Educational needs and challenges in axial spondyloarthritis.
Educational needs and challenges in axial spondyloarthritis.
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DOI：
10.1097/bor.0000000000000806
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发表时间：
2021-07-01
影响因子：
5.1
通讯作者：
Dubreuil M
中科院分区：
文献类型：
--
作者：
Kumthekar A;Bittar M;Dubreuil M
轴性脊柱关节炎（axSpA）影响世界许多地区0.5 - 1%的人口。这篇综述总结了axSpA周围的医学教育的挑战，注意延迟诊断的证据，临床医生熟悉典型的axSpA功能，如炎症性背痛和遵守公认的管理原则。通常治疗慢性背痛或其他典型axSpA特征患者的临床医生并不总是了解炎性背痛的概念和常见的脊柱外表现。此外，临床医生可能不熟悉axSpA的非放射学光谱。可能患有axSpA的患者的管理并不总是遵循建立axSpA诊断的原则，axSpA的诊断平均延迟6 - 7年，有证据表明在某些情况下基于性别和种族的管理差异。转诊建议将axSpA诊断的可能性提高了约40%，并可能补充axSpA的教育工作。axSpA的教育工作应侧重于为一线临床医生提供对炎性背痛、axSpA的非放射学形式和axSpA管理中公认原则的更好理解。
Axial spondyloarthritis (axSpA) affects 0.5–1% of the population in many regions of the world. This review summarizes the challenges in medical education around axSpA with attention to evidence around delayed diagnosis, clinician familiarity with typical axSpA features such as inflammatory back pain and adherence to accepted management principles. Clinicians who commonly manage patients with chronic back pain or other typical axSpA features are not consistently aware of the concept of inflammatory back pain and common extra-spinal manifestations. Further, clinicians may not be familiar with the non-radiographic spectrum of axSpA. Management of patients with possible axSpA does not consistently follow principles that would establish an axSpA diagnosis, and diagnosis of axSpA remains delayed by 6–7 years on average, with evidence suggesting management disparities on the basis of sex and race in some cases. Referral recommendations have increased the probability of axSpA diagnosis up to about 40% and, may complement educational efforts in axSpA Educational efforts in axSpA should focus on providing front-line clinicians with a better understanding of inflammatory back pain, the non-radiographic form of axSpA and accepted principles in axSpA management.