Sj ögren Syndrome and Cancer
This article discusses the accumulating data on various malignancies described in primary Sjögren syndrome, highlighting non-Hodgkin lymphoma and thyroid, multiple myeloma, and skin cancers. These re ported associations may have clinical implications in daily practice and contribute to understanding of both autoimmunity and cancer. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - July 4, 2020 Category: Rheumatology Authors: Ann Igoe, Sali Merjanah, R. Hal Scofield Source Type: research

Cancer and Rheumatic Diseases
Rheumatic Disease Clinics (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - July 4, 2020 Category: Rheumatology Authors: John M. Davis Source Type: research

Copyright
ELSEVIER (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - July 4, 2020 Category: Rheumatology Source Type: research

Contributors
MICHAEL H. WEISMAN, MD (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - July 4, 2020 Category: Rheumatology Source Type: research

Contents
Michael H. Weisman (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - July 4, 2020 Category: Rheumatology Source Type: research

Rheumatic Disease Clinics of North America
Health Disparities in Rheumatic Diseases: Part I (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - July 4, 2020 Category: Rheumatology Source Type: research

Foreword
John Davis has created a thoughtful and scholarly issue addressing the complex relationships between malignancy and chronic rheumatic diseases. The articles are practical in a clinical sense and support the concept of shared decision making when both the patient and his or her doctor face questions about options for further workup and management. As some wise clinicians used to say, it is not about treatment of a rheumatic disease (since we don ’t know the cause, how can we treat?), it is always about patient management, and malignancy potential fits directly into patient management. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - July 4, 2020 Category: Rheumatology Authors: Michael H. Weisman Source Type: research

Risk of Malignancy in Spondyloarthritis
Systematic inflammatory diseases, including rheumatoid arthritis (RA), are associated with an increased risk of malignancies. However, the pathogenesis of spondyloarthritis (SpA), which includes both ankylosing spondylitis and psoriatic arthritis, is different from RA, and the risk of malignancy and sites involved may also be different. It is important to better understand associations of SpA with site-specific cancers to facilitate appropriate cancer screening. The goal of this review was to examine the association of SpA with malignancy and the potential impact of therapy for SpA on development of malignancy. (Source: Rh...
Source: Rheumatic Disease Clinics of North America - June 11, 2020 Category: Rheumatology Authors: Paras Karmacharya, Ravi Shahukhal, Alexis Ogdie Source Type: research

Autoimmunity, Clonal Hematopoiesis, and Myeloid Neoplasms
Clonal hematopoiesis has been linked with the development of hematologic malignancy and atherosclerotic cardiovascular disease; however, the association with autoimmune diseases remains to be defined. The link between autoimmune diseases and myeloid neoplasms (MNs) is complex, often multifactorial, and seems bidirectional. The limited data suggest an increased risk of MNs in rheumatoid arthritis and systemic lupus erythematosus. Paraneoplastic manifestations of MN include arthritis, vasculitis, and connective tissue disease. Treatment options for autoimmune disease such as cyclophosphamide and azathioprine have been associ...
Source: Rheumatic Disease Clinics of North America - June 10, 2020 Category: Rheumatology Authors: Delamo I. Bekele, Mrinal M. Patnaik Source Type: research

Cancer and Systemic Lupus Erythematosus
Systemic lupus erythematosus is associated with a small overall increased cancer risk compared with the general population. This risk includes a 4-fold increased risk of non-Hodgkin lymphoma, but a decreased risk of other cancers (such as breast cancer). The pathophysiology underlying the increased risk of hematologic cancer is not fully understood, but many potential mechanisms have been proposed, including dysfunction of the tumor necrosis factor and other pathways. A decreased risk of breast, ovarian, and endometrial cancer might be driven by hormonal factors or lupus-related antibodies, but these links have not been pr...
Source: Rheumatic Disease Clinics of North America - June 10, 2020 Category: Rheumatology Authors: Alexandra Ladouceur, Basile Tessier-Cloutier, Ann E. Clarke, Rosalind Ramsey-Goldman, Caroline Gordon, James E. Hansen, Sasha Bernatsky Source Type: research

