DE UN INSTRUMENTO EVALUADO

Loreto Carmona Yolanda Dora Martinez Évora

ABSTRACT The authors applied an instrument of patient classification to the patients of Hall B2 of the Hospital das Clinicas de Marilia, in two distinct periods of 1999, seeking to discover the degree of dependency of the patients in relation to nursing staff. The sample consisted of 31 patients in the first period and 35 in the second. The results showed that most of the patients had been classified as needing minimum or intermediary care in their units of admission. Some modifications of the procedures were suggested. KEYWORDS: Nursing administration. Patient selection. Nursing services. Nurse clinicians. RESUMEN Las autoras aplicaron un instrumento de clasificacion en pacientes del Ala B2 del Hospital de Clinicas de Marilia, en dos periodos distintos durante 1999, con el objetivo de conocer el grado de dependencia de dichos pacientes con relacion a los enfermeros. La muestra estuvo constituida de 31 pacientes en el primer periodo y de 35 pacientes en el segundo periodo. Los resultados mostraron que la mayoria de los pacientes fue clasificada como de cuidados minimos o intermedios, siendo preocupante el numero de pacientes clasificados como de cuidados semi-intensivos e intensivos en las unidades de internacion. Se sugieren algunas modificaciones en el instrumento utilizado.

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Citations (1)

Características de los pacientes con espondiloartritis seguidos en unidades de reumatología en España. Estudio emAR II

Reumatología Clínica (2012)

José Luis Casals-Sánchez María Jesús García de Yébenes Prous M.Á. Descalzo Juan Manuel Barrio Olmos Loreto Carmona

10.1016/j.reuma.2012.01.006

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Citations (15)

Patient-journey of fibromyalgia patients: A scoping review

Reumatología Clínica (2023)

Teresa Otón Loreto Carmona Javier Rivera

10.1016/j.reuma.2023.07.006

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Citations (0)

Natural language processing to identify and characterize spondyloarthritis in clinical practice

RMD Open (2024)

Diego Benavent María Benavent Judith Marín‐Corral Javier Arias Victoria Navarro‐Compán

This study aims to use a novel technology based on natural language processing (NLP) to extract clinical information from electronic health records (EHRs) to characterise the clinical profile of patients diagnosed with spondyloarthritis (SpA) at a large-scale hospital.

Clinical Practice

10.1136/rmdopen-2024-004302

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AB1627-HPR DEVELOPMENT OF AN ACTIONABLE AND COMPREHENSIVE STAKEHOLDER INVOLVEMENT STRATEGY FOR COMPLEX MULTINATIONAL PROJECTS: THE SQUEEZE EXPERIENCE

Annals of the Rheumatic Diseases (2024)

Loreto Carmona Estíbaliz Loza Teresa Otón Katia Vladimirova Agnes Kocher

Background:

Complex multinational projects aiming at developing solutions in healthcare, like the SQUEEZE project, need to build fruitful relationships with stakeholders to make the research more efficient, relevant and implementable. Many institutions and networks have developed frameworks for stakeholder engagement. Still, the practicalities are unclear, and many are focused solely on patient and public involvement, not on the involvement of researchers, clinicians, or other stakeholders.

Objectives:

To develop a stakeholder strategy efficient enough to provide clear guidance on where, when, and how to involve stakeholders in the context of the SQUEEZE project. To implement it and test it in the first year after its development.

Methods:

The overall SQUEEZE stakeholder strategy was built systematically and iteratively adapting Barkhordarian et al.'s framework [1] consisting of seven steps: 1) Defining, 2) Long-listing, 3) Mapping, 4) Visualizing, 5) Verifying, 6) Mobilizing, and 6) Evaluating. After the development and endorsement, the evaluation included the evaluation of KPIs: stakeholder satisfaction, engagement, influence, and impact. For their measurement, we developed surveys and interviews.

