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Anstalt \u00f6ffentlichen Rechts"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Rheumatol"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heterogeneity in inflammatory arthritis (IA) outcomes limits the effectiveness of non-individualized treatment approaches, and digital health platforms can capture psychosocial and behavioral signals that may stratify responses beyond diagnosis or baseline severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify clinically interpretable patient clusters and evaluate their associations with 12-week outcomes in IA, testing whether cluster membership adds information beyond demographics, diagnosis, and baseline symptom burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed the use of a CE-certified rheumatology application among adult patients. Baseline clinical and psychosocial variables (Patient\u2019s Global Assessment of Disease Activity (PGADA) and Patient\u2019s Global Assessment of Pain Intensity, sleep quality, social support, distress, fatigue, activity, diet\/fasting) were winsorized (1st\/99th), z-scaled, and imputed by median\/mode for features only; outcomes were complete-case. Unsupervised k-means (k\u2009=\u20095) was selected based on silhouette, gap, and consensus diagnostics. The primary validation outcome was remission (12-week PGADA\u2009\u2264\u200920\u00a0mm for patients with baseline PGADA\u2009\u2265\u200940\u00a0mm), with distributional changes in PGADA and percentage change as secondary endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2,924 patients, five clusters were identified (size range 17.7\u201322.9% of the cohort). The 12-week remission rate was 7.0%, with the \"resilience\" profile (characterized by better sleep, stronger social support, and lower distress) showing the highest probability of remission and the most favourable PGADA distribution. In contrast, distress-dominant clusters (characterized by poor sleep and weak support) showed the lowest remission rates and minimal improvement. The median \u0394PGADA% was 8.3% (IQR\u2009\u2212\u20098.2% to 32.0%). In adjusted analyses, the cluster signal persisted beyond baseline severity; percentage-change estimates were attenuated for clusters with lower baseline PGADA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Cluster-level phenotypes derived from routinely collected app data align with short-term clinical outcomes, highlighting sleep, social support, and distress as modifiable factors that may influence short-term outcomes. Programs should emphasize the quality of activity and recovery (not just volume), particularly for patients with high distress and poor sleep. Future work should evaluate cluster-informed, multicomponent interventions in prospective studies.\n                      <jats:table-wrap>\n                        <jats:table>\n                          <jats:tbody>\n                            <jats:tr>\n                              <jats:td colspan=\"2\">\n                                <jats:bold>Key Points<\/jats:bold>\n                                \u2022\n                                <jats:italic>Clinical\u2013psychosocial archetypes derived from routinely collected app data (symptoms, sleep, social support, distress, lifestyle) were strongly associated with 12-week remission and PGADA change, beyond diagnosis and baseline severity.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Distress-dominant archetypes with poor sleep and weak social support had the lowest remission rates and minimal improvement, indicating that unaddressed psychological burden and sleep problems can blunt the benefits of otherwise appropriate pharmacological care.<\/jats:italic>\n                                \u2022\n                                <jats:italic>Resilient archetypes, with better sleep, stronger social support, lower distress, and healthier lifestyle patterns, showed the most favourable outcomes, supporting a stratified care model in which digital tools help identify high-risk patients and prioritise targeted behavioral, psychosocial, and recovery-focused interventions rather than simply prescribing more physical activity.<\/jats:italic>\n                              <\/jats:td>\n                            <\/jats:tr>\n                          <\/jats:tbody>\n                        <\/jats:table>\n                      <\/jats:table-wrap>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10067-026-08186-9","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T14:34:33Z","timestamp":1779978873000},"page":"3943-3955","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical\u2013psychosocial archetypes predict short-term outcomes in inflammatory arthritis: an unsupervised segmentation study"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7965-9438","authenticated-orcid":false,"given":"Dmytro","family":"Fedkov","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4166-6397","authenticated-orcid":false,"given":"Danylo","family":"Yevstifeiev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2095-5819","authenticated-orcid":false,"given":"Oleg","family":"Iaremenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9562-9367","authenticated-orcid":false,"given":"Daria","family":"Koliadenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8330-8681","authenticated-orcid":false,"given":"Liubov","family":"Petelytska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6500-7180","authenticated-orcid":false,"given":"Christine","family":"Peine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6102-2674","authenticated-orcid":false,"given":"Felix","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9969-5462","authenticated-orcid":false,"given":"Abdullah","family":"Khalil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9372-1736","authenticated-orcid":false,"given":"T\u00fcrker","family":"Kurt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5725-5483","authenticated-orcid":false,"given":"Stefan","family":"Vordenb\u00e4umen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"8186_CR1","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1038\/s41584-020-0491-4","volume":"16","author":"C Pitzalis","year":"2020","unstructured":"Pitzalis C, Choy EHS, Buch MH (2020) Transforming clinical trials in rheumatology: towards patient-centric precision medicine. 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Nat Rev Rheumatol 16:525\u2013535. https:\/\/doi.org\/10.1038\/s41584-020-0461-x","journal-title":"Nat Rev Rheumatol"}],"container-title":["Clinical Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-026-08186-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10067-026-08186-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10067-026-08186-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:27:51Z","timestamp":1783398471000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10067-026-08186-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,28]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["8186"],"URL":"https:\/\/doi.org\/10.1007\/s10067-026-08186-9","relation":{},"ISSN":["0770-3198","1434-9949"],"issn-type":[{"value":"0770-3198","type":"print"},{"value":"1434-9949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,28]]},"assertion":[{"value":"6 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 April 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 May 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted following the ethical principles of the Declaration of Helsinki and Good Clinical Practice guidelines and was approved by the appropriate institutional review boards (Local Ethic Committee of Medical Center Medical Clinic Blagomed LLC), protocol #107\/5, dated 13 Aug 2022). Authors fulfilled the ICMJE authorship criteria.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Digital informed consent was obtained from all patients before the study started.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"We utilized a large language model\u2013based assistant (ChatGPT, OpenAI) solely for language polishing and drafting non-substantive text (e.g., wording of figure legends, responses to reviewers). No AI tool was credited as an author. All AI-suggested text was critically reviewed, revised, and approved by the authors, who take full responsibility for the final manuscript. No patient-level identifiable data were provided to AI tools. Statistical analyses and figures were generated using Python 3.10 (scikit-learn, pandas, matplotlib); AI tools were not used to perform statistical estimation.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"AI-assisted tools disclosure"}},{"value":"NA.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Prior presentation and abstract publication"}},{"value":"DF, FL, AK, and CP are employees and have an equity interest in Midaia GmbH and have no other disclosures to make. Midaia GmbH developed a mobile application used in this study, but did not finance it. DY, DK, LP, OI, TK, SV declare that they have no conflict of interest.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}