{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T19:37:37Z","timestamp":1788637057266,"version":"build-2803163510"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR204342"],"award-info":[{"award-number":["NIHR204342"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR203308"],"award-info":[{"award-number":["NIHR203308"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR203330"],"award-info":[{"award-number":["NIHR203330"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>To map from the health assessment questionnaire disability index (HAQ) to the pain visual analogue scale (VAS) for people with rheumatoid arthritis. The estimation sample comprised adults with rheumatoid arthritis and inadequate response to tumour necrosis factor-\u03b1 inhibitors in a multicentre phase 4 randomised controlled trial. Beta mixture models were estimated with combinations of HAQ and its square, age and sex as independent variables. Bayesian Information Criteria informed the number of components. Model performance (root mean squared error; mean absolute error; pseudo-R<jats:sup>2<\/jats:sup>) was estimated by k-fold cross validation. Graphs illustrated mean observed and predicted pain VAS, and cumulative distribution of observed and simulated pain VAS values. For face validity, a probabilistic analysis simulated 5000 pain VAS values at four HAQ scores. For external validation, the performance of the preferred specification was assessed using the Rheumatoid Arthritis Medication Study cohort. There were 1055 observations from 158 participants in the estimation sample (mean age: 55.8; 81% female; mean HAQ: 1.72). The preferred specification was a two-component beta mixture model (probability variables: HAQ, age, sex; main regression variable: HAQ). Visual plots illustrated good fit across the HAQ distribution, and a similar cumulative distribution of observed and predicted pain VAS values. Probabilistic analysis demonstrated that the preferred specification handled uncertainty appropriately. External validation demonstrated that\u00a0the preferred specification performed well in an independent dataset. Beta mixture models provide accurate non-linear estimates of pain VAS from HAQ scores to support evidence synthesis and resource allocation decision-making for people with rheumatoid arthritis.<\/jats:p>","DOI":"10.1007\/s00296-025-05897-1","type":"journal-article","created":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T01:59:14Z","timestamp":1749866354000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Estimating pain visual analogue scale from health assessment questionnaire for rheumatoid arthritis with beta mixture models"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3659-056X","authenticated-orcid":false,"given":"Sean P.","family":"Gavan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3208-9799","authenticated-orcid":false,"given":"Sainan","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6759-7521","authenticated-orcid":false,"given":"Felice","family":"Rivellese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zo\u00eb","family":"Ide","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3689-4256","authenticated-orcid":false,"given":"Michael","family":"Stadler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3938-4350","authenticated-orcid":false,"given":"Katherine","family":"Payne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1395-9344","authenticated-orcid":false,"given":"Darren","family":"Plant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-2527","authenticated-orcid":false,"given":"Anne","family":"Barton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1326-5051","authenticated-orcid":false,"given":"Costantino","family":"Pitzalis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,14]]},"reference":[{"key":"5897_CR1","doi-asserted-by":"publisher","first-page":"e594","DOI":"10.1016\/s2665-9913(23)00211-4","volume":"5","author":"GBD 2021","year":"2023","unstructured":"GBD 2021, Rheumatoid Arthritis Collaborators (2023) Global, regional, and national burden of rheumatoid arthritis, 1990\u20132020, and projections to 2050: a systematic analysis of the global burden of disease study 2021. Lancet Rheumatol 