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  1. Article ; Online: North American musculoskeletal ultrasound scanning protocol of the hip, knee, ankle, and foot: update of a Delphi consensus study.

    Yinh, Janeth / Torralba, Karina D / Choi, Kristal S / Fairchild, Robert M / Cannella, Amy / Salto, Lorena / Kissin, Eugene Y / Thiele, Ralf / Oberle, Edward J / Marston, Bethany / Nishio, Midori Jane

    Clinical rheumatology

    2021  Volume 40, Issue 10, Page(s) 4233–4242

    Abstract: Background/objective: A North American rheumatology consensus on tiered-mastery designation for anatomic views was developed in 2011 for course and fellowship teaching. This study updates the lower extremity joint scanning protocols aiming to inform ... ...

    Abstract Background/objective: A North American rheumatology consensus on tiered-mastery designation for anatomic views was developed in 2011 for course and fellowship teaching. This study updates the lower extremity joint scanning protocols aiming to inform musculoskeletal ultrasound curriculum development for the American College of Rheumatology affiliated Fellowship Programs.
    Methods: Three Delphi rounds were conducted to reach consensus for tiered-level mastery designation for hip, knee, ankle, and foot scanning views. The survey was disseminated (Qualtrics™) to 101 potential participants with ultrasound teaching experience. High agreement was defined as ≥ 85% consensus and final tier designation as having >50% agreement for the preferred tier. Response changes were evaluated by McNemar's chi-square test.
    Results: Consensus regarding tier designations was reached for 80% of the views. Three knee views (anterior transverse suprapatellar, medial, and lateral longitudinal) and 2 ankle views (anterior and posterior transverse) achieved upgrades to tier 1 from 2. The transverse sacroiliac hip joint was downgraded from tier 2 to 3. The lateral longitudinal hip view was added with a tier 1 designation.
    Conclusion: Updated scanning protocols support modifications reflecting current scanning methods delivered by North American rheumatologists performing point of care ultrasound that may inform educators involved in rheumatology ultrasound. Key Points • The anterior transverse suprapatellar, medial, and lateral longitudinal knee views; the anterior and posterior transverse ankle views; and the lateral longitudinal view hip view were perceived as important to master and perform routinely. • The transverse sacroiliac joint view was suggested to be performed based on practice focus.
    MeSH term(s) Ankle/diagnostic imaging ; Consensus ; Delphi Technique ; Humans ; North America ; Ultrasonography
    Language English
    Publishing date 2021-04-05
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 604755-5
    ISSN 1434-9949 ; 0770-3198
    ISSN (online) 1434-9949
    ISSN 0770-3198
    DOI 10.1007/s10067-021-05716-5
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  2. Article ; Online: Musculoskeletal Ultrasound Instruction in Adult Rheumatology Fellowship Programs.

    Torralba, Karina D / Cannella, Amy C / Kissin, Eugene Y / Bolster, Marcy B / Salto, Lorena M / Higgs, Jay / Samuels, Jonathan / Nishio, Midori Jane / Kaeley, Gurjit S / Evangelisto, Amy / De Marco, Paul / Kohler, Minna J

    Arthritis care & research

    2020  Volume 72, Issue 6, Page(s) 859–870

    Abstract: Objective: Musculoskeletal ultrasound (MSUS) in rheumatology in the US has advanced by way of promotion of certifications and standards of use and inclusion of core fellowship curriculum. In order to inform endeavors for curricular integration, the ... ...

