Published in 2015

The MacNew Heart Disease Health-Related Quality of Life Questionnaire: A Scandinavian Validation Study

Alphin, S., Höfer, S., Perk, J., Slørdahl, S., Zwisler, A-D. O. & Oldridge, N., 2015, I: Social indicators research. 122, 2, s. 519-537 19 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Although associated with excess mortality and morbidity, obesity is associated with lower mortality after stroke. The association between obesity and risk of recurrent stroke is unclear.

AIMS: The study aims to investigate the association in stroke patients between body mass index and risk of death and readmission for recurrent stroke.

METHODS: An administrative Danish quality-control registry designed to collect a predefined dataset on all hospitalized stroke patients in Denmark 2000–2010 includes 45 615 acute first-ever stroke patients with information on body mass index in 29 326. Data include age, gender, civil status, stroke severity, computed tomography, and cardiovascular risk factors. Patients were followed up to 9·8 years (median 2·6 years). We used Cox regression models to compare risk of death and readmission for recurrent stroke in the four body mass index groups: underweight (body mass index < 18·5), normal weight (body mass index 18·5–24·9), overweight (body mass index 25·0–29·9), obese (body mass index ≥ 30·0).

RESULTS: Mean age 72·3 years, 48% women. Mean body mass index 23·0. Within follow-up, 7902 (26·9%) patients had died; 2437 (8·3%) were readmitted because of recurrent stroke. Mortality was significantly lower in overweight (hazard ratio 0·72; confidence interval 0·68–0·78) and obese (hazard ratio 0·80; confidence interval 0·73–0·88) patients while significantly higher in underweight patients (hazard ratio 1·66; confidence interval 1·49–1·84) compared with normal weight patients. Risk of readmission for recurrent stroke was significantly lower in obese than in normal weight patients (hazard ratio 0·84; confidence interval 0·72–0·92).

CONCLUSIONS: Obesity was not only associated with reduced mortality relative to normal weight patients. Compared with normal weight, risk of readmission for recurrent stroke was also lower in obese stroke patients.

Originalsprog Engelsk
Tidsskrift International journal of stroke : official journal of the International Stroke Society
Vol/bind 10
Udgave nummer 1
Sider (fra-til) 99-104
Antal sider 6
ISSN 1747-4930
Status Udgivet - jan. 2015

The prevalence of clinically diagnosed ankylosing spondylitis and its clinical manifestations: a nationwide register study

Exarchou, S., Lindström, U., Askling, J., Eriksson, J. K., Forsblad-d'Elia, H., Neovius, M., Turesson, C., Kristensen, L. E. & Jacobsson, L. T. H., 2015, I: Arthritis Research & Therapy. 17, 1, s. 118

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

INTRODUCTION: Prevalence estimates of ankylosing spondylitis vary considerably, and there are few nationwide estimates. The present study aimed to describe the national prevalence of clinically diagnosed ankylosing spondylitis in Sweden, stratified according to age, sex, geographical, and socio-economic factors, and according to subgroups with ankylosing spondylitis-related clinical manifestations and pharmacological treatment.

METHODS: All individuals diagnosed with ankylosing spondylitis according to the World Health Organization International Classification of Disease codes, between 1967 and 2009, were identified from the National Patient Register. Data regarding disease manifestations, patient demographics, level of education, pharmacological treatment, and geographical region were retrieved from the National Patient Register and other national registers.

RESULTS: A total of 11,030 cases with an ankylosing spondylitis diagnosis (alive, living in Sweden, and 16 to 64 years old in December 2009) were identified in the National Patient Register, giving a point prevalence of 0.18% in 2009. The prevalence was higher in northern Sweden, and lower in those with a higher level of education. Men had a higher prevalence of ankylosing spondylitis (0.23% versus 0.14%, P < 0.001), a higher frequency of anterior uveitis (25.5% versus 20.0%, P < 0.001) and were more likely to receive tumor necrosis factor inhibitors than women (15.6% versus 11.8% in 2009, P < 0.001). Women were more likely than men to have peripheral arthritis (21.7% versus 15.3%, P < 0.001), psoriasis (8.0% versus 6.9%, P = 0.03), and treatment with oral corticosteroids (14.0% versus 10.4% in 2009, P < 0.001).

