{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:14:44Z","timestamp":1790673284858,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,6,24]],"date-time":"2016-06-24T00:00:00Z","timestamp":1466726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ministry of Social Affairs and Health (Hospital Clinical Research Program [PHRC])","award":["HUS 4434"],"award-info":[{"award-number":["HUS 4434"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Alsace is a region in eastern France with a population of \u223c2 million. All residents have high access to health care and an accredited referral center for SSc. Seeking care outside of this region is difficult because of the peculiar geography. The aim of this study was to assess the prevalence and spatial variation of systemic sclerosis (SSc) in eastern France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data for SSc patients were obtained from 3 sources (all general practitioners and community specialists, capillaroscopy centers, and all public and private hospital records) and were used to estimate the prevalence of SSc. Surviving patients who resided in Alsace on January 1, 2008 and fulfilled the American College of Rheumatology and\/or the LeRoy and Medsger criteria were included in this study. The clinical characteristics of the patients were also assessed. Potentially incomplete case ascertainment was corrected by capture\u2013recapture analyses. Geographic disparities were assessed by spatial cluster analysis and by comparing our results with those for other geographic areas in the world for which data derived using similar methodology were available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The review of 499 potential cases identified a total of 244 SSc patients. A trend toward a west\u2010to\u2010east gradient was observed but did not reach statistical significance. According to log\u2010linear modeling, an estimated 83.87 additional cases were missed. Thus, the SSc prevalence was 228.42 cases per million adult inhabitants of Alsace (95% confidence interval 203.70\u2013253.14); this prevalence was significantly higher than that in 2 other regions of France and comparable with the reported prevalence in Detroit, Michigan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The stringent methodology used in the current study is very likely to provide an accurate estimation of the prevalence of SSc. Design similarity with 3 other surveys extends the scope of the results by identifying geographic disparities that were previously indistinguishable due to methodologic differences.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.39613","type":"journal-article","created":{"date-parts":[[2016,1,27]],"date-time":"2016-01-27T15:16:06Z","timestamp":1453907766000},"page":"1731-1737","source":"Crossref","is-referenced-by-count":24,"title":["Brief Report: Spatial Heterogeneity of Systemic Sclerosis in France: High Prevalence in the Northeast Region"],"prefix":"10.1002","volume":"68","author":[{"given":"Alain","family":"Meyer","sequence":"first","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Auto\u2010immunes Rares, H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Chifflot","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Auto\u2010immunes Rares, H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Chatelus","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Auto\u2010immunes Rares, H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Fran\u00e7ois","family":"Kleinmann","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Auto\u2010immunes Rares, H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Ronde\u2010Ousteau","sequence":"additional","affiliation":[{"name":"H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Klein","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00e9my","family":"J\u00e9gu","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Geny","sequence":"additional","affiliation":[{"name":"H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Hirshi","sequence":"additional","affiliation":[{"name":"Centre de Comp\u00e9tence des Maladies Pulmonaires Rares, H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Canuet","sequence":"additional","affiliation":[{"name":"Centre de Comp\u00e9tence des Maladies Pulmonaires Rares and Centre de Comp\u00e9tences des Hypertensions Pulmonaires S\u00e9v\u00e8res, H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Blaison","sequence":"additional","affiliation":[{"name":"Centre de Comp\u00e9tence des Maladies Auto\u2010immunes Rares, Centre Hospitalier Colmar France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Kieffer","sequence":"additional","affiliation":[{"name":"Centre Hospitalier Mulhouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Lipsker","sequence":"additional","affiliation":[{"name":"H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thierry","family":"Martin","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Auto\u2010immunes Rares, H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Sauleau","sequence":"additional","affiliation":[{"name":"H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Velten","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Sibilia","sequence":"additional","affiliation":[{"name":"Centre de R\u00e9f\u00e9rence des Maladies Auto\u2010immunes Rares, H\u00f4pitaux Universitaires de Strasbourg Strasbourg France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0806188"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2007.05.003"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400421"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11073"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keh253"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2012.10.001"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230510"},{"key":"e_1_2_7_9_1","first-page":"1573","article-title":"Criteria for the classification of early systemic sclerosis","volume":"28","author":"LeRoy EC","year":"2001","journal-title":"J Rheumatol"},{"key":"e_1_2_7_10_1","unstructured":"CallewaertD FrydelY KuhnC.Chiffres pour l'Alsace: une m\u00e9decine \u00e0 proximit\u00e9 dans les bassins de vie d'Alsace. Institut national de la statistique et des \u00e9tudes \u00e9conomiques; 2013. URL:www.insee.fr\/alsace."},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/03610929708831995"},{"key":"e_1_2_7_12_1","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.2517-6161.1995.tb02015.x","article-title":"Assessment and propagation of model uncertainty","volume":"57","author":"Draper D.","year":"1995","journal-title":"J R Statist Soc"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204424"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203618"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200742"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken179"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/sarh.2001.20268"}],"container-title":["Arthritis &amp; Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.39613","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.39613","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:35:20Z","timestamp":1759937720000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/art.39613"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,24]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,7]]}},"alternative-id":["10.1002\/art.39613"],"URL":"https:\/\/doi.org\/10.1002\/art.39613","archive":["Portico"],"relation":{},"ISSN":["2326-5191","2326-5205"],"issn-type":[{"value":"2326-5191","type":"print"},{"value":"2326-5205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,24]]}}}