{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:03:18Z","timestamp":1789434198299,"version":"build-2803163510"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":81,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Rheumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Systemic Lupus Erythematosus (SLE) is a severe autoimmune disorder that impacts multiple organ systems, with African American (AA) adults having worse outcomes and poor prognoses compared to other ethnic groups. Ineffective patient\u2013provider communication and inadequate screening for modifiable risk factors contribute to poorer SLE outcomes and ongoing health disparities. This scoping review evaluated the influence of patient\u2013provider communication among adults with SLE, with particular attention to implications for African American populations, to inform the development of strategies to mitigate SLE health disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An electronic search was conducted using PubMed, CINAHL, Embase and PsycINFO databases to systematically identify published literature between 2012 and mid-2025. Studies were eligible (1) if participants included African American adults (over 18 years old) with a diagnosis of SLE or included a sample with \u2265\u200950% African American representation, (2) were published in the English language, (3) reported databased original research results, and (4) reported findings related to patient-provider communication, a communication tool, or a communication strategy either independently or in conjunction with health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Search results yielded\n                      <jats:bold>214<\/jats:bold>\n                      articles. After an in-depth screening process using the PRISMA method,\n                      <jats:bold>20<\/jats:bold>\n                      articles met both inclusion and exclusion criteria: seven qualitative, six quantitative, and seven mixed methods. Two studies enrolled exclusively African American participants. A central theme was the importance of embedding effective communication strategies into evidence-based decision aids for individuals with SLE. Additional priorities included identifying key facilitators of communication, such as family involvement, slower speech, and empathy, followed by the need to validate patient-reported outcome measures that support better information exchange. Nevertheless, none of the studies examined targeted communication tools aimed at reducing modifiable risk factors or improving health outcomes among African Americans with SLE, indicating a critical gap warranting further investigation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Research on effective patient-provider communication with African American adults living with SLE is limited and lacks evaluation of specific communication strategies. Findings demonstrated that effective communication, marked by trust, clarity, and adequate appointment duration positively influence the clinical experiences of African American adults with SLE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41927-026-00665-5","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T14:26:37Z","timestamp":1782483997000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing and improving communication strategies among healthcare providers and African American individuals with systemic lupus: a scoping review"],"prefix":"10.1186","volume":"10","author":[{"given":"Mia L.","family":"Barron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin M.","family":"Dawson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia F.","family":"Corbett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Wirth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith M.