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Um die Telemedizin erfolgreich in den rheumatologischen Alltag zu integrieren, sind sowohl die Patienten- als auch Arztperspektive wichtig. Hierzu wurde eine ausfuhrliche Studie mittels webbasierter Umfrage durch die Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft fur Rheumatologie (DGRh) und die Deutsche Rheuma-Liga Bundesverband e. V. durchgefuhrt. Mittels Subgruppenanalyse der Daten im Hinblick auf die Videosprechstunde galt es nun herauszufinden, welche Anforderungen und Wunsche unter den Patienten/innen und Arzte/innen an die Videosprechstunde gestellt wurden. Die prospektive Umfrage wurde uber die sozialen Medien, QR-Code und E‑Mail verteilt. Es wurden deskriptive Statistiken und Regressionsanalysen in Bezug auf die Videosprechstunde durchgefuhrt und Korrelationen aufgezeigt. Die Daten zeigen eine positive Einstellung zur Videosprechstunde sowohl aufseiten der Patienten/innen (n = 299) als auch der Rheumatologen/innen (n = 129) auf. Eine Korrelation zwischen Alter und positiver Meinung zur Videosprechstunde zeigte sich unter den Patienten/innen (r = 0,161, p = 0,006), insbesondere bei den weiblichen Patienten fand sich mit zunehmendem Alter ein positiver Zuspruch fur die Videosprechstunde (r = 0,244, p

Im Mai 2018 wurde die Novellierung der (Muster‑)Weiterbildungsordnung (MWBO) fur die Facharztweiterbildung auf dem Deutschem Arztetag beschlossen, und somit stehen nun auch Anderungen fur die Rheumatologie an. Ziel dieser Arbeit war es, einen Uberblick uber die aktuelle Situation der arztlichen Weiterbildung im Fachgebiet der Rheumatologie zu gewinnen. Hierfur erfolgten sowohl eine quantitative als auch qualitative Analyse der rheumatologischen Facharztweiterbildung. Mittels schriftlicher Abfrage der Landesarztekammern wurde die Zahl der neu ausgebildeten Facharzte fur Rheumatologie in den Jahren 2015 bis 2017 ermittelt. Weiterhin wurde eine onlinebasierte Assistenzarztumfrage mit einem Fragebogen aus 22 Fragen erstellt und diese an 139 Chefarzte sowie Praxisinhaber deutschlandweit verschickt mit der Bitte, diese an ihre jeweiligen Assistenzarzte bzw. Facharzte zu verteilen. Zusatzlich wurde durch den Gebrauch der sozialen Medien sowie der Homepage und des E‑Mail-Verteilers von Rheumadocs e. V. eine breite Zielgruppe erreicht. Es beteiligten sich insgesamt 71 Arzte an der bundesweiten Umfrage. Laut Landesarztekammern absolvierten 53 Facharzte im Jahr 2015 und je 43 Facharzte fur 2016 und 2017 die Facharztprufung. In der Online-Umfrage der Assistenzarzte zeigte sich, dass die Befragten ihre Weiterbildung im Mittel mit der Note 3,1 (SD ± 1,1) beurteilten; 19,4 % der Teilnehmer gaben an, ein regelmasiges Mentoring zu erhalten, und bei 41,7 % der Arzte fanden Evaluationen am Arbeitsplatz statt. Defizite zeigten sich auch im Rahmen der praktischen Diagnostikfahigkeiten: 22,8 % der Befragten praktizierten laut Umfrage keine Gelenksonographie, und weitere 20 % fuhrten diese maximal 1‑mal monatlich durch. Nur 43,6 % der Befragten berichteten, dass sie mehr als 10 Gelenkpunktionen unter Anleitung durchgefuhrt hatten. Als offene Kritikpunkte* wurden von 46,6 % eine fehlende Struktur in der Weiterbildung genannt und 33,3 % bemangelten eine fehlende Supervision am Ausbildungsplatz. Positiv bewertet* wurden u. a. von 46,8 % die Vielfaltigkeit des Faches sowie von 17 % die Moglichkeit zum selbststandigen Arbeiten in der Rheumatologie. Die Mehrzahl der Befragten wunschte sich mehr Weiterbildungsoptionen, vermehrte Supervision sowie eine bessere praktische Ausbildung in der Ultraschalldiagnostik. Schlussfolgerung Die bundesweite Zahl der neu erworbenen Facharztqualifikation in der Rheumatologie zwischen den Jahren 2015 bis 2017 zeigt einen gleichbleibenden bis rucklaufigen Trend. Es ist zu befurchten, dass die Zahlen in den nachsten Jahren weiter stagnieren werden, weshalb es umso wichtiger ist, in die Qualitat der Weiterbildung zu investieren. Die Assistenzarztumfrage zeigte weiterhin, dass die aktuelle Weiterbildung in der Rheumatologie Defizite aufweist. Ein Leitfaden zur Verbesserung der Ausbildungsqualitat konnte die neue MWBO in der Rheumatologie sein, die Wege fur eine bessere und strukturierte Ausbildung schaffen soll. Dieses Curriculum sollte im Arbeits- bzw. Ausbildungsalltag fest im Sinne eines Teach-to-Target verwurzelt sein.

