{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:22:58Z","timestamp":1761895378958,"version":"build-2065373602"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,2,28]],"date-time":"2012-02-28T00:00:00Z","timestamp":1330387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the outcome of early rheumatoid arthritis (RA) patients in a country where early clinics were established versus the outcome of patients in nonprotocolized clinics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared 2 multicenter cohorts: an RA cohort derived from an early arthritis registry set in 36 reference hospitals in which a specific intervention was established (Evaluation of a Model for Arthritis Care in Spain [SERAP]), and a historical control cohort of patients with early RA attending 34 rheumatology departments (Prognosis in Rheumatoid Arthritis [PROAR] cohort). Effectiveness was tested by comparing the change in the Disease Activity Score in 28 joints (DAS28), the change in the Health Assessment Questionnaire (HAQ), and the change in the Sharp\/van der Heijde radiologic score using marginal structural models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 161 early RA patients were recruited in the PROAR cohort and 447 in the SERAP cohort. Being a SERAP patient was inversely correlated with activity, resulting in a decrease of \u22120.24 (95% confidence interval [95% CI] \u22120.39, \u22120.08) units in the population average of the DAS28 after adjustment was made. Moreover, intervention may be seen as a protective factor of radiologic damage, with a decrease of \u22120.05 (95% CI \u22120.09, \u22120.01) units in the logarithm of the total Sharp\/van der Heijde score. On the other hand, a decrease in functional impairment was detected, but intervention was not statistically associated with HAQ changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preventing major radiographic progression in a 2\u2010year term inside structured and organized special programs for the management of disease, such as early arthritis clinics, are effective compared to nonprotocolized referrals, treatment, and followup.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.20682","type":"journal-article","created":{"date-parts":[[2011,11,2]],"date-time":"2011-11-02T09:57:28Z","timestamp":1320227848000},"page":"321-330","source":"Crossref","is-referenced-by-count":16,"title":["Effectiveness of a clinical practice intervention in early rheumatoid arthritis"],"prefix":"10.1002","volume":"64","author":[{"given":"Miguel \u00c1ngel","family":"Descalzo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordi","family":"Carbonell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isidoro","family":"Gonz\u00e1lez\u2010\u00c1lvaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raimon","family":"Sanmart\u00ed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Balsa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valent\u00edn","family":"Hernandez\u2010Barrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Andr\u00e9s","family":"Rom\u00e1n\u2010Ivorra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Ivorra\u2010Cort\u00e9s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Lisbona","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedes","family":"Alperi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Jim\u00e9nez\u2010Garcia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loreto","family":"Carmona","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"SERAP and PROAR Study Groups","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,2,28]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/ar2498"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2004.08.007"},{"issue":"31","key":"e_1_2_8_4_2","first-page":"S20","article-title":"Joint damage and disability in rheumatoid arthritis: an updated systematic review","volume":"21","author":"Scott DL","year":"2003","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.7.611"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20351"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200001)43:1<22::AID-ANR4>3.0.CO;2-9"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.044354"},{"key":"e_1_2_8_9_2","unstructured":"Sociedad Espa\u00f1ola de Reumatolog\u00eda. 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