Cancer and Scleroderma
This article discusses the potential mechanistic links between cancer and scleroderma, the serologic and clinical risk factors associated with increased cancer risk in patients with scleroderma, and implications for cancer screening. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 9, 2020 Category: Rheumatology Authors: Emma Weeding, Livia Casciola-Rosen, Ami A. Shah Source Type: research

Paraneoplastic Musculoskeletal Syndromes
Paraneoplastic syndromes are rare diseases caused by malignancies through means other than mass effect or metastasis. Paraneoplastic phenomena can be the first sign of cancer and can be fatal. Paraneoplastic rheumatic syndromes can occur with hematologic cancers, lymphoproliferative disease, and solid tumors. Diseases that feature an advanced age at onset, significant constitutional upset, inadequate response to treatment, and otherwise atypical characteristics should increase the index of suspicion for a paraneoplastic syndrome. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 7, 2020 Category: Rheumatology Authors: Fahad Khan, Hilary Kleppel, Alexa Meara Source Type: research

Immune Checkpoint Inhibition —Does It Cause Rheumatic Diseases? Mechanisms of Cancer-Associated Loss of Tolerance and Pathogenesis of Autoimmunity
Mechanisms of immune checkpoints and their role in autoimmunity are discussed in the context of immune checkpoint inhibitor (ICI) therapy for cancer. The updated clinical spectrum of immune-related adverse events (irAEs), with an in-depth discussion of rheumatic irAEs, is presented. The relationship between ICI-induced loss of self-tolerance in cancer and the implications for understanding of irAEs, rheumatic irAEs in particular, is overviewed. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 7, 2020 Category: Rheumatology Authors: Uma Thanarajasingam, Noha Abdel-Wahab Source Type: research

Timely Knowledge and Clinical Insights on Cancer and Rheumatic Disease
Questions pertaining to cancer and rheumatic disease arise commonly in clinical practice. Clinicians commonly experience concern for the possibility that an atypical or undifferentiated inflammatory syndrome could be caused by an occult malignancy. Conversely, patients often raise justifiable concerns about the possibility a drug for their rheumatic disease may increase their lifetime risk of cancer. Estimates of the risk of cancer for a given rheumatic disease or related to a certain antirheumatic medication seem to vary from study to study. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 7, 2020 Category: Rheumatology Authors: John Manley Davis Tags: Preface Source Type: research

Overview of the Associations Between Cancer and Rheumatic Disease
This article provides a general overview of the issues related to cancer and rheumatic disease and serves as a springboard for the remaining chapters in this issue. Several topics are reviewed, including epidemiology, bidirectional causal pathways, and issues related to medications. Although uncertainties remain, the issue of cancer is of great importance to patients with rheumatic diseases, and an individualized, person-centered approach to assessment and management is necessary. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - June 7, 2020 Category: Rheumatology Authors: John Manley Davis Source Type: research

Cancer and Rheumatoid Arthritis
Management of rheumatoid arthritis (RA) in patients with cancer is complex and requires a multidisciplinary approach. A few studies have examined the risk for recurrence in patients with RA receiving disease-modifying antirheumatic drugs, primarily tumor necrosis factor- α inhibitors. Although these agents seem to be safe in patients with a history of cancer and no evidence of disease, additional information is needed to determine their potential effects in patients with RA and active cancer. Patients with RA undergoing cancer therapy, including surgery, radiation, chemotherapy, and immunotherapy, need to be carefull...
Source: Rheumatic Disease Clinics of North America - June 7, 2020 Category: Rheumatology Authors: Xerxes Pundole, Maria E. Suarez-Almazor Source Type: research

Risk Factors and Cancer Screening in Myositis
The idiopathic inflammatory myopathies, particularly dermatomyositis, are associated with an increased risk of cancer. Lung, ovarian, breast, colon, prostate, and cervical cancers, and hematologic malignancies, are among the most common associated cancers. Risk stratification for cancer in patients with myositis is based on clinical risk factors/red flags, myositis clinical subtypes, and myositis-specific autoantibodies. Clinical risk factors include older age at disease onset, male gender, dysphagia, acute onset/refractory myositis, cutaneous ulceration, necrosis/vasculitis, and elevated inflammatory markers. Appropriate ...
Source: Rheumatic Disease Clinics of North America - June 7, 2020 Category: Rheumatology Authors: Siamak Moghadam-Kia, Chester V. Oddis, Dana P. Ascherman, Rohit Aggarwal Source Type: research

