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  • Prognosis  (2)
  • Early Arthritis  (1)
  • Follow-Up Study  (1)
  • Funktionsfragebogen Hannover  (1)
  • 1
    ISSN: 1437-160X
    Keywords: Possible ankylosing spondylitis ; HLA-B27 ; peripheral arthritis ; Prognosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among 86 patients selected as possibly having ankylosing spondylitis because of clinical symptoms and radiologically normal sacroiliac joints, HLA-B27 was positive in 41%. Four years later a representative sample of 38 individuals were re-examined and radiographed. HLA-B27 positive patients developed sacroiliitis as defined by radiological criteria twice as often (P〈0.05). They also showed increased uptake of technetium 99 m upon quantitative scintigraphy with a region of interest method and more often probable or definite ankylosing spondylitis as defined by the New York criteria. Further differences between the HLA-B27 positive and negative follow-up groups concerned the frequency of clinical symptoms and peripheral arthritis. It is suggested that HLA-B27 typing may be helpful both in diagnosis and in judging the prognosis of possible or abortive ankylosing spondylitis.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 0340-1855
    Keywords: Schlüsselwörter Chronische Polyarthritis ; Health Assessment Questionnaire Disability Index ; deutsche Version ; Funktionsfragebogen Hannover ; Key words Rheumatoid arthritis ; Health Assessment Questionnaire Disability Index ; German version ; Hannover Functional Ability Questionnaire
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Zielsetzung: Ziel der Studie war die Übersetzung und die Validierung einer deutschen Version des Health Assessment Questionnaire Disability Index (HAQ) und der Vergleich seiner psychometrischen Eigenschaften mit der Version-P und der Version-PR des Funktionsfragebogens Hannover. Methoden: Nach der Übersetzung wurde die Test-Retest-Reliabilität bei 32 ambulanten Patienten der Abteilung Rheumatologie der Medizinischen Hochschule Hannover mit Hilfe der Pearson-Korrelation überprüft. Eine Woche nach der ersten Beantwortung wurde den Patienten der Fragebogen erneut zugesandt. Zur Validierung wurden 110 stationären Patienten in 3 verschiedenen Kliniken vorgelegt. Alle Patienten erfüllten die Kriterien des American College of Rheumatology von 1987 oder die Rom-Kriterien der inaktiven chronischen Polyarthritis (cP). Zur Beurteilung der Kriteriumsvalidität zogen wir den Keitel-Funktionstest (KFT) und die modifizierte Steinbrocker-Klassifikation (mSK) der funktionellen Behinderung heran. Die interne Konsistenz wurde mit Hilfe des Cronbach Koeffizienten Alpha (CKA) bestimmt. Zur Erfassung der Konstruktvalidität wurden die HAQ- und FFbH-Scores mit verschiedenen klinischen und laborchemischen Variablen verglichen und zur Aufklärung der Varianz multiple Regressionen berechnet. Ergebnisse: Die Test-Retest-Reliabilität des HAQ betrug r=0,94. Es zeigte sich ein CKA von 0,91 (HAQ), 0,90 (FFbH-P) und 0,93 (FFbH-PR). Im Vergleich zum KFT ergab sich ein Korrelationskoeffizient von r=–0,73 (HAQ), r=+0,74 (FFbH-P) und r=+0,71 (FFbH-PR) im Vergleich zur mSK ein r=+0,75 (HAQ), r=–0,72 (FFbH-P) und r= –0,70 (FFbH-PR). Der Korrelationskoeffizient des HAQ/FFbH-P betrug r=–0,87 bzw. r=–0,88 beim HAQ/FFbH-PR. Die Korrelationen zwischen den klinischen und laborchemischen Parametern reichten von r=±0,58 (Schmerz/HAQ) bis r=±0,11 (Anzahl der geschwollenen Gelenke/FFbH-PR). In multiplen, rückwärtsgerichteten Regressionsanalysen fanden sich r2-Werte von 0,64 (HAQ), 0,61 (FFbH-P) und 0,59 (FFbH-PR). Der Schmerz erklärte etwa 1/3 und die Bewegungseinschränkung 16–21% der Varianz. Schlußfolgerung: Die hier vorgestellte deutsche Version des HAQ und die zwei verschiedenen Versionen des FFbH erwiesen sich als reliable und valide Instrumente zur Messung der funktionellen Behinderung in einem deutschsprachigen Patientenkollektiv mit cP. Das mit dem HAQ und den beiden Versionen des FFbH gemessene Konstrukt zeigte eine hohe Übereinstimmung.
