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Diagnostic value of a 3-day course of prednisolone in patients with possible rheumatoid arthritis – the TryCort study

Overview of attention for article published in Arthritis Research & Therapy, April 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (72nd percentile)

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8 tweeters
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2 Facebook pages

Citations

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4 Dimensions

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29 Mendeley
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Title
Diagnostic value of a 3-day course of prednisolone in patients with possible rheumatoid arthritis – the TryCort study
Published in
Arthritis Research & Therapy, April 2017
DOI 10.1186/s13075-017-1279-z
Pubmed ID
Authors

Uta Kiltz, Christine von Zabern, Xenofon Baraliakos, Frank Heldmann, Bernd Mintrop, Michael Sarholz, Dietmar Krause, Friedrich Dybowski, Ludwig Kalthoff, Jürgen Braun

Abstract

In patients with tender and swollen finger joints, the differential diagnosis between rheumatoid arthritis (RA) and osteoarthritis (OA) of the hands can be initially difficult. This prospective study (the TryCort study) was performed to study the diagnostic value of prednisolone in differentiating between RA and hand OA. We present the results of this potentially diagnostic test in patients with possible RA in daily clinical practice by demonstrating the results of a pilot and a validation part of this 'prednisolone test' (pred-test). We investigated the response to a 3-day course of 20 mg of prednisolone in patients with suspicion of RA. All patients received 1 g of paracetamol per day for 5 days for pain relief. On days 3-5, a morning dose of 20 mg of prednisolone was added. Hand pain was quantified on a 0-10 Numerical Rating Scale, and the subjective percentage of improvement (0-100%) was recorded. Thresholds for response to prednisolone were investigated in a pilot phase with differentiation in response between patients with RA and patients with OA of the hands, both with pain in the hands ≥4. In a validation phase, the best differentiating cut-off of the pilot phase was applied to discriminate responders from non-responders in consecutive patients with hand pain ≥4 referred because of suspected RA. Final diagnoses were made by the expert upon re-examination at week 12. Primary outcomes were the sensitivity and specificity of a positive test in relation to the diagnosis. A percentage of 40% subjective improvement of pain in the hands on day 3 discriminated best between RA and OA in the pilot phase. Among 95 patients with complete data in the validation phase, RA was diagnosed in about 50%. Patients with RA had more swollen joints, higher C-reactive protein levels and slightly higher Health Assessment Questionnaire scores. The pred-test was positive in 42.1% of all patients (40 of 95). The median percentage of improvement on day 5 was higher in RA than in non-RA: 50% (IQR 30-60%) vs. 20% (IQR 10-30%) (p < 0.001). The sensitivity and specificity of the pred-test were 0.6 (95% CI 0.5-0.8) and 0.8 (95% CI 0.7-0.9), respectively, and the positive and negative predictive values were 0.77 and 0.70, respectively. To our knowledge, this is the first evaluation of the widely used pred-test that has ever been performed. The pred-test had a moderate sensitivity and a good specificity. We conclude that rheumatologists may use this test in unclear clinical situations to better differentiate between inflammatory and other conditions. ClinicalTrials.gov identifier: NCT01395251 . Registered on 14 Jul 2011. EudraCT number: 2011-002633-19. Registered on 21 Dec 2011.

Twitter Demographics

The data shown below were collected from the profiles of 8 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 29 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 7 24%
Student > Ph. D. Student 4 14%
Lecturer 2 7%
Researcher 2 7%
Student > Bachelor 1 3%
Other 2 7%
Unknown 11 38%
Readers by discipline Count As %
Medicine and Dentistry 6 21%
Nursing and Health Professions 3 10%
Pharmacology, Toxicology and Pharmaceutical Science 2 7%
Arts and Humanities 1 3%
Psychology 1 3%
Other 3 10%
Unknown 13 45%

Attention Score in Context

This research output has an Altmetric Attention Score of 6. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 April 2017.
All research outputs
#2,813,496
of 12,667,610 outputs
Outputs from Arthritis Research & Therapy
#712
of 2,070 outputs
Outputs of similar age
#70,184
of 258,835 outputs
Outputs of similar age from Arthritis Research & Therapy
#1
of 1 outputs
Altmetric has tracked 12,667,610 research outputs across all sources so far. Compared to these this one has done well and is in the 77th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,070 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.2. This one has gotten more attention than average, scoring higher than 65% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 258,835 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them