ObjectiveTo analyse the impact of the COVID-19 pandemic on rheumatic patients’ and rheumatologists’ usage, preferences and perception of digital health applications (DHAs).MethodsA web-based national survey was developed by the Working Group Young Rheumatology of the German Society for Rheumatology and the German League against Rheumatism. The prospective survey was distributed via social media (Twitter, Instagram and Facebook), QR code and email. Descriptive statistics were calculated, and regression analyses were performed to show correlations.ResultsWe analysed the responses of 299 patients and 129 rheumatologists. Most patients (74%) and rheumatologists (76%) believed that DHAs are useful in the management of rheumatic and musculoskeletal diseases (RMDs) and felt confident in their own usage thereof (90%; 86%). 38% of patients and 71% of rheumatologists reported that their attitude had changed positively towards DHAs and that their usage had increased due to COVID-19 (29%; 48%). The majority in both groups agreed on implementing virtual visits for follow-up appointments in stable disease conditions. The most reported advantages of DHAs were usage independent of time and place (76.6%; 77.5%). The main barriers were a lack of information on suitable, available DHAs (58.5%; 41.9%), poor usability (42.1% of patients) and a lack of evidence supporting the effectiveness of DHAs (23.2% of rheumatologists). Only a minority (ConclusionThe COVID-19 pandemic instigated an increase in patients’ and rheumatologists’ acceptance and usage of DHAs, possibly introducing a permanent paradigm shift in the management of RMDs.

Objectives: The prevalence of elbow joint arthritis in rheumatoid arthritis (RA) assessed by ultrasound has not yet been investigated. Methods: We investigated 102 patients with RA and 50 patients without rheumatological disease. Both elbow joints were examined by ultrasound for effusion, hypervascularization, and enthesitis. A clinical examination was performed, and Disease Activity Score in 28 joints (DAS28), and visual analog scale for pain (VASp) were recorded. Arthritis was defined as joint effusion (&ge, grade II) and synovial hyperperfusion. Results: The RA cohort versus the control group displayed a joint effusion in 54.9% vs. 6.9%, a hypervascularization in 6.8% vs. 0%. Arthritis was detected in 36 RA patients (35.29%) and no one in the control group. Four (3.8%) RA patients and one (1%) control displayed enthesitis. The RA cohort showed a significant correlation between movement restriction and joint effusion (p-value = 0.001) as well as DAS28 (p-value = 0.02) and between DAS28 and ultrasound detected arthritis (p-value = 0.022). In an overall analysis, a highly significant correlation of VASp with movement restriction (MR) (p-value &le, 0.001), the presence of joint effusion (p-value &le, 0.001), and the diagnosis of RA (p-value &le, 0.001) were observed. Interrater analysis of ultrasound imaging showed good agreement with Cohen&rsquo, s kappa of 0.896. Conclusion: The prevalence of elbow arthritis in RA seems to be high, with 35.29%. Movement restriction is a good indicator, but not in all RA patients (32 vs. 70 patients without MR) compared to the control group (5 vs. 45 patients without MR). Reported pain correlates with joint effusion and MR (p-value &le, 0.001).

