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1. Shortening patient-reported outcome measures through optimal test assembly: Application to the Social Appearance Anxiety Scale in the Scleroderma Patient-centered Intervention Network Cohort

Author

Harel, D., Mills, S.D., Kwakkenbos, L., Carrier, M.E., Nielsen, K., Portales, A., Bartlett, S.J., Malcarne, V.L., Thombs, B.D., Baron, M., Furst, D.E., Gottesman, K., Mayes, M.D., Mouthon, L., Nielson, W.R., Riggs, R., Sauve, M., Wigley, F., Assassi, S., Boutron, I., Maia, A.C., El-Baalbaki, G., Ells, C., Ende, C. van den, Fligelstone, K., Fortune, C., Frech, T., Godard, D., Hudson, M., Impens, A., Jang, Y., Johnson, S.R., Kennedy, A.T., Korner, A., Larche, M., Leite, C., Marra, C., Pope, J., Reyna, T.S.R., Schouffoer, A.A., Steele, R.J., Suarez-Almazor, M.E., Welling, J., Wong-Rieger, D., Agard, C., Albert, A., Andre, M., Arsenault, G., Benmostefa, N., Benzidia, I., Berthier, S., Bissonnette, L., Boire, G., Bruns, A., Carreira, P., Casadevall, M., Chaigne, B., Chung, L., Cohen, P., Dagenais, P., Denton, C., Domsic, R., Dubois, S., Dunne, J.V., Dunogue, B., Esquinca, A., Fare, R., Farge-Bancel, D., Fortin, P.R., Gill, A., Gordon, J., Granel-Rey, B., Grange, C., Gyger, G., Hachulla, E., Hatron, P.Y., Herrick, A.L., Hij, A., Hinchcliff, M., Ikic, A., Jones, N., Fernandes, A.J.D., Kafaja, S., Khalidi, N., Korman, B., Launay, D., Liang, P., London, J., Luna, D., Maillard, H., Manning, J., Martin, M., Martin, T., Masetto, A., Maurier, F., Mekinian, A., Melchor, S., Nikpour, M., Paule, R., Proudman, S., Regent, A., Riviere, S., Robinson, D., Rodriguez, E., Roux, S., Smets, P., Smith, D., Sobanski, V., Spiera, R., Steen, V., Stevens, W., Sutton, E., Terrier, B., Thorne, C., Varga, J., Wilcox, P., Wilson, M., Cumin, J., Fox, R.S., Gholizadeh, S., Jewett, L.R., Levis, B., Pepin, M.R., Turner, K.A., Lambert, M., and SPIN Investigators

Subjects
Adult, Male, medicine.medical_specialty, systemic sclerosis, Concurrent validity, Anxiety, Fear of negative evaluation, Cohort Studies, Experimental Psychopathology and Treatment, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Cronbach's alpha, medicine, Humans, Patient Reported Outcome Measures, optimal test assembly, 030212 general & internal medicine, Aged, Aged, 80 and over, Scleroderma, Systemic, business.industry, Research, short form, Social anxiety, Reproducibility of Results, generalized partial credit model, General Medicine, Middle Aged, stomatognathic diseases, Cross-Sectional Studies, Convergent validity, patient reported outcome measure, Physical Appearance, Body, Physical therapy, Female, Patient-reported outcome, medicine.symptom, business, 030217 neurology & neurosurgery, Cohort study
Abstract

ObjectivesThe Social Appearance Anxiety Scale (SAAS) is a 16-item measure that assesses social anxiety in situations where appearance is evaluated. The objective was to use optimal test assembly (OTA) methods to develop and validate a short-form SAAS based on objective and reproducible criteria.DesignThis study was a cross-sectional analysis of baseline data from adults enrolled in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort.SettingAdults in the SPIN Cohort in the present study were enrolled at 28 centres in Canada, the USA and the UK.ParticipantsThe SAAS was administered to 926 adults with scleroderma.Primary and secondary measuresThe SAAS, Brief Fear of Negative Evaluation II (BFNE II), Brief Satisfaction with Appearance Scale (Brief-SWAP), Patient Health Questionnaire-8 (PHQ8) and Social Interaction Anxiety Scale-6 (SIAS-6) were collected, as well as demographic characteristics.ResultsOTA methods identified a maximally informative shortened version for each possible form length between 1 and 15 items. The final shortened version was selected based on prespecified criteria for reliability, concurrent validity and statistically equivalent convergent validity with the BFNE II scale. A five-item short version was selected (SAAS-5). The SAAS-5 had a Cronbach’s α of 0.95 and had high concurrent validity with the full-length form (r=0.97). The correlation of the SAAS-5 with the BFNE II was 0.66, which was statistically equivalent to that of the full-length form. Furthermore, the correlation of the SAAS-5 with the two subscales of the Brief-SWAP, and the SIAS-6, were statistically equivalent to that of the full-length form.ConclusionsOTA was an efficient method for shortening the full-length SAAS to create the SAAS-5.