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"665_CR1","doi-asserted-by":"publisher","unstructured":"Drenkard C, Bao G, Lewis TT, Pobiner B, Priest J, Lim SS. Physician-patient interactions in African American patients with systemic lupus erythematosus: demographic characteristics and relationship with disease activity and depression. Semin Arthritis Rheum. 2019;48(4):669-677. https:\/\/doi.org\/10.1016\/j.semarthrit.2018.05.012.","DOI":"10.1016\/j.semarthrit.2018.05.012"},{"key":"665_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13075-018-1760-3","volume":"20","author":"L Song","year":"2018","unstructured":"Song L, Wang Y, Zhang J, Song N, Xu X, Lu Y. The risks of cancer development in systemic lupus erythematosus (SLE) patients: a systematic review and meta-analysis. Arthritis Res therapy. 2018;20:1\u20133. https:\/\/doi.org\/10.1186\/s13075-018-1760-3.","journal-title":"Arthritis Res therapy"},{"issue":"7","key":"665_CR3","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.3899\/jrheum.200682","volume":"48","author":"K Sun","year":"2021","unstructured":"Sun K, Eudy AM, Criscione-Schreiber LG, Sadun RE, Rogers JL, Doss J, Corneli AL, Bosworth HB, Clowse ME. Racial differences in patient-provider communication, patient self-efficacy, and their associations with systemic lupus erythematosus\u2013related damage: A cross-sectional survey. J Rhuematol. 2021;48(7):1022\u20138. https:\/\/doi.org\/10.3899\/jrheum.200682.","journal-title":"J Rhuematol"},{"issue":"2","key":"665_CR4","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.pec.2020.12.025","volume":"104","author":"SJ White","year":"2021","unstructured":"White SJ, Barello S, di San Marco EC, Colombo C, Eeckman E, Gilligan C, Graffigna G, Jirasevijinda T, Mosconi P, Mullan J, Rehman SU. Critical observations on and suggested ways forward for healthcare communication during COVID-19: PEACH position paper. Patient Educ Couns. 2021;104(2):217\u201322. https:\/\/doi.org\/10.1016\/j.pec.2020.12.025.","journal-title":"Patient Educ Couns"},{"issue":"12","key":"665_CR5","doi-asserted-by":"publisher","first-page":"1198","DOI":"10.1200\/JOP.2016.013334","volume":"12","author":"RL Street Jr","year":"2016","unstructured":"Street RL Jr, Mazor KM, Arora NK. Assessing patient-centered communication in cancer care: measures for surveillance of communication outcomes. J Oncol Pract. 2016;12(12):1198. https:\/\/doi.org\/10.1200\/JOP.2016.013334.","journal-title":"J Oncol Pract"},{"issue":"11","key":"665_CR6","doi-asserted-by":"publisher","first-page":"e2025349","DOI":"10.1001\/jamanetworkopen.2020.25349","volume":"3","author":"A Schoenthaler","year":"2020","unstructured":"Schoenthaler A, Ravenell J. Understanding the patient experience through the lenses of racial\/ethnic and gender patient-physician concordance. JAMA Netw open. 2020;3(11):e2025349. https:\/\/doi.org\/10.1001\/jamanetworkopen.2020.25349.","journal-title":"JAMA Netw open"},{"key":"665_CR7","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1007\/s11606-012-2298-8","volume":"28","author":"S Saha","year":"2013","unstructured":"Saha S, Korthuis PT, Cohn JA, Sharp VL, Moore RD, Beach MC. Primary care provider cultural competence and racial disparities in HIV care and outcomes. J Gen Intern Med. 2013;28:622\u20139. https:\/\/doi.org\/10.1007\/s11606-012-2298-8.","journal-title":"J Gen Intern Med"},{"issue":"2","key":"665_CR8","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.pec.2014.05.013","volume":"96","author":"C Haywood Jr","year":"2014","unstructured":"Haywood C Jr, Bediako S, Lanzkron S, Diener-West M, Strouse J, Haythornthwaite J, Onojobi G, Beach MC, Import Investigators. An unequal burden: Poor patient\u2013provider communication and sickle cell disease. Patient Educ Couns. 