Evidence map›Paper›PMID 40819036›Full record

ArticleOrphanet journal of rare diseases2025

Health care supply in patients with Ehlers-Danlos syndromes and generalized hypermobility spectrum disorder: a German perspective.

Jonas Rauterberg, Marie Hock, Nikolaus Kernich, Arim Shukri, Henning Klapproth, Vanessa Löw, Michaela Henning, Iliana Tantcheva-Poór

Abstract read
In one paragraph

Article in Orphanet journal of rare diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jonas Rauterberg *Department of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. Jonas.rauterberg@uk-koeln.de.ORCID http://orcid.org/0000-0001-9796-1235
Marie Hock *Department of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Nikolaus KernichDepartment of Orthopedic and Trauma Surgery, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany.
Arim ShukriInstitute of Health and Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany.
Henning KlapprothDepartment of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
Vanessa LöwPain Center, Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany.
Michaela HenningDepartment of Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Iliana Tantcheva-PoórDepartment of Dermatology and Venereology, Faculty of Medicine and University Hospital, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiagnosing Ehlers-Danlos syndromes (EDS) and EDS-related "hypermobility spectrum disorder" (HSD) is challenging and cutaneous manifestations often serve as indicators of these rare connective tissue disorders. Only limited data exist on the healthcare of EDS/HSD in Germany as specialized services have been missing and a national register is not available.

objectivesIn 2020, a dermatologic-orthopedic EDS outpatient service was initiated at the University Hospital of Cologne, Germany. The objectives of the present survey were to examine the "medical journey" and the disease burden of our patients.

methodsA pseudonymized paper survey was sent to all adults who were diagnosed with hypermobile EDS (hEDS), classical EDS (cEDS), classical-like EDS (clEDS) or generalized HSD at the EDS Cologne service from December 2021 until May 2023.

resultsOf the 99 participants, 80 were diagnosed with hEDS/HSD, 16 with cEDS and 3 with clEDS. The mean time to diagnosis was 22.0 years (14.5 years for cEDS/clEDS vs. 23.0 years for hEDS/HSD). 24.2% of the participants had a recognized degree of disability of ≥ 50, the average sick leave in the last 3 months was 4.6 days for cEDS/clEDS and 21.3 days for hEDS/HSD. 44.9% of the hEDS/HSD patients reported on having at least four comorbidities compared to 21.1% in the cEDS/clEDS group (p = 0.023). At least 15 medical specialties were involved in the diagnostics and treatment of participants with multiple therapeutic modalities.

conclusionsThis is the first study providing an insight on the healthcare supply of EDS/HSD patients in Germany. Participants in our survey had a much longer "diagnostic journey" than the one in previous studies and suffered from high morbidity despite high healthcare utilization. Our results point to the urgent necessity of a better coordinated, multidisciplinary care for patients with these complex genodermatoses including innovative political structures, further research and international networking.

Indexed as

Ehlers-Danlos SyndromeJoint InstabilityAdultFemaleGermanyHumansMaleMiddle AgedSurveys and QuestionnairesYoung AdultBurden of diseaseDiagnostic odysseyEhlers-danlos syndromesGeneralized hypermobilityGenodermatosesHealth care supplyHereditary connective skin disordersHypermobility spectrum disorderRare diseases

Identifiers

PMID40819036
PMCPMC12358066

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LicenceCC BY
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Registered trials

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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.