Effectiveness of diagnosis and intervention in patients with rheumatic diseases
The ‘Effectiveness of diagnosis and intervention in patients with rheumatic diseases’ programme consists of five main themes and two sub-themes with transversal involvement with the main themes. The main themes are 1) Outcome in rheumatoid arthritis (RA); 2) Outcome in spondyloarthritis (SpA); 3) Outcome in osteoporosis; 4) Outcome in fibromyalgia, and 5) The Maastricht Population Study. The transverse themes covering all main topics are health economics and cost of illness.
1. Outcome in RA mainly focuses on the individual prediction of relevant outcome, in casu radiographic destruction, function and quality of life. Apart from modeling relationships between signs and symptoms, radiographic damage and function, this theme includes the international biomarker project that is co-chaired by Robert Landewé, and in which the department intellectually contributes. This project aims at enrolling a world-wide cohort of early RA patients in an attempt to collect biomaterials for biomarker validation.
2. Outcome in SpA focuses on the assessment of disease activity in ankylosing spondylitis, exploiting the in- house OASIS cohort, that has passed its 12-year follow up visit. OASIS is a standard in the international world of AS research, and is a continuing source of valuable data regarding functional and structural outcome, cost-of illness, quality of life. Early SpA is a relatively new concept, focusing on the early diagnosis in an attempt to relieve the burdens of illness. An important step forward was the conception of international criteria for axial and peripheral SpA under partial leadership of our department.
3. Outcome in osteoporosis focuses on the clinical course of osteoporosis and the prediction of fracture (fracture risk), and is run in collaboration with the departments of surgery and endocrinology. New initiatives in the field of translational medicine have started in collaboration with the department of orthopaedic surgery.
4. Outcome in fibromyalgia, focuses on Innovation of Care in terms of the diagnostic process, as well as multidisciplinary care, in an attempt to optimise social and labour force participation. This theme is performed in close collaboration with the HTA programme of CAPHRI. This research line has led to the implementation of important innovations in daily clinical care, such as the nurse-led outpatient clinic for patients referred by their general practitioner for unexplained musculoskeletal complaints.
5. The Maastricht Population Study is a recently started 10-year prospective cohort study that will include 10.000 people aged > 40 (50% with the metabolic syndrome / diabetes type 2 and 50% controls from the open regional population). We will concentrate on prevalence, incidence and determinants of hyperuricemia, gout, osteoporosis, fractures, sof-tissue rheumatism and hand and knee osteoarthritis. The determinants to be assessed include co-morbidity and lifestyle factors, such as mobility and nutrition (fructose,vitamine D, calcium intake).