Molecular Biology Approaches to Understanding Spondyloarthritis
New and emerging molecular techniques are expanding understanding of the pathophysiology of spondyloarthritis (SpA). Genome-wide association studies identified novel pathways in antigen processing and presentation as well as helper T  cell type 17 (TH17) immunity associated with SpA. Immune cell profiling techniques have supported TH17 immune responses and increasingly are revealing intestinal mucosal immune cells as associated with disease. Emerging technologies in epigenetics, transcriptomics, microbiome, and proteomics/metab olomics are adding to these, refining disease pathways and potentially identifying biomarke...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Adam Berlinberg, Kristine A. Kuhn Source Type: research

What Does Human Leukocyte Antigen B27 Have to Do with Spondyloarthritis?
Human leukocyte antigen (HLA) B27 is the key laboratory parameter for axial spondyloarthritis (axSpA). Its prevalence is variable across different geographic zones and ethnicities, and often mirrors the prevalence of axSpA. HLA-B27 plays a role in axSpA physiopathology. It is correlated with spondyloarthritis phenotype with a consistent positive association with family history, early disease onset, shorter diagnostic delay, hip involvement, and acute anterior uveitis. HLA-B27 has a pivotal role in many referral strategies. However, these strategies were developed in European populations and need to be evaluated in populati...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Hanna Fahed, Daniele Mauro, Francesco Ciccia, Nelly R. Ziade Source Type: research

Juvenile-Versus Adult-Onset Spondyloarthritis
This article provides an overview of juvenile spondyloarthritis and important differences in the classification criteria, clinical presentation, outcomes, and pathology in juvenile versus adult-onset disease. Key differences in classification criteria between children and adults with spondyloarthritis are important to understand, as they can make transition from pediatric to adult care challenging. MRI and ultrasonography are increasingly relied on for the assessment of adult-onset disease activity and change over time in the pediatric population. The unique features of the maturing axial and peripheral skeleton are descri...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Pamela F. Weiss, Johannes Roth Source Type: research

The Future of Imaging in Axial Spondyloarthritis
This article discusses the current position of conventional radiography and MRI, the techniques recommended by the European League Against Rheumatism for use in imaging in axial spondyloarthritis (axSpA). Several challenges and areas of development regarding radiography and MRI in axSpA are considered. Also, a few interesting focus points for future research are noted. Besides the recommended techniques, this article discusses several nuclear imaging techniques and the usability of these techniques in daily practice. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Manouk de Hooge Source Type: research

Can Imaging Be a Proxy for Remission in Axial Spondyloarthritis?
This article summarizes current evidence on the use of imaging for monitoring disease activity and predicting treatment response in axial spondyloarthritis, and discusses the concept of imaging-driven treat-to-target strategy with a highlight on the newest imaging modalities in spondyloarthritis. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Krystel Aouad, Ann-Sophie De Craemer, Philippe Carron Source Type: research

Intestinal Microbiota, HLA-B27, and Spondyloarthritis
Spondyloarthritis, although primarily a joint-centered disease, is associated with extra-articular features, such as gut inflammation, psoriasis, and/or uveitis. Evidence points to underlying genetic predisposing factors and/or environmental factors. This is most clear in the gut, with progress through 16S and metagenomics sequencing studies and the results of functional studies in preclinical arthritis models. Translation of these findings to the clinic is making progress based on encouraging results of fecal microbial transplant studies in several human diseases. This review elaborates on novel trends in host-microbial i...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Emilie Dumas, Koen Venken, James T. Rosenbaum, Dirk Elewaut Source Type: research