Published
2019

2. Defining appropriate outcome measures in pulmonary arterial hypertension related to systemic sclerosis: A Delphi consensus study with cluster analysis

Author

Distler, O, Behrens, F, Pittrow, D, Huscher, D, Denton, Cp, Foeldvari, I, Humbert, M, Matucci Cerinic, M, Nash, P, Opitz, Cf, Rubin, Lj, Seibold, Jr, Furst, De, EPOSS Omeract Group including Ahmadi Simab, K, Albera, Carlo, Bolster, Mb, Brühlmann, P, Burger, C, Chan, K, Chatterjee, S, Clements, P, Confalonieri, M, Csuka, Me, Farber, H, Fessler, B, Foley, R, Frantz, R, Gran, Jt, Highland, K, Hoeper, M, Hsu, V, Inanc, M, Jansa, P, Johnson, S, Kahaleh, B, Kawut, Sm, Keogh, A, Khanna, D, Kähler, Cm, Lang, I, Mahmud, Th, Mandel, J, Mathier, M, Mayes, M, Mchugh, N, Mckown, K, Mclaughlin, V, Medsger TA Jr, Mehta, S, Merkel, Pa, Mubarak, K, Nathan, S, Oudiz, R, Palevsky, H, Park, M, Pope, J, Presberg, K, Ralph, D, Rich, S, Rothfield, N, Rubenfire, M, Scorza, R, Senecal, Jl, Shanahan, J, Silver, R, Staehler, G, Steen, V, Strange, C, Sweiss, N, Taichman, D, Talwar, A, Voskuyl, A, Wigley, F, Williamson, T, Wollheim, F., and University of Zurich

Subjects
Cardiac Catheterization, medicine.medical_specialty, Delphi Technique, Visual analogue scale, Hypertension, Pulmonary, 2745 Rheumatology, Immunology, Delphi method, Placebo-controlled study, Blood Pressure, 610 Medicine & health, Severity of Illness Index, law.invention, Rheumatology, Quality of life, Randomized controlled trial, law, Outcome Assessment, Health Care, Severity of illness, Cluster Analysis, Immunology and Allergy, Medicine, Pharmacology (medical), Randomized Controlled Trials as Topic, Scleroderma, Systemic, business.industry, 10051 Rheumatology Clinic and Institute of Physical Medicine, Clinical trial, Blood pressure, Echocardiography, Exercise Test, Quality of Life, Physical therapy, business
Abstract

Objective. Outcome measures for pulmonary arterial hypertension associated with systemic sclerosis (PAH-SSc) are only partially validated. The aim of the present study was to establish an expert consensus regarding which outcome measures are most appropriate for clinical trials in PAH-SSc. Methods. Sixty-nine PAH-SSc experts (rheumatologists, cardiologists, pulmonologists) rated a list of disease domains and measurement tools in an Internet-based 3-stage Delphi consensus study. In stages 2 and 3, the medians of domains and measurement tools and frequency distributions of ratings, along with requests for re-ratings, were distributed to respondents to provide feedback. A final score of items was identified by means of cluster analysis. Results. The experts judged the following domains and tools as most appropriate for randomized controlled trials in PAH-SSc: lung vascular/pulmonary arterial pressure and cardiac function both measured by right heart catheterization and echocardiography, exercise testing measured by 6-minute walking test and oxygen saturation at exercise, severity of dyspnea measured on a visual analog scale, discontinuation of treatment measured by (serious) adverse events, quality of life/activities of daily living measured by the Short Form 36 and Health Assessment Questionnaire disability index, and global state assessed by physician measured by survival. Conclusion. Among experts in PAH-SSc, a core set of outcome measures has been defined for clinical trials by Delphi consensus methods. Although these outcome measures are recommended by this expert group to be used as an interim tool, it will be necessary to formally validate the present measures, as well as potential research measures, in further studies.