CONCLUSION: This nationwide, register-based study demonstrated a prevalence of clinically diagnosed ankylosing spondylitis of 0.18%. It revealed phenotypical and treatment differences between the sexes, as well as geographical and socio-economic differences in disease prevalence.

Originalsprog Engelsk
Tidsskrift Arthritis Research & Therapy
Vol/bind 17
Udgave nummer 1
Sider (fra-til) 118
ISSN 1478-6354
DOI
Status Udgivet - 2015

The Pseudomonas aeruginosa Transcriptional Landscape Is Shaped by Environmental Heterogeneity and Genetic Variation

Dötsch, A., Schniederjans, M., Khaledi, A., Hornischer, K., Schulz, S., Bielecka, A., Eckweiler, D., Pohl, S. & Häussler, S., 30 jun. 2015, I: mBio. 6, 4, s. e00749

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

The specificity of ultrasound-detected bone erosions for rheumatoid arthritis

Zayat, A. S., Ellegaard, K., Conaghan, P. G., Terslev, L., Hensor, E. M. A., Freeston, J. E., Emery, P. & Wakefield, R. J., 2015, I: Annals of the Rheumatic Diseases. 74, 5, s. 897-903

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Bone erosion is one of the hallmarks of rheumatoid arthritis (RA), but also seen in other rheumatic diseases. The objective of this study was to determine the specificity of ultrasound (US)-detected bone erosions (including their size) in the classical 'target' joints for RA.
Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 74
Udgave nummer 5
Sider (fra-til) 897-903
ISSN 0003-4967
DOI
Status Udgivet - 2015
Originalsprog Engelsk
Udgivelsessted København
Forlag Faculty of Health Sciences, University of Copenhagen
Vol/bind 1
Udgave 1
Status Udgivet - 2015

Toward Ensuring Health Equity: Readability and Cultural Equivalence of OMERACT Patient-reported Outcome Measures

Petkovic, J., Epstein, J., Buchbinder, R., Welch, V., Rader, T., Lyddiatt, A., Clerehan, R., Christensen, R., Boonen, A., Goel, N., Maxwell, L. J., Toupin-April, K., De Wit, M., Barton, J., Flurey, C., Jull, J., Barnabe, C., Sreih, A. G., Campbell, W., Pohl, C., & 4 flereDuruöz, M. T., Singh, J. A., Tugwell, P. S. & Guillemin, F., dec. 2015, I: Journal of Rheumatology. 42, 12, s. 2448-59 12 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures.

METHODS: The English, Dutch, French, and Turkish Health Assessment Questionnaires and English and French Osteoarthritis Knee and Hip Quality of Life questionnaires were evaluated by applying 3 readability formulas: Flesch Reading Ease, Flesch-Kincaid grade level, and Simple Measure of Gobbledygook; and a new tool, the Evaluative Linguistic Framework for Questionnaires, developed to assess text quality of questionnaires. We also considered a study assessing cross-cultural adaptation with/without back-translation and/or expert committee. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM.

RESULTS: Thirty-one OMERACT delegates attended the equity session. Twenty-six participants agreed that PROM should be assessed for comprehensibility and for use of suitable methods (4 abstained, 1 no). Twenty-two participants agreed that cultural equivalency of PROM should be assessed and suitable methods used (7 abstained, 2 no). Special interest group participants identified challenges with cross-cultural adaptation including resources required, and suggested patient involvement for improving translation and adaptation.

