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Related Concept Videos

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies01:22

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

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The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
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Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

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AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
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Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

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Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
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Genome-wide Association Studies-GWAS01:11

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Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
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Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
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Rheumatic Heart Disease I: Introduction01:23

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Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
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Related Experiment Video

Updated: Jul 30, 2025

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Development of American College of Rheumatology Quality Measures for Systemic Lupus Erythematosus: A Modified Delphi

Christie M Bartels1, April Jorge2, Candace H Feldman3

  • 1University of Wisconsin School of Medicine and Public Health, Madison.

Arthritis Care & Research
|May 11, 2023
PubMed
Summary

This study developed three key digital quality measures for systemic lupus erythematosus (SLE) care, focusing on hydroxychloroquine use, glucocorticoid reduction, and kidney monitoring for improved patient outcomes.

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Area of Science:

  • Rheumatology
  • Digital Health
  • Quality Improvement

Background:

  • Systemic lupus erythematosus (SLE) care requires standardized quality measures for effective clinical practice.
  • Existing guidelines for SLE treatment and monitoring are extensive but lack readily measurable digital components.
  • Developing digital quality measures is crucial for assessing and improving SLE patient care.

Purpose of the Study:

  • To develop and identify essential, measurable digital quality measure statements for clinical care in SLE.
  • To establish a consensus-based selection of top-priority quality measures for SLE management.
  • To lay the groundwork for national implementation of digital quality measures in SLE.

Main Methods:

  • A modified Delphi process was employed, involving an American College of Rheumatology (ACR) workgroup of SLE experts.
  • Guidelines from 2000-2020 were reviewed to extract and rate quality constructs for importance and feasibility.
  • A multidisciplinary panel voted on measure statements, with the top 3 ranked for further development.

Main Results:

  • Fifteen quality measure statements were generated from 57 quality constructs.
  • Five statements achieved high consensus for importance and feasibility, covering treatment and laboratory monitoring.
  • The top 3 recommended measures were: hydroxychloroquine use, limiting long-term high-dose glucocorticoid use, and regular end-organ monitoring (kidney function, urine protein).

Conclusions:

  • Three digital quality measures for SLE care were selected: hydroxychloroquine use, glucocorticoid reduction, and kidney monitoring.
  • These measures will undergo further specification and validity testing in the ACR Rheumatology Informatics System for Effectiveness (RISE) Registry.
  • Successful implementation will support national quality improvement programs for SLE patients.