Published
2008
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3. Characteristics of joint involvement and relationships with systemic inflammation in systemic sclerosis: results from the EULAR Scleroderma Trial and Research Group (EUSTAR) database

Author

Avouac, Jerome, Walker, Ulrich, Tyndall, Alan, Kahan, André, Matucci Cerinic, Marco, Allanore, Yannick, Miniati, I., Müller, A., Iannone, F., Giacomelli, R., Distler, O., Becvar, R., Sierakowsky, S., Kowal Bielecka, O., Coelho, P., Cabane, J., Cutolo, M., Shoenfeld, Y., Rovensky, J., Riemekasten, G., Nicoara, I., Vlachoyiannopoulos, P., Caporali, R., Jiri, S., Inanc, M., Gorska, I. Zimmermann, Carreira, P., Novak, S., Czirjak, L., Ramos, F. Oliveira, Jendro, M., Chizzolini, C., Kucharz, E. J., Richter, J., Cozzi, F., Rozman, B., Mallia, C. M., Gabrielli, A., Farge, D., Kiener, H. P., Schöffel, D., Sticherling, M., Airo, P., Wollheim, F., Martinovic, D., Trotta, F., Hunzelmann, N., Jablonska, S., Reich, K., Bombardieri, S., Siakka, P., Pellerito, R., Bambara, L. M., Morovic Vergles, J., Denton, C., Hinrichs, R., Van Den Hoogen, F., Damjanov, N., Kötter, I., Ortiz, V., Heitmann, S., Krasowska, D., Seidel, M., Hasler, P., Van Laar, J. M., Kaltwasser, J. P., Foeldvari, I., Juan Mas, A., Bajocchi, G., Wislowska, M., Pereira Da Silva, J. A., Jacobsen, S., Worm, M., Graniger, W., Kuhn, A., Stankovic, A., Cossutta, R., Majdan, M., Rajcevska, L. Damjanovska, Tikly, M., Nasonov, E. L., Steinbrink, K., Herrick, A., Müller Ladner, U., Dinc, A., Scorza, R., Sondergaard, K., Indiveri, F., Nielsen, H., Szekanecz, Z., Silver, R. M., Antivalle, M., Espinosa, I. B., García De La Pena Lefebvre, P., Midtvedt, O., Launay, D., Valesini, F., Tuvik, P., Ionescu, R. M., Del Papa, N., Pinto, S., Wigley, F., Mihai, C., Capranu, M. Sinziana, Sunderkötter, C., Jun, J. B., Derk, C., Alhasani, S., Distler, J. H., Ton, E., Soukup, T., Seibold, J., Zeni, S., Nash, P., Mouthon, L., De Keyser, F., Duruöz, M. T., Cantatore, F. P., Strauss, G., Von Mülhen, C. A., Pozzi, M. R., Eyerich, K., Szechinski, J., Keiserman, M., Houssiau, F. A., Rom Ivorra, J. A., Krummel Lorenz, B., Aringer, M., Westhovens, R., Bellisai, F., Mayer, M., Stoeckl, F., Üprus, M., Volpe, A., Buslau, M., Yavuz, S., Granel, B., Feijó, A. Valderílio, Del Galdo, F., Popa, S., Zenone, T., Machado, X. Ricardo, Pileckyte, M., Stebbings, S., Mathieu, A., Tulli, A., Tourinho, T., Souza, R., Acayaba De Toledo, R., Stamp, L., Solanki, K., Veale, D., Neto, J. Francisco Marques, Bagnato, G. F., Loyo, E., Toloza, S., Li, M., Mohamed, W. Ahmed Abdel Atty, Cobankara, V., Olas, J., Salsano, F., Oksel, F., Tanaseanu, C. M., Foti, R., Ancuta, C., Vonk, M., Caramashi, P., Beretta, L., Balbir, A., Shine, B., Chiàla, A., Simic, K. Pasalic, Ghio, M., Stamenkovic, B., Rednic, S., Host, N., Hachulla, E., Furst, D. E., VALENTINI, Gabriele, Avouac, Jerome, Walker, Ulrich, Tyndall, Alan, Kahan, André, Matucci Cerinic, Marco, Allanore, Yannick, Miniati, I., Müller, A., Iannone, F., Giacomelli, R., Distler, O., Becvar, R., Sierakowsky, S., Kowal Bielecka, O., Coelho, P., Cabane, J., Cutolo, M., Shoenfeld, Y., Valentini, Gabriele, Rovensky, J., Riemekasten, G., Nicoara, I., Vlachoyiannopoulos, P., Caporali, R., Jiri, S., Inanc, M., Gorska, I. Zimmermann, Carreira, P., Novak, S., Czirjak, L., Ramos, F. Oliveira, Jendro, M., Chizzolini, C., Kucharz, E. J., Richter, J., Cozzi, F., Rozman, B., Mallia, C. M., Gabrielli, A., Farge, D., Kiener, H. P., Schöffel, D., Sticherling, M., Airo, P., Wollheim, F., Martinovic, D., Trotta, F., Hunzelmann, N., Jablonska, S., Reich, K., Bombardieri, S., Siakka, P., Pellerito, R., Bambara, L. M., Morovic Vergles, J., Denton, C., Hinrichs, R., Van Den Hoogen, F., Damjanov, N., Kötter, I., Ortiz, V., Heitmann, S., Krasowska, D., Seidel, M., Hasler, P., Van Laar, J. M., Kaltwasser, J. P., Foeldvari, I., Juan Mas, A., Bajocchi, G., Wislowska, M., Pereira Da Silva, J. A., Jacobsen, S., Worm, M., Graniger, W., Kuhn, A., Stankovic, A., Cossutta, R., Majdan, M., Rajcevska, L. Damjanovska, Tikly, M., Nasonov, E. L., Steinbrink, K., Herrick, A., Müller Ladner, U., Dinc, A., Scorza, R., Sondergaard, K., Indiveri, F., Nielsen, H., Szekanecz, Z., Silver, R. M., Antivalle, M., Espinosa, I. B., García De La Pena Lefebvre, P., Midtvedt, O., Launay, D., Valesini, F., Tuvik, P., Ionescu, R. M., Del Papa, N., Pinto, S., Wigley, F., Mihai, C., Capranu, M. Sinziana, Sunderkötter, C., Jun, J. B., Derk, C., Alhasani, S., Distler, J. H., Ton, E., Soukup, T., Seibold, J., Zeni, S., Nash, P., Mouthon, L., De Keyser, F., Duruöz, M. T., Cantatore, F. P., Strauss, G., Von Mülhen, C. A., Pozzi, M. R., Eyerich, K., Szechinski, J., Keiserman, M., Houssiau, F. A., Rom Ivorra, J. A., Krummel Lorenz, B., Aringer, M., Westhovens, R., Bellisai, F., Mayer, M., Stoeckl, F., Üprus, M., Volpe, A., Buslau, M., Yavuz, S., Granel, B., Feijó, A. Valderílio, Del Galdo, F., Popa, S., Zenone, T., Machado, X. Ricardo, Pileckyte, M., Stebbings, S., Mathieu, A., Tulli, A., Tourinho, T., Souza, R., Acayaba De Toledo, R., Stamp, L., Solanki, K., Veale, D., Neto, J. Francisco Marque, Bagnato, G. F., Loyo, E., Toloza, S., Li, M., Mohamed, W. Ahmed Abdel Atty, Cobankara, V., Olas, J., Salsano, F., Oksel, F., Tanaseanu, C. M., Foti, R., Ancuta, C., Vonk, M., Caramashi, P., Beretta, L., Balbir, A., Shine, B., Chiàla, A., Simic, K. Pasalic, Ghio, M., Stamenkovic, B., Rednic, S., Host, N., Hachulla, E., Furst, D. E., Chizzolini, Carlo, and Westhovens, Rene

