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- Ndosi, M., et al.
(författare)
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Validation of the Educational Needs Assessment Tool as a Generic Instrument for Rheumatic Diseases in 7 European Countries
- 2013
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ Books. - 0003-4967 .- 1468-2060. ; 72:Suppl. 3, s. A149-A150
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To validate the educational needs assessment tool (The ENAT) as a generic tool with which to assess the educational needs of patients with rheumatic diseases in European Countries.Methods: The study followed a quantitative cross-sectional design. Participants comprised a convenience sample of patients from 7 European countries with each of the following diagnostic group: ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), osteoarthritis (OA) and fibromyalgia syndrome (FMS). Rasch analysis was used to assess the construct validity of the adapted ENATs and cross-cultural invariance.Results: The sample comprised 3015 patients with mean (SD) age 52.6 (13.1), disease duration 13.7 (10.7) years, 1996 (66.2%) of which were female. Patient characteristics (stratified by diagnostic group) were comparable across countries except the educational background, which was variable.Initially, the data from each country and diagnostic group was fitted to the Rasch model separately, and then the pooled data from each diagnostic group. On each occasion the data were required to satisfy Rasch model expectations, after correction for local dependency by creating clusters of items known as teslets. The OA group was an exception as it only did so in country-specific datasets, not within the pooled data. There was no significant differential item functioning (DIF) by age, gender, disease duration or educational background, indicating that the ENAT works in the same way across different patient groups. Uniform cross-cultural DIF was present and this was accounted for by 'splitting' the testlets that were affected. Subsequently, DIF-adjusted conversion tables were calibrated, to enable parametric analyses fully adjusted for cross-cultural bias when comparison of multinational data is required.Conclusions: The ENAT is a cross-culturally valid and a reliable tool, providing accurate estimation of educational needs of people with rheumatic diseases. Further research is required for its cross-cultural use in OA.Disclosure of Interest: None Declared
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| 2. |
- Nandakumar, Kutty Selva, 1965-, et al.
(författare)
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Arthritogenic antibodies specific for a major type II collagen triple-helical epitope bind and destabilize cartilage independent of inflammation
- 2008
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Ingår i: Arthritis & Rheumatology. - : Wiley. - 2326-5191 .- 2326-5205. ; 58:1, s. 184-196
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the significance and pathogenic potential of a highly conserved major type II collagen triple-helical epitope-specific antibody (U1; amino acids 494-504) in vivo and in vitro in patients with early rheumatoid arthritis (RA) and in experimental animal models of collagen-induced arthritis (CIA). METHODS: U1-specific antibodies in sera from patients with early RA (with or without joint erosions) were analyzed. Disease progression in the CIA models in mice and rats with anti-U1 antibodies was compared. The pathogenicity of binding of monoclonal antibodies (mAb) UL1 and CIIF4 to the U1 epitope and the F4 epitope (aa 926-936), respectively, was compared in vivo and on chondrocyte cultures and preformed cartilage in vitro, using Fourier transform infrared microspectroscopy analysis. In addition, UL1-induced proteoglycan depletion in vivo in the presence and absence of the complement factor C5 was analyzed. RESULTS: Increased levels of U1 antibodies were observed in patients with early RA, especially in association with joint erosions. A significant correlation of U1-specific antibodies with disease progression was found in rats and mice with CIA. UL1 mAb induced, whereas CIIF4 mAb inhibited, the progression of arthritis. Similarly, UL1, but not CIIF4, impaired matrix synthesis on chondrocyte cultures and adversely affected preformed cartilage. Furthermore, UL1 induced significant proteoglycan depletion in vivo 3 days after injection, even in the absence of C5. CONCLUSION: Antibody epitope specificity contributes significantly to the development of arthritis, and the early pathogenic events operate independent of inflammation both in vitro and in vivo.
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