AB1299-HPR THE RHEUMA-VOR APP: OPTIMIZING THE EARLY DIAGNOSIS OF RHEUMATIC DISEASES
Authors: M. Dreher, L. Wojnowski, D. Tibyampansha, A. Hilt, A. Schwarting
Journal: Annals of the Rheumatic Diseases (2020)

Background: The proof-of-concept network study “Rheuma-VOR” aims to improve the quality of rheumatological care through coordinated cooperation. In particular, rheumatic diseases should be diagnosed as early as possible and treated quickly in a targeted manner [3]. Smartphone apps have a potential to improve the management of chronic diseases. For example, they can be used to provide health information, or to offer self-monitoring and self-screening options [1, 2]. Objectives: The Rheuma-VOR Screening-App study examines whether a smartphone-based app can increase the detection rate of the three most common chronic inflammatory rheumatic diseases: rheumatoid arthritis, psoriatic arthritis and spondylarthritis. Methods: Based on the multi-stage Delphi Procedure, a minimal list of questions for detection and differentiation between the three diseases was defined. The app for iOS and Android is in use since October 2018 during the screening consultation at the Division of Rheumatology and Clinical Immunology and at the ACURA Center of Rheumatology Rhineland-Palatinate. An additional validation will be performend with a non-preselected cohort based on the data of the Rheuma Bus Tour 2019. Results: The Delphi Procedure identified 17 questions, including four laboratory parameters. They have been deployed in German as a smartphone app. The questions are read to the patient and can be answered with “YES”, “NO”, or “I DO NOT KNOW”. Answering the questions takes approximately four minutes. The suspected diagnoses are based on a cumulative score. Some diagnoses are excluded or confirmed already after a few questions. To date (31 Dec 2019), the app has been used on 466 patients. The sensitivity is 0.91, while the specificity is 0.25. The positive predictive value and the negative predictive values are 0.60 and 0.32, respectively. The false positive value is 0.33 and the false negative value 0.05. Conclusion: The Rheuma-VOR App helps doctors and patients to invalidate or to confirm the suspicion of a possible rheumatic disease. Data from the cohort is currently analyzed to increase the screen’s specificity. The additional validation, based on a non-preselected cohort collected during the Rheuma Bus Tour 2019, is in progress. A final validation concept is currently being developed. In 2020, a section with the most important information about the aforementioned three diseases will be added. The section will include definition, etiology, prognosis, symptoms, therapeutic principles, medication and case studies. Current data will be presented at the conference References: [1]Kuijpers W, Groen WG, Aaronson NK et al. (2013) A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors. Journal of medical Internet research 15:e37 [2]Payne HE, Lister C, West JH et al. (2015) Behavioral functionality of mobile apps in health interventions: a systematic review of the literature. JMIR mHealth and uHealth 3:e20 [3]Schwarting A (2018) From ADAPTHERA to Rheuma-VOR: Concept of Coordinated Cooperation to Improve the Quality of Rheumatology Care Akt Rheumatol 43 (05): 406-409 Acknowledgments: The authors thank all partners and participants of Rheuma-VOR Disclosure of Interests: None declared