Subjects
Male, Systemic disease, Databases, Factual, Cross-sectional study, Joint Diseases/etiology/pathology/physiopathology, Systemic inflammation, Joint involvement, Scleroderma, systemic sclrosis, systemic inflemmetion, joint involvement, Tendons, Systemic sclerosi, Scleroderma, Localized, 0302 clinical medicine, data base, Immunopathology, joint radiography, Immunology and Allergy, Joints/pathology, scleroderma, 030212 general & internal medicine, nuclear magnetic resonance imaging, Range of Motion, Articular, skin and connective tissue diseases, rheumatic disease, ddc:616, interstitial lung disease, Joint contracture, Clinical Trials as Topic, Synovitis, Inflammation/etiology/pathology/physiopathology, integumentary system, article, Tendons/pathology, Middle Aged, musculoskeletal system, cohort analysis, Connective tissue disease, priority journal, Joint, Synoviti, Systemic sclerosis, Female, medicine.symptom, Joint Diseases, Human, musculoskeletal diseases, Adult, medicine.medical_specialty, hand radiography, Immunology, Scleroderma, Localized/etiology/*pathology, Auto-immunity, transplantation and immunotherapy [N4i 4], 03 medical and health sciences, SYSTEMIC SCLEROSIS, JOINT INVOLVEMENT, SYNOVITIS, JOINT CONTRACTURE, TENDON FRICTION RUB, Tendon friction rub, Rheumatology, Internal medicine, medicine, Humans, Health care ethics [NCEBP 5], Tendon, Aged, 030203 arthritis & rheumatology, Cross-Sectional Studie, Inflammation, skin disease, Scleroderma, Systemic, business.industry, echography, medicine.disease, major clinical study, tenosynovitis, Synovitis/etiology/pathology, clinical feature, body regions, Cross-Sectional Studies, Evaluation of complex medical interventions [NCEBP 2], Scleroderma, Systemic/complications/pathology/physiopathology, Joints, disease duration, business, Joint Disease, disease activity
Abstract

