Evidence-based recommendations for the management of ankylosing spondylitis : systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists
Identifieur interne : 003253 ( PascalFrancis/Checkpoint ); précédent : 003252; suivant : 003254Evidence-based recommendations for the management of ankylosing spondylitis : systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists
Auteurs : P. I. Sidiropoulos [Grèce] ; G. Hatemi [Turquie] ; I.-H. Song [Allemagne] ; J. Avouac [France] ; E. Collantes [Espagne] ; V. Hamuryudan [Turquie] ; M. Herold [Autriche] ; T. K. Kvien [Norvège] ; H. Mielants [Belgique] ; J. M. Mendoza [Espagne] ; I. Olivieri [Italie] ; M. Ostergaard [Danemark] ; L. Schachna [Australie] ; J. Sieper [Allemagne] ; D. T. Boumpas [Grèce] ; M. Dougados [France]Source :
- Rheumatology : (Oxford. Print) [ 1462-0324 ] ; 2008.
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- Pascal (Inist)
- Wicri :
- topic : Recommandation.
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Abstract
Objective. Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined with practising rheumatologists addressing specific questions relevant to clinical practice. Methods. Ten countries participated in three rounds of discussions and votes concerning the management of AS. A set of nine questions was formulated in the domains of diagnosis, monitoring and treatment, after a Delphi procedure. A literature search in MedLine was conducted. Predefined outcome parameters for the domains of diagnosis, monitoring and treatment were assessed. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements by each national group, following which the final international recommendations were formulated. Results. A total of 2699 papers were found and 467 were selected for analysis. Twelve key recommendations were developed: three in the domain of diagnosis addressing general diagnostic considerations, early AS diagnosis and general practitioners' referral recommendations; three concerning monitoring of AS disease activity, severity and prognosis; six concerning pharmacological treatment (except biologics): non-steroidal anti-inflammatory drugs/COX-II inhibitors, bisphosphonates and treatment of enthesitis. The compiled agreement among experts ranged from 72% to 93%. Conclusion. Recommendations for the management of AS were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. Involvement of a larger and more representative group of rheumatologists may improve their dissemination and implementation in daily clinical practice.
Affiliations:
- Allemagne, Australie, Autriche, Belgique, Danemark, Espagne, France, Grèce, Italie, Norvège, Turquie
- Communauté de Madrid, Hovedstaden, Victoria (État), Île-de-France, Østlandet
- Copenhague, Madrid, Melbourne, Oslo, Paris
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Evidence-based recommendations for the management of ankylosing spondylitis : systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists</title><author><name sortKey="Sidiropoulos, P I" sort="Sidiropoulos, P I" uniqKey="Sidiropoulos P" first="P. I." last="Sidiropoulos">P. I. Sidiropoulos</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Internal Medicine, Division of Rheumatology, Clinical Immunology and Allergy, University of Crete, Medical School</s1><s2>Heraklion</s2><s3>GRC</s3><sZ>1 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Grèce</country><wicri:noRegion>Heraklion</wicri:noRegion></affiliation></author><author><name sortKey="Hatemi, G" sort="Hatemi, G" uniqKey="Hatemi G" first="G." last="Hatemi">G. Hatemi</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Cerrahpasa Medical Faculty, University of Istanbul</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Song, I H" sort="Song, I H" uniqKey="Song I" first="I.-H." last="Song">I.-H. Song</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</s1><s3>DEU</s3><sZ>3 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University Medicine Berlin</wicri:noRegion><wicri:noRegion>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</wicri:noRegion></affiliation></author><author><name sortKey="Avouac, J" sort="Avouac, J" uniqKey="Avouac J" first="J." last="Avouac">J. Avouac</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Rheumatology Department, Cochin Teaching Hospital, School of Medicine, Paris-Descartes University</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Collantes, E" sort="Collantes, E" uniqKey="Collantes E" first="E." last="Collantes">E. Collantes</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Rheumatology, Reina Sofia University Hospital of Cordoba</s1><s2>Cordoba</s2><s3>ESP</s3><sZ>5 