    Notes: Summary Objective: To translate the Health Assessment Questionnaire Disability Index (HAQ) into a German version, to validate and to compare its properties with two different versions of the Hannover Functional Ability Questionnaire (HFAQ) in a German speaking population. Methods: The test-retest reliability was tested by Pearson correlation in 32 outpatients of the Department of Rheumatology of the Medizinische Hochschule Hannover. For retesting, the questionnaire was mailed to them 1 week later. To validate the questionnaire it was administered to 110 inpatients in three different hospitals. All patients fulfilled the American College of Rheumatology 1987 revised criteria of rheumatoid arthritis (RA) or the Rome criteria of definitive inactive RA. The internal consistency was measured by Cronbach‘s coefficient alpha (CCA). To assess criterion validity we compared the HAQ and the two versions of the HFAQ with Keitel‘s test (KT) and the modified Steinbrocker classification (mSC). Construct validity was assessed by comparing these instruments with different clinical and laboratory variables. A multivariate analysis was used to identify the most important factors that are influencing the HAQ- and HFAQ-scores. Results: Test-retest reliability of the HAQ was r=0.94. CCA was 0.91 (HAQ), 0.90 (HFAQ-P) and 0.93 (HFAQ-PR). The KT Pearson correlation coefficients reached r=–0.73 (HAQ), r=+0.74 (HFAQ-P) and r=+0.71 (HFAQ-PR). The mSC correlated r=+0.75 (HAQ), r=–0.72 (HFAQ-P) and r=–0.70 (HFAQ-PR). The correlation coefficients of HAQ/HFAQ-P was r=–0.87 and of HAQ/HFAQ-PR r=–0.88. The correlations between other clinical and laboratory variables reached from r=±0,58 (pain/HAQ) to r=±0,11 (number of swollen joints/HFAQ-PR). In backward multiple regression analysis 59–64% of the variance of disability measured by the questionnaires was explained predominantly by pain (32–33%) and by range of motion (16–21%). Conclusion: The German version of the HAQ presented here and the two versions of the HFAQ are reliable and valid instruments for measuring functional disability in a German-speaking population with RA. The construct measured by the HAQ and both versions of the HFAQ showed a high degree of correspondence.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1434-9949
    Keywords: Follow-Up Study ; Possible Ankylosing Spondylitis ; Sacroiliitis ; Prognosis ; HLA B27 ; Early Diagnostic Criteria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Of 88 selected patients with possible ankylosing spondylitis (AS) 54 (61%) participated in two phases of a 10 years' follow-up study. Thirty-two (59%) developed definite AS according to the New York criteria, 10 (19%) had possible/undifferentiated seronegative spondylarthropathy (SSA) and 12 patients had other diagnoses. Only 3 (9%) of 35 patients with sacroiliitis did not fulfill the New York criteria for definite AS until the last examination. Sacroiliitis and radiological spinal signs of AS appeared rather late above a mean age of 40 years and after a mean disease duration of more than 10 years. After 18 years mean disease duration 25 (78%) of 32 AS patients had good or sufficient functional capacity indicating an overall good functional prognosis. HLA B27 typing proved to be useful in patients with possible early AS: 29 (71%) of 41 B27 positive and 3 (23%) of 13 B27 negative patients developed definite AS (p〈0.005). A combination of the B27 test with data of the history, clinical, laboratory, and radiological examination proposed as early diagnostic criteria detected patients with the outcome diagnosis of definite AS with even higher significance (p〈0.001). These criteria were also useful in the identification of patients with possible or undifferentiated SSA. The recently recognized entity of undifferentiated SSA should only be diagnosed after long term follow-up.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1434-9949
    Keywords: Early Arthritis ; Undifferentiated Arthritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Diagnosis of arthritis with recent onset is still an unresolved problem. In 1984 we started an outpatient clinic for patients with early arthritis of less than one year duration. Of a total of 226 patients seen 149 (66%) had definite (n=76; 34%) or probable (n=73; 32%) inflammatory rheumatic disease, and 77 (34%) had degenerative or extraarticular rheumatic disease. Thirtynine patients were classified as undifferentiated arthritis. This undefined arthritis was often monoarticular (12%) and oligoarticuler (44%). One patient met 5 ARA-criteria for rheumatoid arthritis, 14 (36%) met 3–4 ARA-criteria and 25 (64%) only 1–2 ARA-criteria. ESR was elevated in only 23 (59%) patients, rheumatoid factor was positive in 7 (19%) patients and HLA-B27 was positive in 9 (23%) patients. Seventeen (44%) patients had a history of recent infections preceding the beginning of joint symptoms. Thus undifferentiated arthritis represents a heterogeneous group of diseases. Despite diagnostic progresses in recent years a high proportion of early arthritis cannot be diagnosed definitely.
    Type of Medium: Electronic Resource
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