Sargious A, Lee S J
University of California San Diego, San Diego, USA.
Clin Exp Rheumatol. 2014 Sep-Oct;32(5 Suppl 85):S-168-72. Epub 2014 Oct 30.
Rheumatoid arthritis (RA) is an autoimmune inflammatory disease associated with rapid loss of function and radiographic damage. Treatment is targeted to achieve low disease activity/remission, as measured by various pooled indices comprised of laboratory measures, patient-derived, and physician-derived measures. Outside clinical trials, it can be difficult to obtain all these components at the time of the visit to provide immediate guidance. Subsequently, several pooled indices of patient reported outcomes (PROs) have been developed and shown to be equally and sometimes more effective as traditional assessor- and laboratory-derived measures in detecting treatment group and predicting long-term outcomes. With growing use of electronic medical record (EMR) and technology, many of these PROs can now be obtained remotely and directly incorporated into EMR to facilitate target to treat approach. Remotely collecting PROs through the internet allows better data capture, easier incorporation into EMR, and more frequent monitoring of patient's disease activity in between clinic visits for quicker assessment of adverse events and therapeutic efficacy. Adapting remotely collected PROs into clinical trials, clinical care, and long-term database has the potential for restructuring medical care while reducing costs and improving quality of care to achieve disease remission.
类风湿关节炎(RA)是一种自身免疫性炎症性疾病,与功能快速丧失和影像学损伤相关。治疗目标是实现低疾病活动度/缓解,这通过由实验室指标、患者报告指标和医生报告指标组成的各种综合指数来衡量。在临床试验之外,在就诊时很难获取所有这些组成部分以提供即时指导。随后,已经开发了几种患者报告结局(PRO)的综合指数,并且在检测治疗组和预测长期结局方面,这些指数已被证明与传统的评估者和实验室得出的指标同样有效,有时甚至更有效。随着电子病历(EMR)和技术的使用日益增加,现在许多这些PRO可以远程获取,并直接纳入EMR以促进靶向治疗方法。通过互联网远程收集PRO可以更好地捕获数据,更轻松地纳入EMR,并在门诊就诊之间更频繁地监测患者的疾病活动度,以便更快地评估不良事件和治疗效果。将远程收集的PRO应用于临床试验、临床护理和长期数据库,有可能在降低成本和提高护理质量以实现疾病缓解的同时,重组医疗护理。