Objective.To determine the prevalence of and independent factors associated with joint involvement in a large population of patients with systemic sclerosis (SSc).Methods.This study was cross-sectional, based on data collected on patients included in the European League Against Rheumatism (EULAR) Scleroderma Trials and Research (EUSTAR) registry. We queried this database to extract data regarding global evaluation of patients with SSc and the presence of any clinical articular involvement: synovitis (tender and swollen joints), tendon friction rubs (rubbing sensation detected as the tendon was moved), and joint contracture (stiffness of the joints that decreased their range of motion). Overall joint involvement was defined by the occurrence of synovitis and/or joint contracture and/or tendon friction rubs.Results.We recruited 7286 patients with SSc; their mean age was 56 ± 14 years, disease duration 10 ± 9 years, and 4210 (58%) had a limited cutaneous disease subset. Frequencies of synovitis, tendon friction rubs, and joint contractures were 16%, 11%, and 31%, respectively. Synovitis, tendon friction rubs, and joint contracture were more prevalent in patients with the diffuse cutaneous subset and were associated together and with severe vascular, muscular, renal, and interstitial lung involvement. Moreover, synovitis had the highest strength of association with elevated acute-phase reactants taken as the dependent variable.Conclusion.Our results highlight the striking level of articular involvement in SSc, as evaluated by systematic examination in a large cohort of patients with SSc. Our data also show that synovitis, joint contracture, and tendon friction rubs are associated with a more severe disease and with systemic inflammation.

Published
2010
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6. Examination of the association of sex and race/ethnicity with appearance concerns: A Scleroderma Patient-centered Intervention Network (SPIN) Cohort study

Author

Jewett, L. R., Kwakkenbos, L., Carrier, M. E., Malcarne, V. L., Bartlett, S. J., Furst, D. E., Gottesman, K., Mayes, M. D., Assassi, S., Harcourt, D., Williamson, H., Johnson, S. R., Körner, A., Steen, V., Fox, R. S., Gholizadeh, S., Mills, S. D., Molnar, J. C., Rice, D. B., Thombs, B. D., Baron, M., Den Hoogen, F., Khanna, D., Mouthon, L., Nielson, W. R., Poiraudeau, S., Riggs, R., Sauve, M., Wigley, F., Boutron, I., Maia, A. C., El-Baalbaki, G., Ells, C., Den Ende, C., Fligelstone, K., Fortune, C., Frech, T., Godard, D., Harel, D., Hudson, M., Impens, A., Jang, Y., Kennedy, A. T., Maggie Larche, Leite, C., Marra, C., Nielsen, K., Poole, J. L., Pope, J., Portales, A., Reyna, T. S. R., Schouffoer, A. A., Steele, R. J., Suarez-Almazor, M. E., Welling, J., Wong-Rieger, D., Albert, A., Arsenault, G., Bissonnette, L., Boire, G., Bruns, A., Carreira, P., Chung, L., Dagenais, P., Denton, C. P., Domsic, R., Dunne, J. V., Fortin, P., Gill, A., Gordon, J., Gyger, G., Herrick, A. L., Manning, J., Hinchcliff, M., Ikic, A., Jones, N., Fernandes, A. J. D. B., Kafaja, S., Nader Khalidi, Korman, B., Liang, P., Masetto, A., Robinson, D., Roux, S., Schiopu, E., Smith, D., Spiera, R., Sutton, E., Thorne, C., Varga, J., Wilcox, P., Delisle, V. C., Fedoruk, C., Levis, B., Milette, K., Pepin, M. R., and Persmann, J.