Background:Digital health applications (DHAs) are gaining influence and promise great potential for the monitoring and management of rheumatic and musculoskeletal diseases (RMDs).Objectives:To analyse the impact of the COVID-19 pandemic on RMD patients’ and rheumatologists’ usage, preferences, and perception of digital health applications (DHAs) in Germany.Methods:A web-based national survey was developed by the Working Group Young Rheumatology of the German Society for Rheumatology and the German League against Rheumatism. The prospective survey was distributed via social media, QR-code, and email. Descriptive statistics were calculated, and regression analyses were performed to show correlations.Results:We analysed the responses of 299 patients and 129 rheumatologists. Most patients (74%) and rheumatologists (76%) believed that DHAs are useful in the management of RMDs and felt confident in their own usage thereof (90%; 86%). 38% of patients and 71% of rheumatologists reported that their attitude had changed positively towards DHAs and that their usage had increased due to COVID-19 (29%; 48%).Usage and recommendation of DHAs for both groups are shown in Figure 1:Figure 1.Usage or recommendation of digital health applications. Patients and rheumatologists were asked to indicate the specific digital health applications (DHAs) they used or were recommended.The majority in both groups agreed on implementing virtual visits for follow-up appointments in stable disease conditions. The most reported advantages of DHAs were usage independent of time and place (76.6%; 77.5%). The main barriers were a lack of information on suitable, available DHAs (58.5%; 41.9%), poor usability (42.1% of patients) and a lack of evidence supporting the effectiveness of DHAs (23.2% of rheumatologists) (Table 1).Table 1.Advantages and Barriers of DHA, n (%).AdvantagesBarriersPatientsRheumatologistsPatientsRheumatologistsLocation-Independence229 (76.6)100 (77.5)Too little information175 (58.5)54 (41.9)Time-independence223 (74.6)94 (72.9)Too little evidence of benefits36 (12.0)30 (23.3)Detailed documentation97 (32.4)47 (36.4)Poor quality of current apps47 (15.7)29 (22.5)Cost saving95 (31.8)37 (28.7)Concernsabout data protection52 (17.4)25 (19.4)More information88 (29.4)38 (29.5)Lack of usability126 (42.1)17 (13.2)Independenceof doctors+36 (12.0)-Lack of accessibility4 (1.3)-More flexibility107 (36.8)77 (59.7)High costs4 (1.3)23 (17.8)Preparationfor discussion+46 (15.4)-No suitable equipment17 (5.7)11 (8.5)No advantages at all18 (6.0)1 (0.8)Lack of user competenceNo Need9 (3.0)39 (13.0)-12 (9.3)Patients and rheumatologists were asked about the advantages and barriers of DHAs. Multiple answers were allowed. Patients had two additional potential advantages and potential barriers to choose from*.Only a minority (Conclusion:The COVID-19 pandemic instigated an increase in patients’ and rheumatologists’ acceptance and usage of DHAs, possibly introducing a permanent paradigm shift in the management of RMDs.Acknowledgements:The authors thank the following persons and societies for their great effort, distributing the online survey: P.Aries, A.Hueber, E.Feist, C.Fiehn, P.Korsten, I.Kötter, F.Mühlensiepen, A.Pfeil, M.Rudwaleit, M.Welcker, S.Zinke, Deutsche Vereinigung Morbus Bechterew e.V., Deutsche Rheuma-Liga Bundesverband e. V., Sklerodermie Selbsthilfe e.V.Disclosure of Interests:Anna Kernder: None declared, Harriet Morf: None declared, Philipp Klemm: None declared, Diana Vossen Speakers bureau: Novartis, Abbvie, Amgen, Consultant of: Abbvie Deutschland GmbH & Co. KG, Bristol-Myer Squibb, Celgene GmbH, Gilead Sciences Inc., Lilly Deutschland GmbH, Medac GmbH, Novartis Pharma GmbH, Pfizer Deutschland GmbH, UCB Pharma GmbH, Grant/research support from: Pfizer, Abbvie, Marco Meyer Consultant of: Medac, Isabell Haase Speakers bureau: Medac, Consultant of: Medac, Grant/research support from: UCB, Abbvie, BMS, Johanna Mucke Speakers bureau: AbbVie Deutschland GmbH & Co. KG, Amgen, Bristol-Myers