{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:23:19Z","timestamp":1780622599243,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,4,3]],"date-time":"2021-04-03T00:00:00Z","timestamp":1617408000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011081","name":"Canadian Rheumatology Association","doi-asserted-by":"publisher","award":["CIORA grant"],"award-info":[{"award-number":["CIORA grant"]}],"id":[{"id":"10.13039\/100011081","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Information about the prediagnosis period in psoriatic arthritis (PsA) is limited. The present study was undertaken to compare health care utilization related to musculoskeletal issues during a 5\u2010year period prior to the diagnosis of PsA versus that of subjects with no prior inflammatory arthritis within a primary care setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a population\u2010based, matched cohort study using electronic medical records and administrative data in Ontario, Canada. Age\u2010 and sex\u2010matched cohorts of PsA patients and comparators from the same family physicians were assembled. Comparators were not allowed to have prior spondyloarthritis, ankylosing spondylitis, or rheumatoid arthritis billing code diagnoses. The study outcomes included health care utilization and costs related to nonspecific musculoskeletal issues during a 5\u2010year period prior to the index date.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We studied 462 PsA patients and 2,310 matched comparators. The odds ratio (OR) related to visiting a primary care physician for nonspecific musculoskeletal issues in patients with PsA was 2.14 (95% confidence interval 1.73\u20132.64) in the year immediately preceding the index date and was similarly elevated up to 5 years prior. The OR related to using other musculoskeletal\u2010related health care services, including musculoskeletal specialists visits, joint injections, joint imaging, and emergency department visits, was higher in PsA as early as 5 years preceding the index date. Total and musculoskeletal\u2010related health care costs prior to the index date were higher for patients with PsA versus comparators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A prodromal PsA phase characterized by nonspecific musculoskeletal symptoms may exist. Further study is needed to determine if this represents a window for earlier diagnosis of PsA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24146","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T09:09:38Z","timestamp":1579597778000},"page":"680-686","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Health Care Utilization for Musculoskeletal Issues During\u00a0the Prediagnosis Period in Psoriatic Arthritis: A\u00a0Population\u2010Based Study"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1473-1715","authenticated-orcid":false,"given":"Lihi","family":"Eder","sequence":"first","affiliation":[{"name":"University of Toronto and Women\u2019s College Research Institute Women\u2019s College Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Tu","sequence":"additional","affiliation":[{"name":"North York General Hospital University of Toronto and Toronto Western Hospital Family Health Team\u2013University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl F.","family":"Rosen","sequence":"additional","affiliation":[{"name":"University of Toronto and Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raed","family":"Alhusayen","sequence":"additional","affiliation":[{"name":"University of Toronto and Sunnybrook Research Institute Sunnybrook Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Y.","family":"Cheng","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Young","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willemina","family":"Campbell","sequence":"additional","affiliation":[{"name":"Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9515-2802","authenticated-orcid":false,"given":"Sasha","family":"Bernatsky","sequence":"additional","affiliation":[{"name":"Research Institute of the McGill University Health Centre  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dafna D.","family":"Gladman","sequence":"additional","affiliation":[{"name":"University of Toronto and Krembil Research Institute University Health Network Toronto Western Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Michael","family":"Paterson","sequence":"additional","affiliation":[{"name":"University of Toronto and Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Widdifield","sequence":"additional","affiliation":[{"name":"University of Toronto Sunnybrook Research Institute, and Institute for Clinical Evaluative Sciences  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1505557"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150165"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00347-5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204858"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2011.150938"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2015.07.005"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2015.05.001"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204867"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20150116"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-017-8630-7"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.170142"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23743"},{"key":"e_1_2_6_14_1","first-page":"e15","article-title":"Evaluation of electronic medical record administrative data linked database (EMRALD)","volume":"20","author":"Tu K","year":"2014","journal-title":"Am J Manag Care"},{"key":"e_1_2_6_15_1","volume-title":"Guidelines on person-level costing using administrative databases in Ontario. 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