Results:

The SQUEEZE stakeholder strategy included objectives, values, and actionable points. Several rounds of eliciting dynamics, including patient journeys, favoured an exhaustive long listing that was further reduced. All the identified stakeholders were categorised into significant domains for the project. The work-package (WP) leaders were then surveyed to identify which of the listed stakeholders were relevant for their studies and outputs and why and whether they could identify additional critical stakeholders. The level of preferred engagement was finally decided for each stakeholder on their relevance for implementing SQUEEZE products, the level of influence, and the likelihood of engagement. The stakeholders were then mapped into the research cycle phases to identify the timing for involvement. Finally, actionable strategies were established by tailoring the different groups to the tasks in the SQUEEZE WPs and adding potential outcomes to guide the evaluation, e.g., improved retention rates and recruitment for the involvement of PRPs, etc. The strategies include specific training, recruitment for focus groups, webinars, checklists, etc. After 6 months of issuing the strategy, the WP leaders identified some areas for improvement (Table 1). The survey to stakeholders showed high levels of engagement and satisfaction with the project. The discussions with the strategy team disclosed potential drawbacks of the strategy that had not been well implemented. Table 1. Overview of the stakeholder strategy evaluation by the WP leaders (randomly represented in columns).

Conclusion:

The SQUEEZE stakeholder strategy provides a comprehensive approach for stakeholder involvement in all work packages of this complex international multinational project. Evaluation, an often-missing part of stakeholder involvement strategies, is an inherent part of the strategy. The developed strategy can be a blueprint for other projects.

REFERENCES:

[1] Barkhordarian A, et al. J Transl Med. 2015;13:15.

Acknowledgements:

This project has received funding from the European Union's Horizon Europe research and innovation programme under grant agreement No 101095052 and from the Swiss State Secretariat for Education, Research and Innovation (SERI).

Disclosure of Interests:

None declared.

10.1136/annrheumdis-2024-eular.1488

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Development of a Tool to Measure the Clinical Response to Biologic Therapy in Uncontrolled Severe Asthma: The FEV1, Exacerbations, Oral Corticosteroids, Symptoms Score

The Journal of Allergy and Clinical Immunology In Practice (2021)

Luís Pérez de Llano Ignacio Dávila Eva Martínez-Moragón Javier Domínguez‐Ortega Carlos Almonacid

10.1016/j.jaip.2021.01.033

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Citations (37)

Epidemiology and health-related services

Current Opinion in Rheumatology (2016)

Fernando Pérez-Ruiz Irati Urionagüena Loreto Carmona

Purpose of review This article presents recent epidemiologic contributions focusing on gout-related conditions, especially if controversial, to find plausible, despite hypothetical, mechanistic explanations from the clinician perspective. Recent findings The prevalence of gout is increasing, but it is only partially clear that the incidence may be increasing as well. Direct associations of gout with increased risk of diabetes, black races, neurodegenerative disorders, and sugar-enriched foods have been recently questioned. A negative association with smoking has been reported, and new evidence shows that the impact of diet may be independent of obesity. Kidney disease and diuretics have been confirmed to be associated with gout, whereas new data on aging and menopause have come to challenge apparently established disease mechanisms. Regarding treatments, increase in bladder cancer associated with chronic allopurinol use has been reported, and the positive effect of urate-lowering treatment on cardiovascular events has been contested. Summary Epidemiological data in gout-related conditions are still evolving and claim for future cohort or intervention studies to prove causality. Controversies in epidemiological results fertilize the ground for studies to prove mechanisms and causality and provides a unique opportunity for clinical intervention to improve outcomes, especially with regard to treatments.

Causality

Allopurinol

10.1097/bor.0000000000000258

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Citations (2)

Reacciones adversas relacionadas con la administración de inhibidores del TNF. Análisis de un registro de terapias biológicas

Reumatología Clínica (2008)

Beatriz Pérez-Zafrilla M.Á. Descalzo Loreto Carmona

10.1016/s1699-258x(08)71810-2

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Citations (16)

El viaje del paciente con fibromialgia en Latinoamérica