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Cordoba</wicri:noRegion></affiliation></author><author><name sortKey="Hamuryudan, V" sort="Hamuryudan, V" uniqKey="Hamuryudan V" first="V." last="Hamuryudan">V. Hamuryudan</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Cerrahpasa Medical Faculty, University of Istanbul</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Herold, M" sort="Herold, M" uniqKey="Herold M" first="M." last="Herold">M. Herold</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Clinical Department of Internal Medicine, Division of General Internal Medicine, Innsbruck Medical University</s1><s3>AUT</s3><sZ>7 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Clinical Department of Internal Medicine, Division of General Internal Medicine, Innsbruck Medical University</wicri:noRegion></affiliation></author><author><name sortKey="Kvien, T K" sort="Kvien, T K" uniqKey="Kvien T" first="T. K." last="Kvien">T. K. Kvien</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen</s1><s2>0319 Oslo</s2><s3>NOR</s3><sZ>8 aut.</sZ></inist:fA14><country>Norvège</country><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Mielants, H" sort="Mielants, H" uniqKey="Mielants H" first="H." last="Mielants">H. Mielants</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Rheumatology, Ghent University Hospital</s1><s2>Gent</s2><s3>BEL</s3><sZ>9 aut.</sZ></inist:fA14><country>Belgique</country><wicri:noRegion>Gent</wicri:noRegion></affiliation></author><author><name sortKey="Mendoza, J M" sort="Mendoza, J M" uniqKey="Mendoza J" first="J. M." last="Mendoza">J. M. Mendoza</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Servicio de Reumatologia, Hospital Puerta de Hierro</s1><s2>Madrid</s2><s3>ESP</s3><sZ>10 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Olivieri, I" sort="Olivieri, I" uniqKey="Olivieri I" first="I." last="Olivieri">I. Olivieri</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Rheumatology Department of Lucania, San Carlo Hospital of Potenza</s1><s2>Potenza</s2><s3>ITA</s3><sZ>11 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Potenza</wicri:noRegion></affiliation></author><author><name sortKey="Ostergaard, M" sort="Ostergaard, M" uniqKey="Ostergaard M" first="M." last="Ostergaard">M. Ostergaard</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Copenhagen University Hospital</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>12 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Schachna, L" sort="Schachna, L" uniqKey="Schachna L" first="L." last="Schachna">L. Schachna</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Austin Spondylitis Centre, Austin Health, Melbourne</s1><s2>Victoria</s2><s3>AUS</s3><sZ>13 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Sieper, J" sort="Sieper, J" uniqKey="Sieper J" first="J." last="Sieper">J. Sieper</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</s1><s3>DEU</s3><sZ>3 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University Medicine Berlin</wicri:noRegion><wicri:noRegion>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</wicri:noRegion></affiliation></author><author><name sortKey="Boumpas, D T" sort="Boumpas, D T" uniqKey="Boumpas D" first="D. T." last="Boumpas">D. T. Boumpas</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Internal Medicine, Division of Rheumatology, Clinical Immunology and Allergy, University of Crete, Medical School</s1><s2>Heraklion</s2><s3>GRC</s3><sZ>1 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Grèce</country><wicri:noRegion>Heraklion</wicri:noRegion></affiliation></author><author><name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M." last="Dougados">M. Dougados</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Rheumatology Department, Cochin Teaching Hospital, School of Medicine, Paris-Descartes University</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">08-0160072</idno><date when="2008">2008</date><idno type="stanalyst">PASCAL 08-0160072 INIST</idno><idno type="RBID">Pascal:08-0160072</idno><idno type="wicri:Area/PascalFrancis/Corpus">003683</idno><idno type="wicri:Area/PascalFrancis/Curation">002959</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">003253</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">003253</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Evidence-based recommendations for the management of ankylosing spondylitis : systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists</title><author><name sortKey="Sidiropoulos, P I" sort="Sidiropoulos, P I" uniqKey="Sidiropoulos P" first="P. I." last="Sidiropoulos">P. I. Sidiropoulos</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Internal Medicine, Division of Rheumatology, Clinical Immunology and Allergy, University of Crete, Medical School</s1><s2>Heraklion</s2><s3>GRC</s3><sZ>1 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Grèce</country><wicri:noRegion>Heraklion</wicri:noRegion></affiliation></author><author><name sortKey="Hatemi, G" sort="Hatemi, G" uniqKey="Hatemi G" first="G." last="Hatemi">G. Hatemi</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Cerrahpasa Medical Faculty, University of Istanbul</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Song, I H" sort="Song, I H" uniqKey="Song I" first="I.