Classification Criteria in Axial Spondyloarthritis
Spondyloarthritis (SpA) is a chronic inflammatory condition that can have a predominately peripheral or axial presentation. Axial SpA (axSpA) affects the axial skeleton with either radiographic (r-axSpA) or nonradiographic (nr-axSpA) changes. Radiographic changes are a late disease feature and earlier disease stages can be identified by incorporating other imaging methods. The diagnosis of axSpA is a clinical diagnosis and classification criteria are not aimed to be diagnostic tools. The split between r-axSpA and nr-axSpA is artificial and we should move toward the unifying concept of axSpA. Our understanding of genetics, ...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Rhys J. Hayward, Pedro M. Machado Source Type: research

Axial Psoriatic Arthritis
Axial involvement in psoriatic arthritis is a well-recognized manifestation with a prevalence between 12.5% and 78%. This huge heterogeneity is due to the different criteria used by authors to define psoriatic arthritis with axial involvement combining clinical features with radiographic evidence of disease. Specific genetic and clinical attributes of axial psoriatic arthritis might differentiate it from axial spondyloarthritis with concurrent skin psoriasis. Few studies address the specific management. The purpose of this review is to acknowledge the current understanding of axial involvement in psoriatic arthritis and hi...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Xabier Michelena, Denis Poddubnyy, Helena Marzo-Ortega Source Type: research

Emerging Imaging Techniques in Spondyloarthritis
This article introduces the novel techniques in imaging of spondyloarthritis, including dual-energy computed tomography and new MRI sequences, with a focus on the imaging of bone marrow edema and erosions of the sacroiliac joint. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Min Chen, Paul Bird, Lennart Jans Source Type: research

Treat to Target in Axial Spondyloarthritis
Treat to target describes a management paradigm that involves choosing a clinically relevant target, assessment with validated measures at a prespecified frequency, and a change in therapy if the target is not met. Although guidelines recommend treating to target in axial spondyloarthritis (axSpA), ideal methods to reach this target remain controversial. This review focuses on background for a treat-to-target strategy in axSpA. Potential targets of treatment, association of targets with outcomes, evidence of treatment impact on outcomes, and how treat to target has been incorporated into treatment guidelines are discussed....
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Jean W. Liew, Maureen Dubreuil Source Type: research

The Patient ’s Perspective on the Burden of Disease in Ankylosing Spondylitis
A patient who has had ankylosing spondylitis for 50  years describes her long journey to diagnosis, living with the disease, the different types of treatments she has tried (both traditional and nontraditional), and her participation in clinical studies. She describes her use of nonsteroidal anti-inflammatory drugs as well as biologics to help manag e inflammation and the importance of diet and exercise—Pilates, yoga, and physical therapy—to maintain and improve movement and flexibility. She offers her own personal advice to those recently diagnosed. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Lisa See Source Type: research

Axial Spondyloarthritis in the Era of Precision Medicine
In axial spondyloarthritis (axSpA), the first treatment step is generally a nonsteroidal anti-inflammatory drug, and if insufficient, a biologic is added. Currently, most evidence is available of the biologic tumor necrosis factor- α inhibitors. In patients who have achieved sustained low disease activity, tumor necrosis factor-α inhibitor tapering is considered, although standardized tapering schedules are lacking. In axSpA patients with extra-articular manifestations, the effect of axSpA treatment on these extra-articular manifestations is important to determine the preferred therapy. Overall, it is recommend...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Rianne E. van Bentum, Irene E. van der Horst-Bruinsma Source Type: research

The Future of Axial Spondyloathritis Treatment
Axial spondyloathritis (axSpA) treatment with biologic DMARDs was previously focused around anti-TNF agents. Significant advances in research have led to new therapeutic options, such as secukinumab, an IL-17 inhibitor, which has been approved for the treatment of axSpA. Two other biologic agents that are already licensed for rheumatoid and psoriatic arthritis, tofacitinib and ixekizumab, have demonstrated improved outcomes in axSpA. Several newer agents have been developed to inhibit IL-17, IL-23, and JAK. Early trials are promising; however, further research is needed. Rapid expansion of therapies available to treat axSp...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Sinead Maguire, Raj Sengupta, Finbar O ’Shea Source Type: research