Squibb, Chugai Pharma Germany GmbH, Celgene GmbH, Gilead Sciences Inc., GlaxoSmithKline, Janssen-Cilag GmbH, Lilly Deutschland GmbH, Novartis Pharma GmbH, Pfizer Deutschland GmbH and UCB Pharma GmbH., Consultant of: AbbVie Deutschland GmbH & Co. KG, Amgen, Bristol-Myers Squibb, Chugai Pharma Germany GmbH, Celgene GmbH, Gilead Sciences Inc., GlaxoSmithKline, Janssen-Cilag GmbH, Lilly Deutschland GmbH, Novartis Pharma GmbH, Pfizer Deutschland GmbH and UCB Pharma GmbH., Arnd Kleyer Shareholder of: yes, Speakers bureau: Lilly, Novartis, Consultant of: Abbvie, Lilly, Novartis BMS, Gilead,Janssen, Grant/research support from: Lilly, Novartis, Gilead,, Philipp Sewerin Consultant of: AbbVie, Amgen, Axiom Health, Biogen, Bristol-Myers Squibb, Celgene, Chugai Pharma Marketing Ltd./Chugai Europe, Deutscher Psoriasis-Bund, Fresenius Kabi, Gilead Sciences, Hexal Pharma, Janssen-Cilag, Johnson & Johnson, Lilly, Medi-login, Mediri GmbH, Novartis Pharma, Onkowissen GmbH, Pfizer, Roche Pharma, Rheumazentrum Rhein-Ruhr, Sanofi-Genzyme, Swedish Orphan Biovitrum, and UCB, Grant/research support from: AbbVie, Amgen, Biogen, Bristol-Myers Squibb, Bundesministerium fuer Bildung und Forschung (BMBF), Deutsche Forschungsgesellschaft (DFG), Deutscher Psoriasis-Bund, Fresenius Kabi, Gilead Sciences, Hexal Pharma, Janssen-Cilag, Lilly, Novartis Pharma, Pfizer, Rheumazentrum Rhein-Ruhr, Roche Pharma, Sanofi-Genzyme, and UCB, Gerlinde Bendzuck: None declared, Sabine Eis: None declared, Johannes Knitza Consultant of: Abbvie, Novartis, Lilly, Medac, BMS, Sanofi, Amgen, Gilead, UCB, ABATON, GSK, Grant/research support from: Novartis, UCB, Thermofisher, Sanofi, Martin Krusche Speakers bureau: Lilly, Medac, Novartis, Roche/Chugai, Consultant of: Abbvie, Lilly, Gilead, Medac, Novartis, Sobi, BMS, Amgen, GSK, Grant/research support from: Sanofi

Background The use of patient-reported outcomes (PROs) allows for patient-centered, measurable, and transparent care. Electronic PROs (ePROs) have many benefits and hold great potential to improve current usage of PROs, yet limited evidence exists regarding their acceptance, usage, and barriers among rheumatologists. Objective This study aims to evaluate the current level of acceptance, usage, and barriers among German rheumatologists regarding the use of ePROs. The importance of different ePRO features for rheumatologists was investigated. Additionally, the most frequently used PROs for patients with rheumatoid arthritis (RA) were identified. Methods Data were collected via an online survey consisting of 18 questions. The survey was completed by members of the Working Group Young Rheumatology of the German Society for Rheumatology (Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie [DGRh]) at the 2019 annual DGRh conference. Only members currently working in clinical adult rheumatology were eligible to complete the survey. Results A total of 119 rheumatologists completed the survey, of which 107 (89.9%) reported collecting PROs in routine practice and 28 (25.5%) already used ePROs. Additionally, 44% (43/97) were planning to switch to ePROs in the near future. The most commonly cited reason for not switching was the unawareness of suitable software solutions. Respondents were asked to rate the features of ePROs on a scale of 0 to 100 (0=unimportant, 100=important). The most important features were automatic score calculation and display (mean 77.50) and simple data transfer to medical reports (mean 76.90). When asked about PROs in RA, the respondents listed pain, morning stiffness, and patient global assessment as the most frequently used PROs. Conclusions The potential of ePROs is widely seen and there is great interest in them. Despite this, only a minority of physicians use ePROs, and the main reason for not implementing them was cited as the unawareness of suitable software solutions. Developers, patients, and rheumatologists should work closely together to help realize the full potential of ePROs and ensure a seamless integration into clinical practice.