2014;96(2):159\u201364. https:\/\/doi.org\/10.1016\/j.pec.2014.05.013.","journal-title":"Patient Educ Couns"},{"key":"665_CR9","doi-asserted-by":"crossref","unstructured":"Advani P, Moreno-Aspitia A. Current strategies for the prevention of breast cancer. Breast Cancer (Dove Med Press). 2014;6:59-71. https:\/\/www.tandfonline.com\/doi\/full\/10.2147\/BCTT.S39114#d1e121.","DOI":"10.2147\/BCTT.S39114"},{"key":"665_CR10","unstructured":"Lupus Foundation of America. Lupus facts and statistics (n.d.-b). https:\/\/www.lupus.org\/resources\/lupus-facts-and-statistics\u00a0"},{"key":"665_CR11","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-018-4016-2","author":"S Georgopoulou","year":"2018","unstructured":"Georgopoulou S, Prothero L, D\u2019Cruz DP. Physician\u2013patient communication in rheumatology: a systematic review. Rheumatol Int. 2018. https:\/\/doi.org\/10.1007\/s00296-018-4016-2. 38:763\u2009\u2013\u200975.","journal-title":"Rheumatol Int"},{"key":"665_CR12","doi-asserted-by":"publisher","unstructured":"Hadie SN. ABC of a scoping review: a simplified JBI scoping review guideline. Educ Med J. 2024;16(2). https:\/\/doi.org\/10.21315\/eimj2024.16.2.14.","DOI":"10.21315\/eimj2024.16.2.14"},{"issue":"6","key":"665_CR13","doi-asserted-by":"publisher","first-page":"1422","DOI":"10.1002\/art.39601","volume":"68","author":"M Jolly","year":"2016","unstructured":"Jolly M, Kosinski M, Garris CP, Oglesby AK. Prospective validation of the Lupus Impact Tracker: a patient-completed tool for clinical practice to evaluate the impact of systemic lupus erythematosus. Arthritis Rheumatol. 2016;68(6):1422\u201331. https:\/\/doi.org\/10.1002\/art.39601.","journal-title":"Arthritis Rheumatol"},{"key":"665_CR14","doi-asserted-by":"publisher","first-page":"2793","DOI":"10.1007\/s10067-019-04643-w","volume":"38","author":"H Qu","year":"2019","unstructured":"Qu H, Hu X, Singh JA. Factors influencing implementation of a computerized, individualized, culturally tailored lupus decision aid in lupus clinics: a qualitative semi-structured interview study. Clin Rheumatol. 2019;38:2793\u2013801. https:\/\/doi.org\/10.1007\/s10067-019-04643-w.","journal-title":"Clin Rheumatol"},{"key":"665_CR15","doi-asserted-by":"publisher","first-page":"e001580","DOI":"10.1136\/lupus-2025-001580","volume":"12","author":"SD Gilman","year":"2025","unstructured":"Gilman SD, Johnson S, Carpenter K, et al. Programme evaluation of Strategies to Embrace Living with Lupus Fearlessly (SELF): an evidence-based digital programme to build and improve lupus self-management skills. Lupus Sci Med. 2025;12:e001580. https:\/\/doi.org\/10.1136\/lupus-2025-001580.","journal-title":"Lupus Sci Med"},{"key":"665_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s43058-021-00118-9","volume":"2","author":"JA Singh","year":"2021","unstructured":"Singh JA, Hearld LR, Hall AG, Beasley TM. Implementing the DEcision-Aid for Lupus (IDEAL): study protocol of a multi-site implementation trial with observational, case study design: Implementing the DEcision-Aid for Lupus. Implement Sci Commun. 2021;2:1\u20133. https:\/\/doi.org\/10.1186\/s43058-021-00118-9.","journal-title":"Implement Sci Commun"},{"issue":"10","key":"665_CR17","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1177\/0961203318778372","volume":"27","author":"S Kasturi","year":"2018","unstructured":"Kasturi S, Burket JC, Berman JR, Kirou KA, Levine AB, Sammaritano LR, Mandl LA. Feasibility of Patient-Reported Outcomes Measurement Information System (PROMIS\u00ae) computerized adaptive tests in systemic lupus erythematosus outpatients. Lupus. 