5:e594\u2013e610. https:\/\/doi.org\/10.1016\/s2665-9913(23)00211-4","journal-title":"Lancet Rheumatol"},{"key":"5897_CR2","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3899\/jrheum.2023-0334","volume":"51","author":"LJ O\u2019Neil","year":"2024","unstructured":"O\u2019Neil LJ, Alp\u00edzar-Rodr\u00edguez D, Deane KD (2024) Rheumatoid arthritis: the continuum of disease and strategies for prediction, early intervention, and prevention. J Rheumatol 51:337\u2013349. https:\/\/doi.org\/10.3899\/jrheum.2023-0334","journal-title":"J Rheumatol"},{"issue":"e001707","key":"5897_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/rmdopen-2021-001707","volume":"7","author":"AA K\u00fc\u00e7\u00fckdeveci","year":"2021","unstructured":"K\u00fc\u00e7\u00fckdeveci AA, Elhan AH, Erdo\u011fan BD et al (2021) Use and detailed metric properties of patient-reported outcome measures for rheumatoid arthritis: a systematic review covering two decades. RMD Open 7(e001707):1\u20139. https:\/\/doi.org\/10.1136\/rmdopen-2021-001707","journal-title":"RMD Open"},{"key":"5897_CR4","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1016\/j.jval.2011.12.014","volume":"15","author":"M Hern\u00e1ndez Alava","year":"2012","unstructured":"Hern\u00e1ndez Alava M, Wailoo AJ, Ara R (2012) Tails from the peak district: adjusted limited dependent variable mixture models of EQ-5D questionnaire health state utility values. Value Health 15:550\u2013561. https:\/\/doi.org\/10.1016\/j.jval.2011.12.014","journal-title":"Value Health"},{"key":"5897_CR5","doi-asserted-by":"publisher","first-page":"944","DOI":"10.1093\/rheumatology\/kes400","volume":"52","author":"M Hern\u00e1ndez Alava","year":"2013","unstructured":"Hern\u00e1ndez Alava M, Wailoo A, Wolfe F et al (2013) The relationship between EQ-5D, HAQ and pain in patients with rheumatoid arthritis. Rheumatology 52:944\u2013950. https:\/\/doi.org\/10.1093\/rheumatology\/kes400","journal-title":"Rheumatology"},{"issue":"20","key":"5897_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1477-7525-1-20","volume":"1","author":"B Bruce","year":"2003","unstructured":"Bruce B, Fries JF (2003) The stanford health assessment questionnaire: dimensions and practical applications. Health Qual Life Outcomes 1(20):1\u20136. https:\/\/doi.org\/10.1186\/1477-7525-1-20","journal-title":"Health Qual Life Outcomes"},{"key":"5897_CR7","first-page":"S77","volume":"23","author":"T Sokka","year":"2005","unstructured":"Sokka T (2005) Assessment of pain in rheumatic diseases. Clin Exp Rheumatol 23:S77\u2013S84","journal-title":"Clin Exp Rheumatol"},{"key":"5897_CR8","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1002\/1529-0131(200002)43:2<386::AID-ANR19>3.0.CO;2-Z","volume":"43","author":"T Sokka","year":"2000","unstructured":"Sokka T, Kankainen A, Hannonen P (2000) Scores for functional disability in patients with rheumatoid arthritis are correlated at higher levels with pain scores than with radiographic scores. Arthritis Rheum 43:386\u2013389","journal-title":"Arthritis Rheum"},{"key":"5897_CR9","first-page":"1837","volume":"34","author":"SM Verstappen","year":"2007","unstructured":"Verstappen SM, Jacobs JW, Huisman AM et al (2007) Functional health assessment questionnaire (HAQ) and psychological HAQ are associated with and predicted by different factors in rheumatoid arthritis. J Rheumatol 34:1837\u20131840","journal-title":"J Rheumatol"},{"issue":"35","key":"5897_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta20350","volume":"20","author":"M Stevenson","year":"2016","unstructured":"Stevenson M, Archer R, Tosh J et al (2016) Adalimumab, etanercept, infliximab, certolizumab pegol, golimumab, tocilizumab and abatacept for the treatment of rheumatoid arthritis not previously treated with disease-modifying antirheumatic drugs and after the failure of conventional disease-modifying antirheumatic drugs only: systematic review and economic evaluation. Health Technol Assess 20(35):1\u2013610. https:\/\/doi.org\/10.3310\/hta20350","journal-title":"Health Technol Assess"},{"issue":"18","key":"5897_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2474-3-18","volume":"3","author":"P Sarzi-Puttini","year":"2002","unstructured":"Sarzi-Puttini P, Fiorini T, Panni B et al (2002) Correlation of the score for subjective