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  1. T. Helleputte1,
  2. D. Bertrand1
  1. 1DNAlytics, Ottignies-Louvain-la-Neuve, Belgium


Background: Different scores are used for patient management in rheumatoid arthritis (RA), including patient characterization such as ACR/EULAR criterion [1], disease activity monitoring by healthcare professionnals such as DAS28 [2], DAS28-CRP [2], CDAI [1], SDAI [3], or by patients such as HAQ-DI [4] or RAPID3 [5]. Most of these scores involve computations that are difficult to perform mentally (such as a square root function). Accordingly, several software tools have been designed over the years to help clinicians and patients compute these scores [6].

Objectives: This work reports for the first time usage statistics for one of these software tools, the RheumaKit online platform, from 2016 to 2020, showing that it has become a standard tool used worldwide by the rheumatology community. It also investigates the increasing use of repeated measurements, as enabled by that platform. Finally, a comparison between different disease activity scores is proposed, and usage preferences are documented.

Methods: Until January 2020, RheumaKit online portal has allowed users to compute scores without registering on the portal. In such cases, the computations and results are not stored, yet this activity is tracked by Google Analytics (as per explicit cookie policy). Users may also create an account, enabling storage and retrospective access to the computed results. Such entry recording in the RheumaKit database is only available for healthcare professionnals. The system then allows users to create individual patient files in which multiple scores and timepoints are recorded. These two data sources (Google Analytics and internal database) are used to perform this study: counts and trends are reported over the period ranging from 01 Jan 2016 to 31 Dec 2019.

Results: RheumaKit online application had been accessed by 7,300 distinct users in 2016; this number has grown to 86,000 distinct users in 2019. User distribution has also evolved: in 2016, users were reported from Russia (13% of the 7,300 users), USA (12.2%), Belgium (9.7% – this figure being explained by the fact that the tool is developed in Belgium), France (7.3%), and UK (7.2%); wereas in 2019, users are from the USA (21.1% of the 86,000 users), France (14.4%), Germany (5.4%), Brazil (5.3%), UK (5.3%). With respect to scores, the usage ranking over 2016-2019 outlines a preference for DAS28-CRP (93,900 computations) followed by HAQ-DI (72,800), DAS28 (63,600), CDAI (56,500), SDAI (42,700), RAPID3 (33,800), and ACR-EULAR2010 (19,800). The tendency in registering scores is also increasing, as the number of registered healthcare professionnals went from 117 on the 1st of Jan 2016 to almost 1,200 on 31 Dec 2019.

Conclusion: The use of computer-assisted clinical scoring for RA patients is an increasing trend observed worldwide, with dominance in Europe and America. The tendency to perform repeated, longitudinal measurements of these scores for a given patient is also increasing exponentially. DAS28-CRP and HAQ-DI are the most used scores among those available in this study.

References: [1]Aletaha et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 2010

[2]Prevoo et al. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995.

[3]Smolen et al. A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology (Oxford) 2003

[4]Bruce and Fries. The Stanford Health Assessment Questionnaire: Dimensions and Practical Applications. Health Qual Life Outcomes 2003

[5]Pincus et al. An index of only patient-reported outcome measures, routineassessment of patient index data 3 (RAPID3), in two abataceptclinical trials: similar results to disease activity score (DAS28) andother RAPID indices that include physician-reported measures. Rheumatology 2008.

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Disclosure of Interests: Thibault Helleputte Shareholder of: DNAlytics, Damien Bertrand Employee of: DNAlytics.

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