-H." last="Song">I.-H. Song</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</s1><s3>DEU</s3><sZ>3 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University Medicine Berlin</wicri:noRegion><wicri:noRegion>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</wicri:noRegion></affiliation></author><author><name sortKey="Avouac, J" sort="Avouac, J" uniqKey="Avouac J" first="J." last="Avouac">J. Avouac</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Rheumatology Department, Cochin Teaching Hospital, School of Medicine, Paris-Descartes University</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Collantes, E" sort="Collantes, E" uniqKey="Collantes E" first="E." last="Collantes">E. Collantes</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Rheumatology, Reina Sofia University Hospital of Cordoba</s1><s2>Cordoba</s2><s3>ESP</s3><sZ>5 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Cordoba</wicri:noRegion></affiliation></author><author><name sortKey="Hamuryudan, V" sort="Hamuryudan, V" uniqKey="Hamuryudan V" first="V." last="Hamuryudan">V. Hamuryudan</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Cerrahpasa Medical Faculty, University of Istanbul</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Herold, M" sort="Herold, M" uniqKey="Herold M" first="M." last="Herold">M. Herold</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Clinical Department of Internal Medicine, Division of General Internal Medicine, Innsbruck Medical University</s1><s3>AUT</s3><sZ>7 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>Clinical Department of Internal Medicine, Division of General Internal Medicine, Innsbruck Medical University</wicri:noRegion></affiliation></author><author><name sortKey="Kvien, T K" sort="Kvien, T K" uniqKey="Kvien T" first="T. K." last="Kvien">T. K. Kvien</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen</s1><s2>0319 Oslo</s2><s3>NOR</s3><sZ>8 aut.</sZ></inist:fA14><country>Norvège</country><placeName><settlement type="city">Oslo</settlement><region nuts="2">Østlandet</region></placeName></affiliation></author><author><name sortKey="Mielants, H" sort="Mielants, H" uniqKey="Mielants H" first="H." last="Mielants">H. Mielants</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Rheumatology, Ghent University Hospital</s1><s2>Gent</s2><s3>BEL</s3><sZ>9 aut.</sZ></inist:fA14><country>Belgique</country><wicri:noRegion>Gent</wicri:noRegion></affiliation></author><author><name sortKey="Mendoza, J M" sort="Mendoza, J M" uniqKey="Mendoza J" first="J. M." last="Mendoza">J. M. Mendoza</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Servicio de Reumatologia, Hospital Puerta de Hierro</s1><s2>Madrid</s2><s3>ESP</s3><sZ>10 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Olivieri, I" sort="Olivieri, I" uniqKey="Olivieri I" first="I." last="Olivieri">I. Olivieri</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Rheumatology Department of Lucania, San Carlo Hospital of Potenza</s1><s2>Potenza</s2><s3>ITA</s3><sZ>11 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Potenza</wicri:noRegion></affiliation></author><author><name sortKey="Ostergaard, M" sort="Ostergaard, M" uniqKey="Ostergaard M" first="M." last="Ostergaard">M. Ostergaard</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Copenhagen University Hospital</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>12 aut.</sZ></inist:fA14><country>Danemark</country><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Schachna, L" sort="Schachna, L" uniqKey="Schachna L" first="L." last="Schachna">L. Schachna</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Austin Spondylitis Centre, Austin Health, Melbourne</s1><s2>Victoria</s2><s3>AUS</s3><sZ>13 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Sieper, J" sort="Sieper, J" uniqKey="Sieper J" first="J." last="Sieper">J. Sieper</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</s1><s3>DEU</s3><sZ>3 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>University Medicine Berlin</wicri:noRegion><wicri:noRegion>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</wicri:noRegion></affiliation></author><author><name