CONCLUSION: Future work will include consensus exercises on what methods are required to ensure PROM are appropriate for people with low literacy and different cultures.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 42
Udgave nummer 12
Sider (fra-til) 2448-59
Antal sider 12
ISSN 0315-162X
DOI
Status Udgivet - dec. 2015

Tumor Cell Adhesion As a Risk Factor for Sentinel Lymph Node Metastasis in Primary Cutaneous Melanoma

Meves, A., Nikolova, E., Heim, J. B., Squirewell, E. J., Cappel, M. A., Pittelkow, M. R., Otley, C. C., Behrendt, N., Saunte, D. M., Lock-Andersen, J., Schenck, L. A., Weaver, A. L. & Suman, V. J., 10 aug. 2015, I: Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 33, 23, s. 2509-15 7 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Ultrasound as an Outcome Measure in Gout. A Validation Process by the OMERACT Ultrasound Working Group

Terslev, L., Gutierrez, M., Schmidt, W. A., Keen, H. I., Filippucci, E., Kane, D., Thiele, R., Kaeley, G., Balint, P., Mandl, P., Delle Sedie, A., Hammer, H. B., Christensen, R., Möller, I., Pineda, C., Kissin, E., Bruyn, G. A., Iagnocco, A., Naredo, E., D'Agostino, M. A., & 1 flereOMERACT Ultrasound Working Group, nov. 2015, I: Journal of Rheumatology. 42, 11, s. 2177-81 5 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: To summarize the work performed by the Outcome Measures in Rheumatology (OMERACT) Ultrasound (US) Working Group on the validation of US as a potential outcome measure in gout.

METHODS: Based on the lack of definitions, highlighted in a recent literature review on US as an outcome tool in gout, a series of iterative exercises were carried out to obtain consensus-based definitions on US elementary components in gout using a Delphi exercise and subsequently testing these definitions in static images and in patients with proven gout. Cohen's κ was used to test agreement, and values of 0-0.20 were considered poor, 0.20-0.40 fair, 0.40-0.60 moderate, 0.60-0.80 good, and 0.80-1 excellent.

RESULTS: With an agreement of > 80%, consensus-based definitions were obtained for the 4 elementary lesions highlighted in the literature review: tophi, aggregates, erosions, and double contour (DC). In static images interobserver reliability ranged from moderate to almost perfect, and similar results were found for the intrareader reliability. In patients the intraobserver agreement was good for all lesions except DC (moderate). The interobserver agreement was poor for aggregates and DC but moderate for the other components.

CONCLUSION: These first steps in evaluating the validity of US as an outcome measure for gout show that the reliability of the definitions ranged from moderate to excellent in static images and somewhat lower in patients, indicating that a standardized scanning technique may be needed, before testing the responsiveness of those definitions in a composite US score.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 42
Udgave nummer 11
Sider (fra-til) 2177-81
Antal sider 5
ISSN 0315-162X
DOI
Status Udgivet - nov. 2015

Objective. To validate the agreement between the 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) and the 28-joint disease activity score based on C-reactive protein (DAS28-CRP) in a group of Danish patients with rheumatoid arthritis (RA). Methods. Data from 109 Danish RA patients initiating biologic treatment were analysed at baseline and following one year of treatment. Participants were retrospectively enrolled from a previous cohort study and were considered eligible for this project if CRP and ESR were measured at baseline and at the follow-up visit. To assess the extent of agreement between the two DAS28 definitions, the "European League Against Rheumatism" (EULAR) response criteria based on each definition were calculated with cross-classification. Weighted Kappa (κ) coefficients were calculated, and Bland-Altman plots were used to illustrate degree of agreement between DAS28 definitions. Results. The 75 eligible patients were classified as EULAR good, moderate, and nonresponders with good agreement (61/75; 81%) between DAS28-CRP and DAS28-ESR (κ = 0.75 (95% CI: 0.63 to 0.88)). Conclusions. According to our findings, DAS28-CRP and DAS28-ESR are interchangeable when assessing RA patients and the two versions of DAS28 are comparable between studies.

Originalsprog Engelsk
Tidsskrift Arthritis
Vol/bind 2015
Sider (fra-til) 401690
ISSN 2090-1984
DOI
Status Udgivet - 2015

Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register

Lindström, U., Exarchou, S., Sigurdardottir, V., Sundström, B., Askling, J., Eriksson, J. K., Forsblad-d'Elia, H., Turesson, C., Kristensen, L. E. & Jacobsson, L., okt. 2015, I: Scandinavian Journal of Rheumatology. 44, 5, s. 369-76 8 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: Epidemiological studies of spondyloarthritis (SpA), using ICD codes from the Swedish National Patient Register (NPR), offer unique possibilities but hinge upon an understanding of the validity of the codes. The aim of this study was to validate the ICD codes for ankylosing spondylitis (AS) and undifferentiated SpA (uSpA) in the NPR against the established classification criteria [modified New York (mNY), Assessment of SpondyloArthritis international Society (ASAS), Amor, and European Spondyloarthropathy Study Group (ESSG) criteria].

