{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T16:19:20Z","timestamp":1723565960771},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T00:00:00Z","timestamp":1595289600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T00:00:00Z","timestamp":1595289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Z Rheumatol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n<jats:sec>\n<jats:title>Hintergrund<\/jats:title>\n<jats:p>Der oft langsame Beginn einer axialen Spondyloarthritis (axSpA), die initial zum Teil wenig spezifischen Symptome (R\u00fcckenschmerzen), aber auch begrenzte Ressourcen und die damit verbundenen Verz\u00f6gerungen in der rheumatologischen Versorgung sind Faktoren, die zu versp\u00e4teter Diagnose und Therapie dieser meist jungen Patienten mit beitragen. Rheumatologische Fachassistenten (RFA) k\u00f6nnen zur Verbesserung der Versorgung beitragen, indem sie vom Rheumatologen delegierte \u00e4rztliche Leistungen \u00fcbernehmen.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Ziel der Arbeit<\/jats:title>\n<jats:p>Ziel ist, zu untersuchen, ob geschulte RFA bei Patienten mit chronischem R\u00fcckenschmerz und noch unklarer Diagnose mithilfe eines strukturierten Fragebogens anamnestische und klinische Befunde wie Rheumatologen erheben k\u00f6nnen.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Material und Methoden<\/jats:title>\n<jats:p>In der multizentrisch durchgef\u00fchrten PredAS-Studie wurden bei Patienten mit dem Leitsymptom chronischer R\u00fcckenschmerz demografische Basisdaten, Anamnese und patientenberichtete Endpunkte mittels strukturierter Frageb\u00f6gen von RFA und Rheumatologen unabh\u00e4ngig voneinander erfasst. Zudem wurden Funktion (BASFI) und Wirbels\u00e4ulenbeweglichkeit (BASMI) standardisiert gemessen. Um die m\u00f6gliche Erleichterung durch Nutzung digitaler Medien zu testen, wurden 2\u00a0Patientengruppen getrennt untersucht: Die Ergebnisse der einen Kohorte wurden mittels papierbasierter Case Report Forms (CRF) und die Ergebnisse der anderen elektronisch mittels iPad dokumentiert. Die Konkordanz der Dokumentationen zwischen RFA und Rheumatologen wurde als Kappa-Koeffizient, als prozentuale \u00dcbereinstimmung und auf individueller Patientenebene berechnet.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Ergebnisse<\/jats:title>\n<jats:p>Bei fast drei Viertel der 141 Patienten mit chronischen R\u00fcckenschmerzen wurden Charakteristika des entz\u00fcndlichen R\u00fcckenschmerzes identifiziert. Die Konkordanz bei Dokumentation durch RFA und Arzt war bei den anamnestischen Angaben zum R\u00fcckenschmerz h\u00f6her als bei der Angabe zur Lokalisation des R\u00fcckenschmerzes. Bei der Erhebung des BASMI zeigte sich kein Unterschied zwischen RFA und Arzt (ICC 0,925) (95\u202f%-CI 0,879\u20130,953). Der Zeitaufwand f\u00fcr die strukturierte Dokumentation betrug beim Arzt 20\u202f\u00b1\u20096,7\u202fmin und bei der RFA 28,5\u202f\u00b1\u200913\u202fmin.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Diskussion<\/jats:title>\n<jats:p>Die Ergebnisse sprechen daf\u00fcr, dass geschulte RFA die Rheumatologen bei der anamnestischen Aufarbeitung und ersten k\u00f6rperlichen Untersuchung im Rahmen der Diagnosestellung erheblich und qualifiziert unterst\u00fctzen k\u00f6nnen.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00393-020-00838-8","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T13:04:59Z","timestamp":1595336699000},"page":"729-736","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Ist eine Delegation \u00e4rztlicher Leistungen auf rheumatologische Fachassistenten bei der Evaluierung von Patienten mit Verdacht auf ankylosierende Spondylitis m\u00f6glich? \u2013 Ergebnisse der PredAS-Studie"],"prefix":"10.1007","volume":"79","author":[{"given":"U.","family":"Kiltz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Spiller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Sieper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Braun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,21]]},"reference":[{"issue":"12","key":"838_CR1","doi-asserted-by":"publisher","first-page":"1664","DOI":"10.1002\/acr.22643","volume":"67","author":"DH Solomon","year":"2015","unstructured":"Solomon\u00a0DH, Fraenkel\u00a0L, Lu\u00a0B, Brown\u00a0E, Tsao\u00a0P, Losina\u00a0E et\u00a0al (2015) Comparison of care provided in practices with nurse practitioners and physician assistants versus subspecialist physicians only: a cohort study of rheumatoid arthritis. 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AbbVie war an der Erstellung und \u00dcberpr\u00fcfung des Manuskripts beteiligt. U.\u00a0Kiltz, J.\u00a0Sieper und J.\u00a0Braun geben an, Referenten- oder Beratungsgeb\u00fchren von AbbVie erhalten zu haben. I.\u00a0Spiller gibt an, dass kein Interessenkonflikt besteht.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"Alle beschriebenen Untersuchungen am Menschen oder an menschlichem Gewebe wurden mit Zustimmung der zust\u00e4ndigen Ethikkommission, im Einklang mit nationalem Recht sowie gem\u00e4\u00df der Deklaration von Helsinki von 1975 (in der aktuellen, \u00fcberarbeiteten Fassung) durchgef\u00fchrt. Von allen beteiligten Patienten liegt eine Einverst\u00e4ndniserkl\u00e4rung vor.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}