Pathogenesis of Axial Spondyloarthritis — Sources and Current State of Knowledge
Scientific breakthroughs have culminated in the development of the spondyloarthritis (SpA) concept as a family of rheumatic diseases, distinct from rheumatoid arthritis. The demonstration of inflammatory lesions in the sacroiliac joints and spine of patients with axial symptoms of SpA who lacked radiographic features of ankylosing spondylitis (AS) helped refine the SpA concept. Axial SpA includes patients with AS and patients with axial symptoms previously categorized as undifferentiated SpA. This review examines the sources of knowledge that inform axial SpA pathogenesis, highlighting current limitations, and a basic work...
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Joerg Ermann Source Type: research

(Health-Related) Quality of Life as an Outcome in Studies of Axial Spondyloarthritis
This article summarizes the literature on relevant concepts and frameworks when measuring overall health or HRQoL, available measures assessing this outcome in axSpA, the hierarchical relations between overall health/HRQoL and specific axSpA impairments, and the role of context when interpreting interventions for overall health or HRQoL outcomes. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Uta Kiltz, David Kiefer, Annelies Boonen Source Type: research

Spondyloarthritis: The Changing Landscape —Are We There Yet?
Dear friends, dear colleagues, (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Xenofon Baraliakos, Michael H. Weisman Tags: Preface Source Type: research

Spondyloarthritis: The Changing Landscape Today
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Authors: Xenofon Baraliakos, Michael H. Weisman Source Type: research

Copyright
ELSEVIER (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Source Type: research

Contributors
MICHAEL H. WEISMAN, MD (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Source Type: research

Contents
Xenofon Baraliakos and Michael H. Weisman (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Source Type: research

Forthcoming Issues
Cancer and Rheumatic Diseases (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - April 25, 2020 Category: Rheumatology Source Type: research

Approach to the Patient with Axial Spondyloarthritis and Suspected Inflammatory Bowel Disease
To adequately and efficiently evaluate patients with gastrointestinal symptoms in the context of axial spondyloarthritis can be difficult, considering that many of these patients suffer from chronic pain, present high inflammatory parameters, and use drugs with possible gastrointestinal adverse effects. In addition, the immunosuppressive treatments that these patients can receive make it necessary to always consider infections within the differential diagnoses of inflammatory bowel disease. In this article, we propose a practical approach to patients diagnosed with axial spondyloarthritis and suspected inflammatory bowel d...
Source: Rheumatic Disease Clinics of North America - March 9, 2020 Category: Rheumatology Authors: Sebasti án Eduardo Ibáñez Vodnizza, María Paz Poblete De La Fuente, Elisa Catalina Parra Cancino Source Type: research

AS Patient
Being seriously affected by a rheumatic disease at the age of 16 seems a catastrophe that somehow must be learned to manage. And the challenges that come up when the illness worsens in the life course have to be coped with. So, this article tries to outline some of the points I have experienced and find relevant for patients with ankylosing spondylitis. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - March 9, 2020 Category: Rheumatology Authors: Dieter Wiek Source Type: research

Active Learning Strategies to Improve Progression from Knowledge to Action
Lectures, a form of passive learning, are a modality of teaching used in medical education. Active learning strategies allow learners and teachers to interact and be more engaged with the subject matter in a manner that encourages discussion, critical thinking, and advanced clinical reasoning skills. Learning to be effective requires vigilance, which promotes memory retention and should afford a way for learners to build on preexisting knowledge via scaffolding and concept mapping that uses critical thinking. Educators should also to use evaluation models that seek to improve patient care, health care systems, and communit...
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Karina D. Torralba, Loomee Doo Source Type: research

Modern Landscapes and Strategies for Learning Ultrasound in Rheumatology
This article discusses ultrasound in rheumatology education opportunities, competency assessment, and certification pathways. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Benjamin B. Widener, Amy Cannella, Linett Martirossian, Eugene Y. Kissin Source Type: research

Enhancing the Inpatient Consultation Learning Environment to Optimize Teaching and Learning
Subspecialty consultation is an increasingly used resource in inpatient medicine. Teaching the primary team is an important element of effective consultation and has many potential benefits. However, within academic medical centers many barriers to effective consultation and the consult learning environment exist. High workload, burnout, inexperience, lack of familiarity between teams, quality of the consult requests, and pushback may impede teaching and learning. Herein, the authors review the role of teaching and learning during consultation, challenges to effective consultation facing fellows, and interventions that can...
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Naomi Serling-Boyd, Eli M. Miloslavsky Source Type: research