METHOD: All patients with an ICD-8/9/10 code of AS or uSpA in the NPR 1966-2009 at a visit to a specialist in rheumatology or internal medicine or corresponding hospitalization, alive and living in Sweden 2009, were identified (n = 20 089). Following a structured procedure to achieve geographical representativeness, 500 random patients with a diagnosis of AS or uSpA in 2007-2009 were selected. Based on a structured review of clinical records, positive predictive values (PPVs) for fulfilling the criteria sets were calculated.

RESULTS: For those having received an ICD code for AS, the PPVs for fulfilling the mNY criteria or any set of SpA criteria were 70% and 89%, respectively. For those with an uSpA diagnosis (and never an AS diagnosis), the corresponding PPVs were 20% and 79%. The subset with both AS and uSpA diagnoses (overlap = 12%) were as likely to fulfil the mNY criteria as the group that had been coded as AS only.

CONCLUSIONS: The diagnosis codes for AS or uSpA had high PPVs, suggesting that our case identification in the Swedish NPR can be used for nationwide, population-based, epidemiological studies of these diseases.

Originalsprog Engelsk
Tidsskrift Scandinavian Journal of Rheumatology
Vol/bind 44
Udgave nummer 5
Sider (fra-til) 369-76
Antal sider 8
ISSN 0300-9742
DOI
Status Udgivet - okt. 2015

Work Disability in Early Systemic Sclerosis: A Longitudinal Population-based Cohort Study

Sandqvist, G., Hesselstrand, R., Petersson, I. F. & Kristensen, L. E., okt. 2015, I: Journal of Rheumatology. 42, 10, s. 1794-800 7 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: To study work disability (WD) with reference to levels of sick leave and disability pension in early systemic sclerosis (SSc).

METHODS: Patients with SSc living in the southern part of Sweden with onset of their first non-Raynaud symptom between 2003 and 2009 and with a followup of 36 months were included in a longitudinal study. Thirty-two patients (26 women, 24 with limited SSc) with a median age of 47.5 years (interquartile range 43-53) were identified. WD was calculated in 30-day intervals from 12 months prior to disease onset until 36 months after, presented as the prevalence of WD per year (0-3) and as the period prevalence of mean net days per month (± SD). Comparisons were made between patients with different disease severity and sociodemographic characteristics, and between patients and a reference group (RG) from the general population.

RESULTS: Seventy-eight percent had no WD 1 year prior to disease onset, which decreased to 47% after 3 years. The relative risk for WD in patients with SSc compared with RG was 0.95 (95% CI 0.39-2.33) at diagnosis, and increased to 2.41 (1.28-4.55) after 3 years. There were no significant correlations between WD and disease severity, but between WD and years at workplace (rs = -0.72; p = 0.002), education (rs = -0.51; p = 0.004), and sickness absence the month before disease onset (rs = 0.58; p = 0.001), respectively.

CONCLUSION: Considerable increase in WD was noted 3 years after disease onset. Limited education, fewer years at workplace, and sickness absence before disease onset may be risk factors for sustained WD.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 42
Udgave nummer 10
Sider (fra-til) 1794-800
Antal sider 7
ISSN 0315-162X
DOI
Status Udgivet - okt. 2015