8. Assessment of right ventricular reserve utilizing exercise provocation in systemic sclerosis

Author

Fredrick M. Wigley, Ami A. Shah, Susan A. Mayer, Steven Hsu, Monica Mukherjee, Valentina Mercurio, Paul M. Hassoun, Laura K. Hummers, David A. Kass, Ryan J. Tedford, Stephen C. Mathai, Mukherjee, M., Mercurio, V., Hsu, S., Mayer, S. A., Mathai, S. C., Hummers, L. K., Kass, D. A., Hassoun, P. M., Wigley, F. M., Tedford, R. J., and Shah, A. A.

Subjects
medicine.medical_specialty, Supine position, Heart Ventricles, Hypertension, Pulmonary, Ventricular Dysfunction, Right, Exercise stre, Provocation test, Predictive Value of Test, Longitudinal strain, 030204 cardiovascular system & hematology, Article, Pulmonary hypertension, Heart Ventricle, Contractility, Systemic sclerosi, 03 medical and health sciences, Basal (phylogenetics), 0302 clinical medicine, Afterload, Predictive Value of Tests, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Exercise, Subclinical infection, 030203 arthritis & rheumatology, Scleroderma, Systemic, business.industry, medicine.disease, Blood pressure, Echocardiography, Ventricular Function, Right, Cardiology, Right ventricle, Cardiology and Cardiovascular Medicine, business, Human
Abstract

PURPOSE: Right ventricular (RV) capacity to adapt to increased afterload is the main determinant of outcome in pulmonary hypertension (PH), a common morbidity seen in systemic sclerosis (SSc). We hypothesized that supine bicycle echocardiography (SBE), coupled with RV longitudinal systolic strain (RVLSS), improves detection of limitations in RV reserve in SSc. METHODS: 56 SSc patients were prospectively studied during SBE with RV functional parameters compared at rest and peak stress. We further dichotomized patients based on resting RV systolic pressure (RVSP) to determine the effects of load on contractile response. RESULTS: Our pooled cohort analysis revealed reduced global RVLSS at rest (−16.2 ± 3.9%) with normal basal contractility (−25.6 ± 7.7%) and relative hypokinesis of the midventricular (−14.1 ± 6.0%) and apical (−8.9 ± 5.1%) segments. With exercise, global RVLSS increased significantly (p=0.0005), however despite normal basal contractility at rest, there was no further augmentation with exercise. Mid and apical RVLSS increased with exercise suggestive of RV contractile reserve. In patients with resting RVSP < 35 mmHg, global and segmental RVLSS increased with exercise. In patients with resting RVSP ≥35 mmHg, global and segmental RVLSS did not increase with exercise and there was evidence of exertional RV dilation. CONCLUSION: Exercise provocation in conjunction with RVLSS identified differential regional contractile response to exercise in SSc patients. We further demonstrate the effect of increased loading conditions on RV contractile response exercise. These findings suggest subclinical impairments in RV reserve in SSc that may be missed by resting noninvasive 2DE-based assessments alone.

Published
2021
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9. Biomarkers of Fibrosis

Author

Oliver Distler, Christian Beyer, Jörg H W Distler, University of Zurich, Varga, J, Denton, C P, Wigley, F M, and Distler, O

Subjects
Drug, Modern medicine, medicine.medical_specialty, Past medical history, medicine.diagnostic_test, business.industry, media_common.quotation_subject, 10051 Rheumatology Clinic and Institute of Physical Medicine, 610 Medicine & health, Physical examination, Computed tomography, 2700 General Medicine, medicine.disease, Disease activity, Drug development, Fibrosis, Medicine, business, Intensive care medicine, media_common
Abstract

Biomarkers are modern diagnostics that can guide the treatment of our patients in daily clinical life and direct drug development in preclinical and clinical studies. Biological markers allow screening for diseases, giving prognostic information, and assessing disease activity. Over the last 20 years, biomarkers helped to prioritize drug development and minimize risks for drug attrition in late-phase clinical studies. Despite their central roles in modern medicine, the numbers of disease-specific biomarkers that we routinely assess in our patients with systemic sclerosis (SSc) are limited. So far, past medical history, clinical examination, and equipment-based diagnostics (e.g., computed tomography, body plethysmography, and right-heart catheterization studies) dominate our treatment decisions in SSc.

Published
2011
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