sortKey="Boumpas, D T" sort="Boumpas, D T" uniqKey="Boumpas D" first="D. T." last="Boumpas">D. T. Boumpas</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Internal Medicine, Division of Rheumatology, Clinical Immunology and Allergy, University of Crete, Medical School</s1><s2>Heraklion</s2><s3>GRC</s3><sZ>1 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Grèce</country><wicri:noRegion>Heraklion</wicri:noRegion></affiliation></author><author><name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M." last="Dougados">M. Dougados</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Rheumatology Department, Cochin Teaching Hospital, School of Medicine, Paris-Descartes University</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Rheumatology : (Oxford. Print)</title><title level="j" type="abbreviated">Rheumatol. : (Oxf. Print)</title><idno type="ISSN">1462-0324</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Rheumatology : (Oxford. Print)</title><title level="j" type="abbreviated">Rheumatol. : (Oxf. Print)</title><idno type="ISSN">1462-0324</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ankylosing spondylitis</term><term>Chronic</term><term>Diagnosis</term><term>Disseminated</term><term>Recommendation</term><term>Rheumatology</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Recommandation</term><term>Spondylarthrite ankylosante</term><term>Rhumatologie</term><term>Disséminé</term><term>Diagnostic</term><term>Traitement</term><term>Chronique</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Recommandation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective. Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined with practising rheumatologists addressing specific questions relevant to clinical practice. Methods. Ten countries participated in three rounds of discussions and votes concerning the management of AS. A set of nine questions was formulated in the domains of diagnosis, monitoring and treatment, after a Delphi procedure. A literature search in MedLine was conducted. Predefined outcome parameters for the domains of diagnosis, monitoring and treatment were assessed. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements by each national group, following which the final international recommendations were formulated. Results. A total of 2699 papers were found and 467 were selected for analysis. Twelve key recommendations were developed: three in the domain of diagnosis addressing general diagnostic considerations, early AS diagnosis and general practitioners' referral recommendations; three concerning monitoring of AS disease activity, severity and prognosis; six concerning pharmacological treatment (except biologics): non-steroidal anti-inflammatory drugs/COX-II inhibitors, bisphosphonates and treatment of enthesitis. The compiled agreement among experts ranged from 72% to 93%. Conclusion. Recommendations for the management of AS were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. Involvement of a larger and more representative group of rheumatologists may improve their dissemination and implementation in daily clinical practice.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>1462-0324</s0></fA01><fA03 i2="1"><s0>Rheumatol. : (Oxf. Print)</s0></fA03><fA05><s2>47</s2></fA05><fA06><s2>3</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Evidence-based recommendations for the management of ankylosing spondylitis : systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists</s1></fA08><fA11 i1="01" i2="1"><s1>SIDIROPOULOS (P. I.)</s1></fA11><fA11 i1="02" i2="1"><s1>HATEMI (G.)</s1></fA11><fA11 i1="03" i2="1"><s1>SONG (I.-H.)</s1></fA11><fA11 i1="04" i2="1"><s1>AVOUAC (J.)</s1></fA11><fA11 i1="05" i2="1"><s1>COLLANTES (E.)</s1></fA11><fA11 i1="06" i2="1"><s1>HAMURYUDAN (V.)</s1></fA11><fA11 i1="07" i2="1"><s1>HEROLD (M.)</s1></fA11><fA11 i1="08" i2="1"><s1>KVIEN (T. K.)</s1></fA11><fA11 i1="09" i2="1"><s1>MIELANTS (H.)</s1></fA11><fA11 i1="10" i2="1"><s1>MENDOZA (J. M.)</s1></fA11><fA11 i1="11" i2="1"><s1>OLIVIERI (I.)</s1></fA11><fA11 i1="12" i2="1"><s1>OSTERGAARD (M.)</s1></fA11><fA11 i1="13" i2="1"><s1>SCHACHNA (L.)</s1></fA11><fA11 i1="14" i2="1"><s1>SIEPER (J.)</s1></fA11><fA11 i1="15" i2="1"><s1>BOUMPAS (D. T.)</s1></fA11><fA11 i1="16" i2="1"><s1>DOUGADOS (M.)</s1></fA11><fA14 i1="01"><s1>Department of Internal Medicine, Division of Rheumatology, Clinical Immunology and Allergy, University of Crete, Medical School</s1><s2>Heraklion</s2><s3>GRC</s3><sZ>1 aut.</sZ><sZ>15 aut.</sZ></fA14><fA14 i1="02"><s1>Cerrahpasa Medical Faculty, University of Istanbul</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>2 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Medicine, Rheumatology, Charite, University Medicine Berlin</s1><s3>DEU</s3><sZ>3 aut.