pain with physical disability, clinical and radiographic scores in recent onset rheumatoid arthritis. BMC Musculoskelet Disord 3(18):1\u20134. https:\/\/doi.org\/10.1186\/1471-2474-3-18","journal-title":"BMC Musculoskelet Disord"},{"key":"5897_CR12","doi-asserted-by":"publisher","first-page":"1027","DOI":"10.1007\/s10067-022-06432-4","volume":"42","author":"I Yoshii","year":"2023","unstructured":"Yoshii I, Sawada N, Chijiwa T (2023) Associations between clinical metrics of joint deformity, disease duration, disease activity, functional capacity, quality of life, pain, and fatigue in patients with rheumatoid arthritis. Clin Rheumatol 42:1027\u20131038. https:\/\/doi.org\/10.1007\/s10067-022-06432-4","journal-title":"Clin Rheumatol"},{"issue":"34","key":"5897_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta24340","volume":"24","author":"M Hern\u00e1ndez Alava","year":"2020","unstructured":"Hern\u00e1ndez Alava M, Wailoo A, Pudney S et al (2020) Mapping clinical outcomes to generic preference-based outcome measures: development and comparison of methods. Health Technol Assess 24(34):1\u201368. https:\/\/doi.org\/10.3310\/hta24340","journal-title":"Health Technol Assess"},{"key":"5897_CR14","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.jval.2016.11.006","volume":"20","author":"AJ Wailoo","year":"2017","unstructured":"Wailoo AJ, Hernandez-Alava M, Manca A et al (2017) Mapping to estimate health-state utility from non-preference-based outcome measures: an ISPOR good practices for outcomes research task force report. Value Health 20:18\u201327. https:\/\/doi.org\/10.1016\/j.jval.2016.11.006","journal-title":"Value Health"},{"key":"5897_CR15","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1016\/j.jval.2017.09.017","volume":"21","author":"LA Gray","year":"2018","unstructured":"Gray LA, Hernandez Alava M, Wailoo AJ (2018) Development of methods for the mapping of utilities using mixture models: mapping the AQLQ-S to the EQ-5D-5L and the HUI3 in patients with asthma. Value Health 21:748\u2013757. https:\/\/doi.org\/10.1016\/j.jval.2017.09.017","journal-title":"Value Health"},{"key":"5897_CR16","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1177\/1536867X1801800105","volume":"18","author":"LA Gray","year":"2018","unstructured":"Gray LA, Alava MH (2018) A command for fitting mixture regression models for bounded dependent variables using the beta distribution. Stand Genomic Sci 18:51\u201375. https:\/\/doi.org\/10.1177\/1536867X1801800105","journal-title":"Stand Genomic Sci"},{"key":"5897_CR17","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1007\/s40273-015-0312-9","volume":"33","author":"S Petrou","year":"2015","unstructured":"Petrou S, Rivero-Arias O, Dakin H et al (2015) The MAPS reporting statement for studies mapping onto generic preference-based outcome measures: explanation and elaboration. Pharmacoeconomics 33:993\u20131011. https:\/\/doi.org\/10.1007\/s40273-015-0312-9","journal-title":"Pharmacoeconomics"},{"key":"5897_CR18","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1016\/s0140-6736(20)32341-2","volume":"397","author":"F Humby","year":"2021","unstructured":"Humby F, Durez P, Buch MH et al (2021) Rituximab versus tocilizumab in anti-TNF inadequate responder patients with rheumatoid arthritis (R4RA): 16-week outcomes of a stratified, biopsy-driven, multicentre, open-label, phase 4 randomised controlled trial. Lancet 397:305\u2013317. https:\/\/doi.org\/10.1016\/s0140-6736(20)32341-2","journal-title":"Lancet"},{"key":"5897_CR19","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1136\/ard.2010.138461","volume":"62","author":"D Aletaha","year":"2010","unstructured":"Aletaha D, Neogi T, Silman AJ et al (2010) 2010 Rheumatoid arthritis classification criteria: an American college of rheumatology\/european league against rheumatism collaborative initiative. Arthritis Rheum 62:2569\u20132581. https:\/\/doi.org\/10.1136\/ard.2010.138461","journal-title":"Arthritis Rheum"},{"key":"5897_CR20","doi-asserted-by":"publisher","first-page":"1845","DOI":"10.1002\/1529-0131(199810)41:10<1845::AID-ART17>3.0.CO;2-K","volume":"41","author":"AM van Gestel","year":"1998","unstructured":"van Gestel AM, Haagsma CJ, van Riel PL (1998) Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum 41:1845\u20131850","journal-title":"Arthritis Rheum"},{"key":"5897_CR21","doi-asserted-by":"publisher","first-page":"R796","DOI":"10.1186\/ar1740","volume":"7","author":"D Aletaha","year":"2005","unstructured":"Aletaha D, Nell VP, Stamm T et al (2005) Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther 7:R796\u2013R806. https:\/\/doi.org\/10.1186\/ar1740","journal-title":"Arthritis Res Ther"},{"key":"5897_CR22","volume-title":"Statistics at square one","author":"T Swinscow","year":"1997","unstructured":"Swinscow T (1997) Statistics at square one, 9th edn. BMJ Publishing Group, London","edition":"9"},{"key":"5897_CR23","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1214\/aos\/1176344136","volume":"6","author":"G Schwarz","year":"1978","unstructured":"Schwarz G (1978) Estimating the dimension of a model. Ann Stat 6:461\u2013464","journal-title":"Ann Stat"},{"key":"5897_CR24","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1080\/10485252.2015.1010532","volume":"27","author":"Y Jung","year":"2015","unstructured":"Jung Y, Hu J (2015) A K-fold averaging cross-validation procedure. J Nonparametr Stat 27:167\u2013179. https:\/\/doi.org\/10.1080\/10485252.2015.1010532","journal-title":"J Nonparametr Stat"},{"key":"5897_CR25","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1002\/hec.985","volume":"14","author":"K Claxton","year":"2005","unstructured":"Claxton K, Sculpher M, McCabe C et al (2005) Probabilistic sensitivity analysis for NICE technology assessment: not an optional extra. Health Econ 14:339\u2013347. https:\/\/doi.org\/10.1002\/hec.985","journal-title":"Health Econ"},{"issue":"147","key":"5897_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13075-018-1645-5","volume":"20","author":"JC Sergeant","year":"2018","unstructured":"Sergeant JC, Hyrich KL, Anderson J et al (2018) Prediction of primary non-response to methotrexate therapy using demographic, clinical and psychosocial variables: results from the UK rheumatoid arthritis medication study (RAMS). Arthritis Res Ther 20(147):1\u201311. https:\/\/doi.org\/10.1186\/s13075-018-1645-5","journal-title":"Arthritis Res Ther"},{"key":"5897_CR27","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1007\/s00296-024-05553-0","volume":"44","author":"LH Lindgren","year":"2024","unstructured":"Lindgren LH, Thurah A, Thomsen T et al (2024) Sociodemographic and clinical variables associated with negative illness perception in patients newly diagnosed with rheumatoid arthritis, axial spondyloarthritis, or psoriatic arthritis-a survey based cross-sectional study. Rheumatol Int 44:1119\u20131131. https:\/\/doi.org\/10.1007\/s00296-024-05553-0","journal-title":"Rheumatol Int"},{"key":"5897_CR28","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1007\/s00296-023-05383-6","volume":"43","author":"I Suardi","year":"2023","unstructured":"Suardi I, Posio C, Luconi E et al (2023) Disease activity and disease-related factors are drivers of patient global assessment in rheumatoid arthritis: a real-life cross-sectional study. Rheumatol Int 43:1885\u20131895. https:\/\/doi.org\/10.1007\/s00296-023-05383-6","journal-title":"Rheumatol Int"},{"key":"5897_CR29","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1007\/s00296-021-05070-4","volume":"42","author":"M Wilk","year":"2022","unstructured":"Wilk M, \u0141osi\u0144ska K, Pripp AH et al (2022) Pain catastrophizing in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis: biopsychosocial perspective and impact on health-related quality of life. Rheumatol Int 42:669\u2013682. https:\/\/doi.org\/10.1007\/s00296-021-05070-4","journal-title":"Rheumatol Int"},{"key":"5897_CR30","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1007\/s00296-024-05583-8","volume":"44","author":"M Wilk","year":"2024","unstructured":"Wilk M, Zimba O, Haugeberg G et al (2024) Pain catastrophizing in rheumatic diseases: prevalence, origin, and implications. Rheumatol Int 44:985\u20131002. https:\/\/doi.org\/10.1007\/s00296-024-05583-8","journal-title":"Rheumatol Int"},{"key":"5897_CR31","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1016\/j.jval.2012.10.010","volume":"16","author":"L Longworth","year":"2013","unstructured":"Longworth L, Rowen D (2013) Mapping to obtain