Interprofessional Musculoskeletal Education
This article reviews several national programs in musculoskeletal education initiated by the Department of Veterans Affairs over the past decade. These programs have become sustained interprofessional opportunities for learners across disciplines and along the continuum of health professions education (HPE) and training pathways. This article also describes opportunities for leaders in rheumatology and other HPE programs to join these efforts and to collaborate in the scholarship that will be necessary in constructing educational programs fit for the purpose of ensuring a well-trained, competent workforce of health care pr...
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Michael J. Battistone, Andrea M. Barker, Steven J. Durning Source Type: research

Education and Professional Development in Rheumatology
This article reviews the unique benefits and challenges of involving and teaching fellows to conduct QI initiatives. Strategies and resources available to overcome these challenges and develop a successful quality driven training environment are outlined in this article. (Source: Rheumatic Disease Clinics of North America)
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Christina Downey, Deepa Ragesh Panikkath, Daniel H. Solomon Source Type: research

Learning to Critically Appraise Rheumatic Disease Literature
To provide optimal patient care, rheumatologists must be equipped and motivated to critically appraise the literature. The conceptual frameworks Retrieval Enhanced Learning, Self-Determination Theory, and Communities of Practice can inform the design of educational approaches to promote critical appraisal in practice. HSS CLASS-Rheum ® is a learning tool that can be used to help rheumatologists learn skills for critical appraisal through retrieval practice. Combining retrieval practice with opportunities for connection through Peer Instruction, journal clubs, and other forums can help support engagement and internaliza...
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Juliet Aizer, Julie A. Schell, Marianna B. Frey, Michael D. Tiongson, Lisa A. Mandl Source Type: research

Ethics and Industry Interactions
Physicians in training and their mentors must be cognizant of ethical concerns related to industry interactions. Mentors perceived to have conflicts of interest or to be engaging in misconduct can unconsciously and profoundly affect the learning and academic environment by implying certain values and expectations. Despite increased awareness of ethical concerns related to industry interactions in clinical practice and research, there remains a need for interventions to prevent ethical transgressions. Ethics education is essential and a move in the right direction, but it alone is likely inadequate in preventing unethical b...
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Jane S. Kang Source Type: research

Mind the Gap
Adolescence and young adulthood represents a vulnerable period in the life of patients with rheumatic diseases, many of whom struggle with self-management of their chronic disease and adjustment to care with adult rheumatologists. Many adult rheumatologists are uncomfortable caring for young adults, especially those with pediatric-onset diagnoses. The recent development of evidence-based best practices, expert opinion recommendations, and validated tools can assist pediatric and adult rheumatologists in caring for adolescent and young adult patients. Uptake of these guidelines and resources remains low, underscoring the ne...
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Rebecca E. Sadun Source Type: research

Underserved Communities
The shortage of health care professionals is projected to worsen in the coming years. This is particularly concerning in underserved areas that are fraught with disparities in disease outcomes and life expectancy, quality of life, and health care access. The onus is on medical education institutions to train students to serve vulnerable communities to improve both health care access and the quality of medical school education. When health disparities are formally included in medical education curricula and the culture of medical education shifts to a community-based learning approach, patients and health care providers ali...
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Vaneet K. Sandhu, Donna M. Jose, Candace H. Feldman Source Type: research

Turning Objective Structured Clinical Examinations into Reality
Objective structured clinical examinations assess learners “showing how” to perform complex clinical tasks. Devised as summative evaluations, these examinations with immediate feedback are useful formative evaluations to improve learner performance. This review describes how objective structured clinical examinations have been used in rheumatology educa tion. Steps for creating an objective structured clinical examination are discussed. Validity and reproducibility are important considerations, especially for high-stakes summative objective structured clinical examinations. Consideration of the potential benefi...
Source: Rheumatic Disease Clinics of North America - November 20, 2019 Category: Rheumatology Authors: Lisa Criscione-Schreiber Source Type: research