Evidence map›Paper›PMID 31220322›Full record

ArticleRheumatology (Oxford, England)2019

Comorbidity burden in axial spondyloarthritis: a cluster analysis.

Sizheng Steven Zhao, Helga Radner, Stefan Siebert, Stephen J Duffield, Daniel Thong, David M Hughes, Robert J Moots, Daniel H Solomon, Nicola J Goodson

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In one paragraph

Article in Rheumatology (Oxford, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 6 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Sizheng Steven ZhaoMusculoskeletal Biology I, Institute of Ageing and Chronic Disease, University of Liverpool.
Helga RadnerDepartment of Internal Medicine III, Division of Rheumatology, Medical University of Vienna, Vienna, Austria.
Stefan SiebertInstitute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow.
Stephen J DuffieldMusculoskeletal Biology I, Institute of Ageing and Chronic Disease, University of Liverpool.
Daniel ThongDepartment of Academic Rheumatology, Aintree University Hospital, Liverpool, UK.
David M HughesDepartment of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
Robert J MootsMusculoskeletal Biology I, Institute of Ageing and Chronic Disease, University of Liverpool.
Daniel H SolomonDivision of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA.
Nicola J GoodsonMusculoskeletal Biology I, Institute of Ageing and Chronic Disease, University of Liverpool.

Funding

VERITY: Value and Evidence in Rheumatology using bioInformaTics, and advanced analYticsP30AR072577 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI Katherine Phoenix Liao · 2017 to 2026
$9.8M
Patient Centered Outcomes Research in RheumatologyK24AR055989 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI SOLOMON, DANIEL HAL · 2008 to 2017
$1.5M
NIAMS NIH HHS K24 AR055989NIAMS NIH HHS P30 AR072577
6 · The paper itself

Abstract

objectivesTo examine how comorbidities cluster in axial spondyloarthritis (axSpA) and whether these clusters are associated with quality of life, global health and other outcome measures.

methodsWe conducted a cross-sectional study of consecutive patients meeting ASAS criteria for axSpA in Liverpool, UK. Outcome measures included quality of life (EQ5D), global health and disease activity (BASDAI). We used hierarchical cluster analysis to group patients according to 38 pre-specified comorbidities. In multivariable linear models, the associations between distinct comorbidity clusters and each outcome measure were compared, using axSpA patients with no comorbidities as the reference group. Analyses were adjusted for age, gender, symptom duration, BMI, deprivation, NSAID-use and smoking.

resultsWe studied 419 patients (69% male, mean age 46 years). 255 patients (61%) had at least one comorbidity, among whom the median number was 1 (range 1-6). Common comorbidities were hypertension (19%) and depression (16%). Of 15 clusters identified, the most prevalent clusters were hypertension-coronary heart disease and depression-anxiety. Compared with patients with no comorbidities, the fibromyalgia-irritable bowel syndrome cluster was associated with adverse patient-reported outcome measures; these patients reported 1.5-unit poorer global health (95%CI 0.01, 2.9), reduced quality of life (0.25-unit lower EQ5D; 95%CI -0.37, -0.12) and 1.8-unit higher BASDAI (95% CI 0.4, 3.3). Similar effect estimates were found for patients in the depression-anxiety cluster.

conclusionComorbidity is common among axSpA patients. The two most common comorbidities were hypertension and depression. Patients in the depression-anxiety and fibromyalgia-IBS clusters reported poorer health and increased axSpA severity.

Indexed as

Cost of IllnessSeverity of Illness IndexAdultAnxietyCluster AnalysisComorbidityCoronary DiseaseCross-Sectional StudiesDepressionFemaleFibromyalgiaHumansHypertensionIrritable Bowel SyndromeLinear ModelsMaleankylosing spondylitisaxial spondyloarthritiscluster analysiscomorbiditydepressionfibromyalgiamultimorbidity

Identifiers

PMID31220322
PMCPMC7967906

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.