2018;27(10):1591\u20139. https:\/\/doi.org\/10.1177\/0961203318778372.","journal-title":"Lupus"},{"issue":"1","key":"665_CR18","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1002\/acr.24756","volume":"75","author":"LC Plantinga","year":"2023","unstructured":"Plantinga LC, Xu G, Hoge C, Vandenberg A, Dunlop-Thomas C, Jones BD, Johnson J, Drenkard C, Lim SS, Bowling CB, Comprehension. Utility, and Acceptability of a Multidomain Physical Functioning Report for Systemic Lupus Erythematosus Patients and Their Providers. Arthritis Care Res. 2023;75(1):180\u20139. https:\/\/doi.org\/10.1002\/acr.24756.","journal-title":"Arthritis Care Res"},{"key":"665_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13075-019-1942-7","volume":"21","author":"AA Twumasi","year":"2019","unstructured":"Twumasi AA, Shao A, Dunlop-Thomas C, Drenkard C, Cooper HL. Health service utilization among African American women living with systemic lupus erythematosus: perceived impacts of a self-management intervention. Arthritis Res therapy. 2019;21:1\u20131. https:\/\/doi.org\/10.1186\/s13075-019-1942-7.","journal-title":"Arthritis Res therapy"},{"issue":"14","key":"665_CR20","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1177\/0961203312458842","volume":"21","author":"C Drenkard","year":"2012","unstructured":"Drenkard C, Dunlop-Thomas C, Easley K, Bao G, Brady T, Lim SS. Benefits of a self-management program in low-income African-American women with systemic lupus erythematosus: results of a pilot test. Lupus. 2012;21(14):1586\u201393. https:\/\/doi.org\/10.1177\/0961203312458842.","journal-title":"Lupus"},{"issue":"1","key":"665_CR21","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1002\/acr.25030","volume":"75","author":"AC Barr","year":"2023","unstructured":"Barr AC, Clowse M, Maheswaranathan M, Eder L, Eudy AM, Criscione-Schreiber LG, Rogers JL, Sadun RE, Doss J, Sun K. Association of hurried communication and low patient self\u2010efficacy with persistent nonadherence to lupus medications. Arthritis Care Res. 2023;75(1):69\u201375. https:\/\/doi.org\/10.1002\/acr.25030.","journal-title":"Arthritis Care Res"},{"issue":"11","key":"665_CR22","doi-asserted-by":"publisher","first-page":"e022701","DOI":"10.1136\/bmjopen-2018-022701","volume":"8","author":"TD Faith","year":"2018","unstructured":"Faith TD, Flournoy-Floyd M, Ortiz K, Egede LE, Oates JC, Williams EM. My life with lupus: contextual responses of African American women with systemic lupus participating in a peer mentoring intervention to improve disease self-management. BMJ open. 2018;8(11):e022701. https:\/\/doi.org\/10.1136\/bmjopen-2018-022701.","journal-title":"BMJ open"},{"issue":"1","key":"665_CR23","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1177\/0961203312463979","volume":"22","author":"CH Feldman","year":"2013","unstructured":"Feldman CH, Bermas BL, Zibit M, Fraser P, Todd DJ, Fortin PR, Massarotti E, Costenbader KH. Designing an intervention for women with systemic lupus erythematosus from medically underserved areas to improve care: a qualitative study. Lupus. 2013;22(1):52\u201362. https:\/\/doi.org\/10.1177\/0961203312463979.","journal-title":"Lupus"},{"issue":"10","key":"665_CR24","doi-asserted-by":"publisher","first-page":"e2340688","DOI":"10.1001\/jamanetworkopen.2023.40688","volume":"6","author":"B Yalavarthi","year":"2023","unstructured":"Yalavarthi B, Summerville J, Farahani N, Xiao LZ, Yu C, Aboul-Hassan D, Rajgarhia S, Clauw DJ, Kahlenberg JM, DeJonckheere M, Bergmans RS. Recommendations for improving systemic lupus erythematosus care from black adults: a qualitative study. JAMA Netw Open. 2023;6(10):e2340688. https:\/\/jama.jamanetwork.com\/article.aspx?doi=10.1001\/jamanetworkopen. 