</sZ><sZ>14 aut.</sZ></fA14><fA14 i1="04"><s1>Rheumatology Department, Cochin Teaching Hospital, School of Medicine, Paris-Descartes University</s1><s2>Paris</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>16 aut.</sZ></fA14><fA14 i1="05"><s1>Department of Rheumatology, Reina Sofia University Hospital of Cordoba</s1><s2>Cordoba</s2><s3>ESP</s3><sZ>5 aut.</sZ></fA14><fA14 i1="06"><s1>Clinical Department of Internal Medicine, Division of General Internal Medicine, Innsbruck Medical University</s1><s3>AUT</s3><sZ>7 aut.</sZ></fA14><fA14 i1="07"><s1>Department of Rheumatology, Diakonhjemmet Hospital, Box 23 Vinderen</s1><s2>0319 Oslo</s2><s3>NOR</s3><sZ>8 aut.</sZ></fA14><fA14 i1="08"><s1>Department of Rheumatology, Ghent University Hospital</s1><s2>Gent</s2><s3>BEL</s3><sZ>9 aut.</sZ></fA14><fA14 i1="09"><s1>Servicio de Reumatologia, Hospital Puerta de Hierro</s1><s2>Madrid</s2><s3>ESP</s3><sZ>10 aut.</sZ></fA14><fA14 i1="10"><s1>Rheumatology Department of Lucania, San Carlo Hospital of Potenza</s1><s2>Potenza</s2><s3>ITA</s3><sZ>11 aut.</sZ></fA14><fA14 i1="11"><s1>Copenhagen University Hospital</s1><s2>Copenhagen</s2><s3>DNK</s3><sZ>12 aut.</sZ></fA14><fA14 i1="12"><s1>Austin Spondylitis Centre, Austin Health, Melbourne</s1><s2>Victoria</s2><s3>AUS</s3><sZ>13 aut.</sZ></fA14><fA20><s1>355-361</s1></fA20><fA21><s1>2008</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>14528</s2><s5>354000175135900220</s5></fA43><fA44><s0>0000</s0><s1>© 2008 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>93 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>08-0160072</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Rheumatology : (Oxford. Print)</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Objective. Recommendations and/or guidelines represent a popular way of integrating evidence-based medicine into clinical practice. The 3E Initiatives is a multi-national effort to develop recommendations for the management of rheumatic diseases, which involves a large number of experts combined with practising rheumatologists addressing specific questions relevant to clinical practice. Methods. Ten countries participated in three rounds of discussions and votes concerning the management of AS. A set of nine questions was formulated in the domains of diagnosis, monitoring and treatment, after a Delphi procedure. A literature search in MedLine was conducted. Predefined outcome parameters for the domains of diagnosis, monitoring and treatment were assessed. The evidence to support each proposition was evaluated and scored. After discussion and votes, the final recommendations were presented using brief statements by each national group, following which the final international recommendations were formulated. Results. A total of 2699 papers were found and 467 were selected for analysis. Twelve key recommendations were developed: three in the domain of diagnosis addressing general diagnostic considerations, early AS diagnosis and general practitioners' referral recommendations; three concerning monitoring of AS disease activity, severity and prognosis; six concerning pharmacological treatment (except biologics): non-steroidal anti-inflammatory drugs/COX-II inhibitors, bisphosphonates and treatment of enthesitis. The compiled agreement among experts ranged from 72% to 93%. Conclusion. Recommendations for the management of AS were developed using an evidence-based approach followed by expert/physician consensus with high level of agreement. Involvement of a larger and more representative group of rheumatologists may improve their dissemination and implementation in daily clinical practice.</s0></fC01><fC02 i1="01" i2="X"><s0>002B15D</s0></fC02><fC02 i1="02" i2="X"><s0>002B15F</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Recommandation</s0><s5>07</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Recommendation</s0><s5>07</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Recomendación</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Spondylarthrite ankylosante</s0><s5>08</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Ankylosing spondylitis</s0><s5>08</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Espondiloartritis