Background:The use of patient-reported outcomes (PROs) allows for patient-centered, measurable and transparent care. Electronic PROs (ePROs) have many benefits and hold great potential to improve current usage of PROs; yet, limited evidence exists regarding acceptance, usage and barriers among rheumatologists.Objectives:This study aimed to evaluate the current level of acceptance, usage, and barriers among German rheumatologists regarding the utilization of ePROs. The importance of different ePRO features for rheumatologists was investigated. Additionally, the most frequently used PROs for patients with rheumatoid arthritis (RA) were identifiedMethods:Data was collected via an online survey consisting of 18 questions. The survey was completed by members of the Working Group Young Rheumatologists of the German Society for Rheumatology (Deutsche Gesellschaft für Rheumatologie (DGRh)) at the annual 2019 DGRh conference. Only members currently working in clinical rheumatology were eligible to complete the survey.Results:A total of 119 rheumatologists completed the survey. 90% reported collecting PROs in routine practice and 25.5% already used ePROs. 44.3% were planning to switch to ePROs in the near future.The main reason for collecting PROs was for clinical decision making (66.4%), followed by research (39.5%), reimbursement (23.5%), internal quality management (21.9%) and patient satisfaction (16.8%). The most commonly cited reason for not switching to ePROs was the unawareness of suitable software solutions (figure 1).Respondents were asked to rate the features for ePROs on a scale of 0-100 (0 = unimportant, 100 = important). The most important features were automatic score calculation and display (score: 77.5), as well as the simple data transfer to medical reports (76.9) (table 1).When asked about PROs in RA, the respondents listed pain, morning stiffness and physician global assessment (PGA) as the most frequently used PROs (figure 2).Table 1.Ratings for features of ePRO on a scale of 0-100 (0 = unimportant, 100 = important))QuestionmeanSDHow important would the graphic display be to you for ePROs?63.531.19How important would the automatic score calculation and display of ePROs be to you?77.527.64How important would the simple transfer of the ePROs in medical report be to you?76.930.07How important would an automatic alarm of yourself be for you if a critical threshold is exceeded by an ePRO?51.6533.5How important would an automatic alarm of the patient be for you if a critical threshold is exceeded by an ePRO?34.5530.61Figure 1.Reasons why ePROs are currently not used (multiple answers were possible for question)Figure 2.PROs being used in clinical practice and their respective frequencyConclusion:The potential of ePROs is widely seen, and there is a great interest in ePROs. Despite this, a minority of physicians only uses ePROs, and the main reason for not implementing was cited as the unawareness of suitable software solutions.Developers, patients and rheumatologists should work closely together to help realize the full potential of ePROs and ensure a seamless integration into clinical practice.Disclosure of Interests:Martin Krusche Consultant of: Sanofi, Novartis and Medac, Speakers bureau: Roche/Chugai, Novartis, Sobi,, Philipp Klemm Consultant of: Lilly, Medac, Manuel Grahammer Shareholder of: MG is MD and shareholder of Abaton GmbH, Johanna Mucke: None declared, Diana Vossen Consultant of: Medac, Novartis, Abvie, Speakers bureau: Abvie, BMS, Arnd Kleyer Consultant of: Lilly, Gilead, Novartis,Abbvie, Speakers bureau: Novartis, Lilly, Philipp Sewerin Grant/research support from: AbbVie Deutschland GmbH & Co. KGBristol-Myers Squibb Celgene GmbHLilly Deutschland GmbHNovartis Pharma GmbH Pfizer Deutschland GmbHRheumazentrum Rhein-Ruhr, Consultant of: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Speakers bureau: AMGEN GmbH AbbVie Deutschland GmbH & Co. KG Biogen GmbHBristol-Myers Squibb Celgene GmbH Chugai Pharma arketing Ltd. / Chugai Europe GmbHHexal Pharma Janssen-CilagGmbH Johnson & Johnson Deutschland GmbHLilly Deutschland GmbH / Lilly Europe / Lilly Global Novartis Pharma GmbH Pfizer Deutschland GmbH Roche Pharma Rheumazentrum Rhein-Ruhr Sanofi-Genzyme Deutschland GmbH Swedish Orphan Biovitrum GmbH UCB Pharma GmbH, Johannes Knitza Grant/research support from: Research Grant: Novartis

Background: The anti-cardiolipin and β2-glycoprotein I antibodies represent the important diagnostic parameters in routine autoimmune screening and represent the important diagnostic criteria for systemic lupus erythematosus (SLE). In this study, five different automated, semiautomated, and manual immunoassays detecting IgG/IgM anti-cardiolipin and anti-β2-glycoprotein I antibodies were tested. Methods: A total of 43 samples from the patients with SLE diagnosed in the rheumatology outpatient centers in Germany were included in this study. Results: For anticardiolipin and anti-β2-glycoprotein I, considerable differences in the percentage of the positive results were found between all the five methods, and the itemization of all the positive test results reached only a poor accordance. These findings were confirmed by Cohen’s κ coefficients. Conclusions: We found a moderate to poor accordance between the five different modern test systems for anticardiolipin and anti-β2-glycoprotein I antibodies. Such discrepancies can result in the clinical misinterpretation of data and may lead to wrong diagnoses. Therefore, further standardization of the tests for the antiphospholipid antibodies (APAs) is required.