{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:30:58Z","timestamp":1760189458702,"version":"3.44.0"},"reference-count":23,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2015,10,22]]},"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To investigate whether patients with ankylosing spondylitis (AS) adapt to their disease, using the \u2018then-test\u2019.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from patients participating in the AS Study for Evaluation of Recombinant Infliximab Therapy (ASSERT) and continuing in the European AS Infliximab Cohort (EASIC) were used. At 5 assessments in EASIC, patients were asked to rerate their global well-being before the start of infliximab in ASSERT. The patients evaluated their past situation by using a \u2018then-test\u2019 (\u2018retrospective patient global\u2019). Initial and retrospective patient global were compared using a paired t test, and mixed linear models investigated whether the retrospective score of well-being was stable at all follow-up assessments in EASIC. Linear regression analysis explored whether treatment response was associated with the difference between the initial and retrospective score (\u2018gap\u2019) while adjusting for possible confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>86 patients (mean age 39.8\u2005years (SD=10.4), mean disease duration 10.8\u2005years (SD=8.5)) contributed to the current analyses. At the time of starting infliximab, patients judged their global at 7.0 (SD=1.6), and with the \u2018then-test\u2019 at 7.2 (SD=2.3) (p=0.45). Time elapsed did not influence the \u2018then-test\u2019 (p=0.13). Multivariably, the gap was irrespective of treatment response, but associated with initial patient global (p&lt;0.01) and initial Bath AS Disease Activity Index (p=0.02).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with AS accurately judged their global well-being before starting treatment with tumour necrosis factor inhibition, even though substantial time had elapsed. The difference between initial and retrospective judgment was irrespective of treatment response. In this setting, the \u2018then-test\u2019 could not prove adaptation in AS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>NCT01286545.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2015-000164","type":"journal-article","created":{"date-parts":[[2015,11,17]],"date-time":"2015-11-17T21:59:07Z","timestamp":1447797547000},"page":"e000164","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Do patients with ankylosing spondylitis adapt to their disease? Evidence from a \u2018then-test\u2019 in patients treated with TNF inhibitors"],"prefix":"10.1136","volume":"1","author":[{"given":"Ivette","family":"Essers","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands"},{"name":"School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrid","family":"van Tubergen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands"},{"name":"School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Heldmann","sequence":"additional","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-9362","authenticated-orcid":false,"given":"Xenofon","family":"Baraliakos","sequence":"additional","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrgen","family":"Braun","sequence":"additional","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uta","family":"Kiltz","sequence":"additional","affiliation":[{"name":"Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annelies","family":"Boonen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands"},{"name":"School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,11,17]]},"reference":[{"issue":"(Suppl)","key":"2025090313095156000_1.1.e000164.1","first-page":"S244","article-title":"Fake good test-taking attitude in ankylosing spondylitis (abstr)","volume":"35","author":"Hidding","year":"1992","journal-title":"Arthritis Rheum"},{"key":"2025090313095156000_1.1.e000164.2","first-page":"245","article-title":"Development and validation of the Psychological Adaptation Scale (PAS): use in six studies of adaptation to a health condition or risk","volume":"93","author":"Biesecker","year":"2013","journal-title":"Patient Educ Couns"},{"key":"2025090313095156000_1.1.e000164.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2004.03.001"},{"key":"2025090313095156000_1.1.e000164.4","first-page":"818","article-title":"Comparison between self-report measures and clinical observations of functional disability in ankylosing spondylitis, rheumatoid arthritis and fibromyalgia","volume":"21","author":"Hidding","year":"1994","journal-title":"J Rheumatol"},{"key":"2025090313095156000_1.1.e000164.5","doi-asserted-by":"publisher","DOI":"10.1023\/A:1023211129926"},{"key":"2025090313095156000_1.1.e000164.6","doi-asserted-by":"publisher","DOI":"10.1186\/ar4144"},{"key":"2025090313095156000_1.1.e000164.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.20852"},{"key":"2025090313095156000_1.1.e000164.8","first-page":"672","article-title":"The European ankylosing spondylitis infliximab cohort (EASIC): a European multicentre study of long term outcomes in patients with ankylosing spondylitis treated with infliximab","volume":"29","author":"Heldmann","year":"2011","journal-title":"Clin Exp Rheumatol"},{"key":"2025090313095156000_1.1.e000164.9","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2004.020503"},{"key":"2025090313095156000_1.1.e000164.10","first-page":"2286","article-title":"A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index","volume":"21","author":"Garrett","year":"1994","journal-title":"J Rheumatol"},{"key":"2025090313095156000_1.1.e000164.11","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.094870"},{"key":"2025090313095156000_1.1.e000164.12","first-page":"2281","article-title":"A new approach to defining functional ability in ankylosing spondylitis: the development of the Bath Ankylosing Spondylitis Functional Index","volume":"21","author":"Calin","year":"1994","journal-title":"J Rheumatol"},{"key":"2025090313095156000_1.1.e000164.13","first-page":"1694","article-title":"Defining spinal mobility in ankylosing spondylitis (AS). 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