Maese Jesús, García De Yébenes María Jesús, Carmona Loreto, Hernández-García Cesar
Grupo de Trabajo de Reumatología Basada en la Evidencia, Sociedad Española de Reumatología, Madrid, Spain.
Reumatol Clin. 2012 Sep-Oct;8(5):236-42. doi: 10.1016/j.reuma.2012.03.009. Epub 2012 May 19.
There is a wide variability in the diagnostic and therapeutic methods in rheumatoid arthritis (AR) in Spain, according to prior studies. The quality of care could benefit from the application of appropriate clinical practice standards; we present a study on the variability of clinical practice.
Descriptive review of clinical records (CR) of patients aged 16 or older diagnosed with RA, selected by stratified sampling of the Autonomous Communities in two stages per Hospital Center and patient. Collected analysis of sociodemographic data, evolution, follow-up, joint count, reactants, function, job history, Visual Analogue Scales (VAS) and other.
We obtained valid information of 1,272 RA patients. The ESR, CRP and rheumatoid factor (RF) were regularly used parameters. The percentages of missing data in tender (TJN) and swollen (SJN) joint counts were 8.2% and 9.6% respectively; regarding the VAS we found 53.6% (patient), 59.1% (pain), and 72% in the physician VAS.
Despite having clinical practice guidelines on RA, there still exists a significant variability in RA management in our country.
根据先前的研究,西班牙类风湿关节炎(RA)的诊断和治疗方法存在很大差异。应用适当的临床实践标准可能会提高医疗质量;我们开展了一项关于临床实践差异的研究。
对16岁及以上诊断为RA的患者的临床记录(CR)进行描述性回顾,通过每个医院中心和患者分两个阶段对自治区进行分层抽样来选择患者。收集社会人口统计学数据、病情演变、随访情况、关节计数、反应物质、功能、工作史、视觉模拟量表(VAS)等的分析数据。
我们获得了1272例RA患者的有效信息。血沉(ESR)、C反应蛋白(CRP)和类风湿因子(RF)是常用参数。压痛关节计数(TJN)和肿胀关节计数(SJN)中缺失数据的百分比分别为8.2%和9.6%;关于VAS,我们发现患者VAS缺失数据的比例为53.6%,疼痛VAS为59.1%,医生VAS为72%。
尽管有关于RA的临床实践指南,但我国RA的管理仍存在显著差异。