    Abstract Objective: Musculoskeletal ultrasound (MSUS) in rheumatology in the US has advanced by way of promotion of certifications and standards of use and inclusion of core fellowship curriculum. In order to inform endeavors for curricular integration, the objectives of the present study were to assess current program needs for curricular incorporation and the teaching methods that are being employed.
    Methods: A needs-assessment survey (S1) was sent to 113 rheumatology fellowship program directors. For programs that taught MSUS, a curriculum survey (S2) was sent to lead faculty. Programs were stratified according to program size and use of a formal written curriculum.
    Results: S1 (108 of 113 respondents; response rate 96%) revealed that 94% of programs taught MSUS, with 41% having a curriculum. Curricular implementation was unaffected by program size. Formal curricular adoption of MSUS was favored by 103 directors (95.3%), with 65.7% preferring such adoption to be optional. S2 (74 of 101 respondents; response rate 73%) showed that 41% of programs utilized a formal curriculum. Multiple teaching strategies were used, with content that was generally similar. Use of external courses, including the Ultrasound School of North American Rheumatologists course, was prevalent. Fewer barriers were noted compared to past surveys, but inadequate time, funding, and number of trained faculty still remained. Lack of divisional interest (P = 0.046) and interest of fellows (P = 0.012) were noted among programs without a formal curriculum.
    Conclusion: MSUS is taught by a significantly larger number of rheumatology fellowship programs today. Multiple teaching strategies are used with common content, and barriers still remain for some programs. Most program directors favor inclusion of a standardized MSUS curriculum, with many favoring inclusion to be optional.
    MeSH term(s) Curriculum ; Humans ; Musculoskeletal System/diagnostic imaging ; Needs Assessment ; Rheumatology/education ; Surveys and Questionnaires ; Ultrasonography
    Language English
    Publishing date 2020-05-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645059-3
    ISSN 2151-4658 ; 0893-7524 ; 2151-464X
    ISSN (online) 2151-4658
    ISSN 0893-7524 ; 2151-464X
    DOI 10.1002/acr.23336
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  3. Article ; Online: The Effect of IL-6 Inhibitors on Mortality Among Hospitalized COVID-19 Patients: A Multicenter Study.

    Sinha, Pranay / Jafarzadeh, S Reza / Assoumou, Sabrina A / Bielick, Catherine G / Carpenter, Bethanne / Garg, Shivani / Harleen, Sahni / Neogi, Tuhina / Nishio, Midori Jane / Sagar, Manish / Sharp, Veronika / Kissin, Eugene Y

    The Journal of infectious diseases

    2020  Volume 223, Issue 4, Page(s) 581–588

    Abstract: Background: The effectiveness of interleukin-6 inhibitors (IL-6i) in ameliorating coronavirus disease 2019 (COVID-19) remains uncertain.: Methods: We analyzed data for patients aged ≥18 years admitted with a positive severe acute respiratory syndrome ...

    Abstract Background: The effectiveness of interleukin-6 inhibitors (IL-6i) in ameliorating coronavirus disease 2019 (COVID-19) remains uncertain.
    Methods: We analyzed data for patients aged ≥18 years admitted with a positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction test at 4 safety-net hospital systems with diverse populations and high rates of medical comorbidities in 3 US regions. We used inverse probability of treatment weighting via machine learning for confounding adjustment by demographics, comorbidities, and disease severity markers. We estimated the average treatment effect, the odds of IL-6i effect on in-hospital mortality from COVID-19, using a logistic marginal structural model.
    Results: Of 516 patients, 104 (20.1%) received IL-6i. Estimate of the average treatment effect adjusted for confounders suggested a 37% reduction in odds of in-hospital mortality in those who received IL-6i compared with those who did not, although the confidence interval included the null value of 1 (odds ratio = 0.63; 95% confidence interval, .29-1.38). A sensitivity analysis suggested that potential unmeasured confounding would require a minimum odds ratio of 2.55 to nullify our estimated IL-6i effect size.
    Conclusions: Despite low precision, our findings suggested a relatively large effect size of IL-6i in reducing the odds of COVID-19-related in-hospital mortality.
    MeSH term(s) Adult ; Aged ; Antibodies, Monoclonal, Humanized/therapeutic use ; COVID-19/drug therapy ; COVID-19/mortality ; Comorbidity ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Interleukin-6/antagonists & inhibitors ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome ; United States/epidemiology
    Chemical Substances Antibodies, Monoclonal, Humanized ; Interleukin-6
    Language English
    Publishing date 2020-10-13
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiaa717
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  4. Article ; Online: Musculoskeletal ultrasound and anatomy: comment on the article by Navarro-Zarza et al.

    Evangelisto, Amy M / Nishio, Midori Jane / Higgs, Jay B / Kissin, Eugene Y / Kaeley, Gurjt S

    Arthritis care & research

    2014  Volume 66, Issue 9, Page(s) 1432–1433

    MeSH term(s) Anatomy/education ; Education, Medical, Graduate ; Fellowships and Scholarships ; Health Knowledge, Attitudes, Practice ; Humans ; Musculoskeletal System/anatomy & histology ; Rheumatology/education
    Language English
    Publishing date 2014-09
    Publishing country United States
    Document type Comment ; Letter
    ZDB-ID 645059-3
    ISSN 2151-4658 ; 0893-7524 ; 2151-464X
    ISSN (online) 2151-4658
    ISSN 0893-7524 ; 2151-464X
    DOI 10.1002/acr.22344
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