EQ-5D utility values for use in NICE health technology assessments. Value Health 16:202\u2013210. https:\/\/doi.org\/10.1016\/j.jval.2012.10.010","journal-title":"Value Health"},{"key":"5897_CR32","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780198526629.001.0001","volume-title":"Decision modelling for health economic evaluation","author":"A Briggs","year":"2006","unstructured":"Briggs A, Claxton K, Sculpher M (2006) Decision modelling for health economic evaluation. Oxford University Press, Oxford"},{"key":"5897_CR33","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/s40744-015-0020-0","volume":"2","author":"J Madan","year":"2015","unstructured":"Madan J, Ades T, Barton P et al (2015) Consensus decision models for biologics in rheumatoid and psoriatic arthritis: recommendations of a multidisciplinary working party. Rheumatol Ther 2:113\u2013125. https:\/\/doi.org\/10.1007\/s40744-015-0020-0","journal-title":"Rheumatol Ther"},{"key":"5897_CR34","doi-asserted-by":"publisher","first-page":"1727","DOI":"10.1007\/s11136-011-9903-x","volume":"20","author":"M Herdman","year":"2011","unstructured":"Herdman M, Gudex C, Lloyd A et al (2011) Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 20:1727\u20131736. https:\/\/doi.org\/10.1007\/s11136-011-9903-x","journal-title":"Qual Life Res"},{"key":"5897_CR35","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/0168-8510(90)90421-9","volume":"16","author":"EuroQol Group","year":"1990","unstructured":"EuroQol Group (1990) EuroQol\u2013a new facility for the measurement of health-related quality of life. Health Policy 16:199\u2013208. https:\/\/doi.org\/10.1016\/0168-8510(90)90421-9","journal-title":"Health Policy"},{"issue":"324","key":"5897_CR36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1745-6215-14-324","volume":"14","author":"JJ Kirkham","year":"2013","unstructured":"Kirkham JJ, Boers M, Tugwell P, Clarke M, Williamson PR (2013) Outcome measures in rheumatoid arthritis randomised trials over the last 50 years. Trials 14(324):1\u20138. https:\/\/doi.org\/10.1186\/1745-6215-14-324","journal-title":"Trials"},{"key":"5897_CR37","doi-asserted-by":"publisher","first-page":"1164","DOI":"10.3899\/jrheum.181076","volume":"46","author":"MA Lopez-Olivo","year":"2019","unstructured":"Lopez-Olivo MA, Negr\u00f3n JB, Zogala RJ et al (2019) Core outcome sets specifically for longterm observational studies: OMERACT special interest group update in rheumatoid arthritis. J Rheumatol 46:1164\u20131167. https:\/\/doi.org\/10.3899\/jrheum.181076","journal-title":"J Rheumatol"}],"container-title":["Rheumatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-025-05897-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00296-025-05897-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-025-05897-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T19:28:12Z","timestamp":1757186892000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00296-025-05897-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,14]]},"references-count":37,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["5897"],"URL":"https:\/\/doi.org\/10.1007\/s00296-025-05897-1","relation":{},"ISSN":["1437-160X"],"issn-type":[{"value":"1437-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,14]]},"assertion":[{"value":"10 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"SPG, SC, FR, ZI, MS, KP, and DP declare no conflicts of interest. AB reports receiving grant funding from Pfizer and BMS, and speaker fees from Galapagos. CP reports receiving honoraria and\/or research & development grants from: AbbVie, AnaptysBio, BMS, Janssen\/J&J, Kiniksa, Novartis, Pfizer, Sanofi, Roche, and UCB.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All individuals in the R4RA trial dataset and the RAMS external validation dataset provided written informed consent to participate. Ethical approval for the R4RA trial was attained by the institutional review board of each study centre or relevant independent ethics committee (UK Medical Research and Ethics Committee, reference no. 12\/WA\/0307). Ethical approval for the RAMS study was attained by the Central Manchester NHS Research Ethics Committee (reference 08\/H1008\/25).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"154"}}