2023.40688&utm_campaign=articlePDF%26utm_medium=articlePDFlink%26utm_source=articlePDF%26utm_content=jamanetworkopen.2023.40688.","journal-title":"JAMA Netw Open"},{"issue":"12","key":"665_CR25","doi-asserted-by":"publisher","first-page":"3622","DOI":"10.1093\/rheumatology\/keaa383","volume":"59","author":"E Chessa","year":"2020","unstructured":"Chessa E, Piga M, Floris A, Devilliers H, Cauli A, Arnaud L. Use of Physician Global Assessment in systemic lupus erythematosus: a systematic review of its psychometric properties. Rheumatology (Oxford). 2020;59(12):3622\u201332. https:\/\/doi.org\/10.1093\/rheumatology\/keaa383.","journal-title":"Rheumatology (Oxford)"},{"issue":"3","key":"665_CR26","first-page":"675","volume":"27","author":"C Neville","year":"2000","unstructured":"Neville C, Clarke AE, Joseph L, Belisle P, Ferland D, Fortin PR. Learning from discordance in patient and physician global assessments of systemic lupus erythematosus disease activity. J Rheumatol. 2000;27(3):675\u20139. PMID: 10743807.","journal-title":"J Rheumatol"},{"issue":"10","key":"665_CR27","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1177\/0961203313499958","volume":"22","author":"K Beusterien","year":"2013","unstructured":"Beusterien K, Bell JA, Grinspan J, Utset TO, Kan H, Narayanan S. Physician-patient interactions and outcomes in systemic lupus erythematosus (SLE): a conceptual model. Lupus. 2013;22(10):1038\u201345. https:\/\/doi.org\/10.1177\/0961203313499958.","journal-title":"Lupus"},{"issue":"6","key":"665_CR28","doi-asserted-by":"publisher","first-page":"568","DOI":"10.1177\/0961203313499419","volume":"23","author":"EC Somers","year":"2014","unstructured":"Somers EC, Richardson B. Environmental exposures, epigenetic changes and the risk of lupus. Lupus. 2014;23(6):568\u201376. https:\/\/doi.org\/10.1177\/0961203313499419.","journal-title":"Lupus"},{"key":"665_CR29","doi-asserted-by":"publisher","first-page":"118373","DOI":"10.1016\/j.socscimed.2025.118373","volume":"382","author":"S Gunning","year":"2025","unstructured":"Gunning S, Boateng S, Romann L. Hintz e. Credibility work in disenfranchising patient-clinician conversations for Mono\/Multiracial women of color with autoimmune disease. U S Social Sci Med. 2025;382:118373. https:\/\/doi.org\/10.1016\/j.socscimed.2025.118373.","journal-title":"U S Social Sci Med"},{"issue":"7","key":"665_CR30","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.3390\/ijerph17072285","volume":"17","author":"W Rodgers","year":"2020","unstructured":"Rodgers W, Williams EM, Smalls BL, Singleton T, Tennessee A, Kamen D, Gilkeson G. Treating systemic lupus erythematosus (SLE): The impact of historical environmental context on healthcare perceptions and decision-making in Charleston, South Carolina. Int J Environ Res Public Health. 2020;17(7):2285. https:\/\/doi.org\/10.3390\/ijerph17072285.","journal-title":"Int J Environ Res Public Health"},{"issue":"9","key":"665_CR31","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1093\/rheumatology\/kes128","volume":"51","author":"ER Vina","year":"2012","unstructured":"Vina ER, Masi CM, Green SL, Utset TO. A study of racial\/ethnic differences in treatment preferences among lupus patients. Rheumatology. 2012;51(9):1697\u2013706. https:\/\/doi.org\/10.1093\/rheumatology\/kes128.","journal-title":"Rheumatology"},{"issue":"1","key":"665_CR32","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1097\/JPO.0000000000000165","volume":"30","author":"A Sherwood","year":"2018","unstructured":"Sherwood A, Brinkmann J, Fatone S. Review of benefits to practitioners of using good patient-practitioner communication. JPO: J Prosthetics Orthot. 