Published in 2014

Anti-nuclear antibodies (ANA) have traditionally been evaluated using indirect fluorescence assays (IFA) with HEp-2 cells. Quantitative immunoassays (EIA) have replaced the use of HEp-2 cells in some laboratories. Here, we evaluated ANA in 400 consecutive and unselected routinely referred patients using IFA and automated EIA techniques. The IFA results generated by two independent laboratories were compared with the EIA results from antibodies against double-stranded DNA (dsDNA), from ANA screening, and from tests of the seven included subantigens. The final IFA and EIA results for 386 unique patients were compared. The majority of the results were the same between the two methods (n = 325, 84%); however, 8% (n = 30) yielded equivocal results (equivocal-negative and equivocal-positive) and 8% (n = 31) yielded divergent results (positive-negative). The results showed fairly good agreement, with Cohen's kappa value of 0.30 (95% confidence interval (CI) = 0.14-0.46), which decreased to 0.23 (95% CI = 0.06-0.40) when the results for dsDNA were omitted. The EIA method was less reliable for assessing nuclear and speckled reactivity patterns, whereas the IFA method presented difficulties detecting dsDNA and Ro activity. The automated EIA method was performed in a similar way to the conventional IFA method using HEp-2 cells; thus, automated EIA may be used as a screening test.

Originalsprog Engelsk
Tidsskrift Autoimmune Diseases
Vol/bind 2014
Sider (fra-til) 534759
ISSN 2090-0422
DOI
Status Udgivet - 2014

A dynamic contrast enhanced MRI quantification method for objective assessment of treatment response in patients with inflammatory arthritis.

Kubassova, O. A., Boesen, M., Østergaard, M., Bliddal, H., Cimmino, M. A., Axelsen, M. B., Poggenborg, R. P., Bouert, R., Rastogi, A., Tzaribachev, N., Hinton, M. & Taylor, P. C., 2014, I: Radiographics : a review publication of the Radiological Society of North America, Inc.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Tidsskrift Radiographics : a review publication of the Radiological Society of North America, Inc
ISSN 0271-5333
Status Udgivet - 2014

A gluten-free diet lowers NKG2D and ligand expression in BALB/c and non-obese dfiabetic (NOD) mice

Adlercreutz, E. H., Weile, C. R. A., Larsen, J., Engkilde, K., Agardh, D., Buschard, K. S. & Antvorskov, J. C., 2014, I: Clinical and Experimental Immunology. 177, 2, s. 391-403 doi.10.1111/cei.12340.PMID:24673402.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Disease management programmes have been developed for chronic obstructive pulmonary disease (COPD) to facilitate the integration of care across healthcare settings. The purpose of the present study was to examine the experiences of COPD patients and their relatives of integrated care after implementation of a COPD disease management programme.

METHODS: Seven focus groups and five individual interviews were held with 34 patients with severe or very severe COPD and two focus groups were held with eight of their relatives. Data were analysed using inductive content analysis.

RESULTS: Four main categories of experiences of integrated care emerged: 1) a flexible system that provides access to appropriate healthcare and social services and furthers patient involvement; 2) the responsibility of health professionals to both take the initiative and follow up; 3) communication and providing information to patients and relatives; 4) coordination and professional cooperation. Most patients were satisfied with their care and raised few criticisms. However, patients with more unstable and severe disease tended to experience more problems.

CONCLUSIONS: Participant suggestions for optimizing the integration of healthcare included assigning patients a care coordinator, telehealth solutions for housebound patients and better information technology to support interprofessional cooperation. Further studies are needed to explore these and other possible solutions to problems with integrated care among COPD patients. A future effort in this field should be informed by detailed knowledge of the extent and relative importance of the identified problems. It should also be designed to address variable levels of severity of COPD and relevant comorbidities and to deliver care in ways appropriate to the respective healthcare setting. Future studies should also take health professionals' views into account so that interventions may be planned in the light of the experiences of all those involved in the treatment of COPD patients.

Originalsprog Engelsk
Tidsskrift B M C Health Services Research
Vol/bind 14
Sider (fra-til) 471
ISSN 1472-6963
DOI
Status Udgivet - 2014

A three-day course can increase knowledge and interest in disaster medicine for medical students

Rubin, M. A., Viggers, S. R., Ballegaard, C. & Bæk, N. H., 2014, I: Europe PMC. 31, s. 213 1 s.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Tidsskrift Europe PMC
Vol/bind 31
Sider (fra-til) 213
Antal sider 1
Status Udgivet - 2014

Achilles tendon rupture: assessment of non-operative treatment

Barfod, K. W., 2014, I: Danish Medical Bulletin (Online). 61, 4

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Pages