Performance of the UCLA Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 instrument as a clinical decision aid in the routine clinical care of patients with systemic sclerosis

Autor: Oliver Distler, Britta Maurer, Mike O Becker, A. Garaiman, Rucsandra Dobrota, Norina Zampatti, Suzana Jordan, Carina Mihai
Přispěvatelé: University of Zurich, Mihai, Carina
Rok vydání: 2021
Předmět:
Male
Gastrointestinal
medicine.medical_specialty
Gastrointestinal Diseases
2745 Rheumatology
610 Medicine & health
Diseases of the musculoskeletal system
Severity of Illness Index
Decision Support Techniques
03 medical and health sciences
0302 clinical medicine
Bloating
Surveys and Questionnaires
Internal medicine
Humans
Medicine
skin and connective tissue diseases
030203 arthritis & rheumatology
2403 Immunology
Scleroderma
Systemic
medicine.diagnostic_test
business.industry
UCLA GIT 2.0
10051 Rheumatology Clinic and Institute of Physical Medicine
Reflux
Endoscopy
Middle Aged
medicine.disease
Rheumatology
Gastrointestinal Tract
Clinical trial
RC925-935
Cohort
2723 Immunology and Allergy
Systemic sclerosis
Female
030211 gastroenterology & hepatology
Cohort study
business
Esophagitis
Research Article
Zdroj: Arthritis Research & Therapy, Vol 23, Iss 1, Pp 1-11 (2021)
Arthritis Research & Therapy
Zampatti, Norina; Garaiman, Alexandru; Jordan, Suzana; Dobrota, Rucsandra; Becker, Mike Oliver; Maurer, Britta; Distler, Oliver; Mihai, Carina (2021). Performance of the UCLA Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 instrument as a clinical decision aid in the routine clinical care of patients with systemic sclerosis. Arthritis research & therapy, 23(1), p. 125. BioMed Central 10.1186/s13075-021-02506-x
ISSN: 1478-6362
DOI: 10.1186/s13075-021-02506-x
Popis: Background and objectives The University of California Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument 2.0 (UCLA GIT 2.0) is validated to capture gastrointestinal (GI) tract morbidity in patients with systemic sclerosis (SSc). The aims of this study were to determine in a large SSc cohort if the UCLA GIT 2.0 is able to discriminate patients for whom a rheumatologist with experience in SSc would recommend an esophago-gastro-duodenoscopy (EGD), and if it could identify patients with endoscopically proven esophagitis or with any pathologic finding on EGD. Methods We selected patients fulfilling the ACR/EULAR 2013 criteria for SSc from our EUSTAR center having completed at least once the UCLA GIT 2.0 questionnaire, and we collected data on gastrointestinal symptoms and EGD from their medical charts. We analyzed by general linear mixed effect models several parameters, including UCLA GIT 2.0, considered as potentially associated with the indication of EGD, as well as with endoscopic esophagitis and any pathologic finding on EGD. Results We identified 346 patients (82.7% female, median age 63 years, median disease duration 10 years, 23% diffuse cutaneous SSc) satisfying the inclusion criteria, who completed UCLA GIT 2.0 questionnaires at 940 visits. EGD was recommended at 169 visits. In multivariable analysis, UCLA GIT 2.0 and some of its subscales (reflux, distention/bloating, social functioning) were associated with the indication of EGD. In 177 EGD performed in 145 patients, neither the total ULCA GIT 2.0 score nor any of its subscales were associated with endoscopic esophagitis, nor with any pathologic EGD findings. Conclusions In a real-life setting, the UCLA GIT 2.0 and its reflux subscale were able to discriminate patients with SSc who had an indication for EGD, but did not correlate with findings in EGD. We conclude that, while using the UCLA GIT 2.0 in the routine care of patients with SSc may help the rheumatologist to better understand the burden of GI symptoms in the individual patient, it should not be used as a stand-alone instrument to identify an indication of EGD.
Databáze: OpenAIRE
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