2018;30(1):5\u201312. https:\/\/doi.org\/10.1097\/JPO.0000000000000165.","journal-title":"JPO: J Prosthetics Orthot"},{"issue":"11","key":"665_CR33","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1002\/acr.22032","volume":"65","author":"B Sutanto","year":"2013","unstructured":"Sutanto B, Singh-Grewal D, McNeil HP, O\u2019Neill S, Craig JC, Jones J, Tong A. Experiences and perspectives of adults living with systemic lupus erythematosus: thematic synthesis of qualitative studies. Arthritis Care Res. 2013;65(11):1752\u201365. https:\/\/doi.org\/10.1002\/acr.22032.","journal-title":"Arthritis Care Res"},{"key":"665_CR34","doi-asserted-by":"publisher","unstructured":"Wu QL, Kindratt TB, Brannon G. How can clinical communication alleviate the negative impacts of social determinants of health? A secondary HINTS 6 dataset analysis. SAGE Open Med. 2024;12. https:\/\/doi.org\/10.1177\/23743735241310094.","DOI":"10.1177\/23743735241310094"},{"key":"665_CR35","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1136\/annrheumdis-2016-eular.2381","volume":"75","author":"C Drenkard","year":"2016","unstructured":"Drenkard C, Bao G, Kan H, Pobiner B, Julie P, Eastman W, Lim SS. THU0595 Impact of Physician-Patient Interactions on Disease Activity in Patients with Systemic Lupus Erythematosus. Ann Rheum Dis. 2016;75:407. https:\/\/doi.org\/10.1136\/annrheumdis-2016-eular.2381.","journal-title":"Ann Rheum Dis"},{"issue":"7","key":"665_CR36","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1097\/RHU.0000000000000794","volume":"24","author":"E Heiman","year":"2018","unstructured":"Heiman E, Lim SS, Bao G, Drenkard C. Depressive symptoms are associated with low treatment adherence in African American individuals with systemic lupus erythematosus. JCR: J Clin Rheumatol. 2018;24(7):368\u201374. https:\/\/doi.org\/10.1097\/RHU.0000000000000794.","journal-title":"JCR: J Clin Rheumatol"},{"issue":"9","key":"665_CR37","doi-asserted-by":"publisher","first-page":"1380","DOI":"10.1002\/art.1780370917","volume":"37","author":"AI Blakemore","year":"1994","unstructured":"Blakemore AI, Tarlow JK, Cork J, Gordon M, Emery C, Duff P. Interleukin\u20131 receptor antagonist gene polymorphism as a disease severity factor in systemic lupus erythematosus. Arthritis Rheumatism: Official J Am Coll Rheumatol. 1994;37(9):1380\u20135. https:\/\/doi.org\/10.1002\/art.1780370917.","journal-title":"Arthritis Rheumatism: Official J Am Coll Rheumatol"},{"issue":"3","key":"665_CR38","doi-asserted-by":"publisher","first-page":"rkae075","DOI":"10.1093\/rap\/rkae075","volume":"8","author":"S Huot","year":"2024","unstructured":"Huot S, Fortin PR, Godbout A, Laflamme C, Pouliot M. A tool to assist rheumatologists to engage their lupus patients: the Purple Butterfly. Rheumatol Adv Pract. 2024;8(3):rkae075. https:\/\/doi.org\/10.1093\/rap\/rkae075.","journal-title":"Rheumatol Adv Pract"},{"key":"665_CR39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s43058-021-00118-9","volume":"2","author":"JA Singh","year":"2021","unstructured":"Singh JA, Hearld LR, Hall AG, Beasley TM. Implementing the DEcision-Aid for Lupus (IDEAL): study protocol of a multi-site implementation trial with observational, case study design: Implementing the DEcision-Aid for Lupus. Implement Sci Commun. 2021;2:1\u20133. https:\/\/doi.org\/10.1186\/s43058-021-00118-9.","journal-title":"Implement Sci Commun"}],"container-title":["BMC Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41927-026-00665-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41927-026-00665-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s41927-026-00665-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:05:50Z","timestamp":1789430750000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s41927-026-00665-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["665"],"URL":"https:\/\/doi.org\/10.1186\/s41927-026-00665-5","relation":{},"ISSN":["2520-1026"],"issn-type":[{"value":"2520-1026","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,26]]},"assertion":[{"value":"30 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"70"}}