anquilosante</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Rhumatologie</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Rheumatology</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Reumatología</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Disséminé</s0><s5>13</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Disseminated</s0><s5>13</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Diseminado</s0><s5>13</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Diagnostic</s0><s5>14</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Diagnosis</s0><s5>14</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Diagnóstico</s0><s5>14</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Traitement</s0><s5>15</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Treatment</s0><s5>15</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Tratamiento</s0><s5>15</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Chronique</s0><s5>30</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Chronic</s0><s5>30</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Crónico</s0><s5>30</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie du rachis</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Spine disease</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Raquis patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Rhumatisme inflammatoire</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Inflammatory joint disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Reumatismo inflamatorio</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Spondylarthropathie</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Spondylarthropathy</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Espondilartropatia</s0><s2>NM</s2><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie du système ostéoarticulaire</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Diseases of the osteoarticular system</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema osteoarticular patología</s0><s5>40</s5></fC07><fN21><s1>098</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Autriche</li><li>Belgique</li><li>Danemark</li><li>Espagne</li><li>France</li><li>Grèce</li><li>Italie</li><li>Norvège</li><li>Turquie</li></country><region><li>Communauté de Madrid</li><li>Hovedstaden</li><li>Victoria (État)</li><li>Île-de-France</li><li>Østlandet</li></region><settlement><li>Copenhague</li><li>Madrid</li><li>Melbourne</li><li>Oslo</li><li>Paris</li></settlement></list><tree><country name="Grèce"><noRegion><name sortKey="Sidiropoulos, P I" sort="Sidiropoulos, P I" uniqKey="Sidiropoulos P" first="P. I." last="Sidiropoulos">P. I. Sidiropoulos</name></noRegion><name sortKey="Boumpas, D T" sort="Boumpas, D T" uniqKey="Boumpas D" first="D. T." last="Boumpas">D. T. Boumpas</name></country><country name="Turquie"><noRegion><name sortKey="Hatemi, G" sort="Hatemi, G" uniqKey="Hatemi G" first="G." last="Hatemi">G. Hatemi</name></noRegion><name sortKey="Hamuryudan, V" sort="Hamuryudan, V" uniqKey="Hamuryudan V" first="V." last="Hamuryudan">V. Hamuryudan</name></country><country name="Allemagne"><noRegion><name sortKey="Song, I H" sort="Song, I H" uniqKey="Song I" first="I.-H." last="Song">I.-H. Song</name></noRegion><name sortKey="Sieper, J" sort="Sieper, J" uniqKey="Sieper J" first="J." last="Sieper">J. Sieper</name></country><country name="France"><region name="Île-de-France"><name sortKey="Avouac, J" sort="Avouac, J" uniqKey="Avouac J" first="J." last="Avouac">J. Avouac</name></region><name sortKey="Dougados, M" sort="Dougados, M" uniqKey="Dougados M" first="M." last="Dougados">M. Dougados</name></country><country name="Espagne"><noRegion><name sortKey="Collantes, E" sort="Collantes, E" uniqKey="Collantes E" first="E." last="Collantes">E. Collantes</name></noRegion><name sortKey="Mendoza, J M" sort="Mendoza, J M" uniqKey="Mendoza J" first="J. M." last="Mendoza">J. M. Mendoza</name></country><country name="Autriche"><noRegion><name sortKey="Herold, M" sort="Herold, M" uniqKey="Herold M" first="M." last="Herold">M. Herold</name></noRegion></country><country name="Norvège"><region name="Østlandet"><name sortKey="Kvien, T K" sort="Kvien, T K" uniqKey="Kvien T" first="T. K." last="Kvien">T. K. Kvien</name></region></country><country name="Belgique"><noRegion><name sortKey="Mielants, H" sort="Mielants, H" uniqKey="Mielants H" first="H." last="Mielants">H. Mielants</name></noRegion></country><country name="Italie"><noRegion><name sortKey="Olivieri, I" sort="Olivieri, I" uniqKey="Olivieri I" first="I." last="Olivieri">I. Olivieri</name></noRegion></country><country name="Danemark"><region name="Hovedstaden"><name sortKey="Ostergaard, M" sort="Ostergaard, M" uniqKey="Ostergaard M" first="M." last="Ostergaard">M. Ostergaard</name></region></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Schachna, L" sort="Schachna, L" uniqKey="Schachna L" first="L." last="Schachna">L. Schachna</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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