Browsing by Author "Weisman, MH"

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    Polygenic Risk Scores have high diagnostic capacity in ankylosing spondylitis
    Li, ZX; Wu, X; Leo, PJ; De Guzman, E; Akkoc, N; Breban, M; Macfarlane, GJ; Mahmoudi, M; Marzo-Ortega, H; Anderson, LK; Wheeler, L; Chou, CT; Harrison, AA; Stebbings, S; Jones, GT; Bang, SY; Wang, G; Jamshidi, A; Farhadi, E; Song, J; Lin, L; Li, MM; Wei, JCC; Martin, NG; Wright, MJ; Lee, M; Wang, YQ; Zhan, J; Zhang, JS; Wang, XB; Jin, ZB; Weisman, MH; Gensler, LS; Ward, MM; Rahbar, MH; Diekman, L; Kim, TH; Reveille, JD; Wordsworth, BP; Xu, HJ; Brown, MA
    Objective We sought to test the hypothesis that Polygenic Risk Scores (PRSs) have strong capacity to discriminate cases of ankylosing spondylitis (AS) from healthy controls and individuals in the community with chronic back pain. Methods PRSs were developed and validated in individuals of European and East Asian ethnicity, using data from genome-wide association studies in 15 585 AS cases and 20 452 controls. The discriminatory values of PRSs in these populations were compared with other widely used diagnostic tests, including C-reactive protein (CRP), HLA-B27 and sacroiliac MRI. Results In people of European descent, PRS had high discriminatory capacity with area under the curve (AUC) in receiver operator characteristic analysis of 0.924.This was significantly better than for HLA-B27 testing alone (AUC=0.869), MRI (AUC=0.885) or C-reactive protein (AUC=0.700). PRS developed and validated in individuals of East Asian descent performed similarly (AUC=0.948). Assuming a prior probability of AS of 10% such as in patients with chronic back pain under 45 years of age, compared with HLA-B27 testing alone, PRS provides higher positive values for 35% of patients and negative predictive values for 67.5% of patients. For PRS, in people of European descent, the maximum positive predictive value was 78.2% and negative predictive value was 100%, whereas for HLA-B27, these values were 51.9% and 97.9%, respectively. Conclusions PRS have higher discriminatory capacity for AS than CRP, sacroiliac MRI or HLA-B27 status alone. For optimal performance, PRS should be developed for use in the specific ethnic groups to which they are to be applied.
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    Development of ASAS quality standards to improve the quality of health and care services for patients with axial spondyloarthritis
    Kiltz, U; Landewé, RBM; van der Heijde, D; Rudwaleit, M; Weisman, MH; Akkoc, N; Boonen, A; Brandt, J; Carron, P; Dougados, M; Gossec, L; Jongkees, M; Machado, PM; Marzo-Ortega, H; Molto, A; Navarro-Compán, V; Niederman, K; Sampaio-Barros, PD; Slobodin, G; van den Bosch, FE; van Tubergen, A; van Weely, S; Wiek, D; Braun, J
    Objectives The Assessment of SpondyloArthritis International Society (ASAS) aimed to develop a set of quality standards (QS) to help improve the quality of healthcare provided to adult patients affected by axial spondyloarthritis (axSpA) worldwide. Methods An ASAS task force developed a set of QS using a stepwise approach. First, key areas for quality improvement were identified, discussed, rated and agreed on. Thereafter, areas were prioritised and statements for the most important key areas were phrased on consensus. Appropriate quality measures were defined to allow quantification of the QS at the community level. Results The ASAS task force, consisting of 20 rheumatologists, two physiotherapists and two patients, selected and proposed 34 potential key areas for quality improvement which were then commented by 140 ASAS members and patients. Within that process three new key areas came up, which led to a re-evaluation of all 37 key areas by 120 ASAS members and patients. Five key areas were identified as most important to determine quality of care: referral including rapid access, rheumatology assessment, treatment, education/self-management and comorbidities. Finally, nine QS were agreed on and endorsed by the whole ASAS membership. Conclusions ASAS successfully developed the first set of QS to help improving healthcare for adult patients with axSpA. Even though it may currently not be realistic to achieve the QS in all healthcare systems, they provide high-quality of care framework for patients with axSpA that should be aimed for.