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Taking AI Out of AutoImmunity: Predicting disease before it develops

Akhil Sood, MD Nov 18, 2024

the predictive value of a positive ANA test—especially in the absence of other clinical symptoms—remains a challenge. A positive test often leads to further testing, yet it does not necessarily indicate whether a patient truly has an underlying autoimmune disease. The development of AI and machine learning algorithms presents an opportunity to interpret autoantibody tests and predict autoimmune diseases. Here are three studies looking at this issue.

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ACR 2024 - Day 2 Report

Jack Cush, MD Nov 17, 2024

Plenary sessions began the day, followed by thousands on the abstract floor. Here are a few of my favorite presentations from day 2 at ACR 2024.

A#2529 Disparities in JIA Outcome documentation, best practices, access to at-risk pts, agency and access - outcomes initially appeared to worsen - reflection of better documentation Improvement driven by pt global scores Disparity gap closed by 17% #ACR24 @RheumNow https://t.co/oOxs0jIvBK

https://x.com/ericdeinmd/status/1858521979877233068/photo/1

A call for ANA stewardship? Abstract 1931: Educating clinicians on wise ANA ordering via EMR Alert plus removing the comprehensive ANA panel --> - ↓ ANA testing (outpatient 15.9%→7.4%, inpatient 25.5%→6.4%) ↓ costs ($440k→$130k) #ACR24 @RheumNow

RheumNow’s expanded coverage of the #ACR24 meeting is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty.

Can you build systems that stop that ANA neg ENA pos anxiety? Plus $$? Lehigh Valley, Allentown, PA: lab would run ENA+dsDNA automatically, but only when ANA >1:80 (i.e. leave the ENA order to the lab) first voluntary, then compulsory it's possible! #ACR24 ABST1931 @RheumNow https://t.co/UQjWwve7DV

https://x.com/drdavidliew/status/1858459070023479790/photo/1

Probably no surprise, but if you can navigate the digital world, it portends work for your rheum disease. all @MedUni_Wien rheum clinic pts did an eHealth survey high eHealth literacy did much better We can't leave digital stragglers behind! #ACR24 ABST1942 @Stiddyo @RheumNow https://t.co/c9IyPz6ujJ

https://x.com/drdavidliew/status/1858476245261959262/photo/1

My ramblings on the SELECT-GCA study and predictions of the place of upadacitinib in clinical practice in GCA are up now on RheumNow #ACR24 @RheumNow https://t.co/DR5VgVmdse

SELECT-GCA: Efficacy and Safety of Upadacitinib | RheumNow

Older RA patients in RISE with high disease activity show a higher incidence of hip and major osteoporotic fractures. Practice T2T and monitor bone health closely! #ACR24 @RheumNow ABST#1748 https://t.co/7MCAIrfXhp

https://x.com/JihaRheum/status/1858263593927778331/photo/1

A#1748 Fracture incidence in RA - RISE registry Incidence rate of MOF, hip Fx by disease activity 50% did not have CDAI available IR 12 per 1000py hip, 43 for MOF High activity worst, low/mod similar, remission is best Supports remission is better than LDA @RheumNow #ACR24 https://t.co/78FCLemfZD

https://x.com/ericdeinmd/status/1858258817164685795/photo/1

A#1746 companion for RA Like plenary for PsA, PBO response incr w time 1%/yr More trials in less affluent countries may be related to increasing PBO response in trials Possible reason: access to health care improves PBO in less affluent areas @RheumNow #ACR24 https://t.co/S3LffF8vPH

https://twitter.com/ericdeinmd/status/1857803974922903912

A#1744 AI for RA to improve scheduling in UK 39% pts meet quality metric for early intervention Input: RF, CRP, CCP, gender, age -> 51% accuracy (compare to first appt clinical accur 46%) Focusing on highest risk -> 88% accuracy -> 50% wait time for high-risk pts #ACR24 @RheumNow

A#1743 Are there benefits of getting LDA to remission? Remission CDAI <2.8, VLDA 2.8-6, LDA 6-10 After 1 yr f/u of LDA, 45% Rem, 40 VLDA, 16 LDA Not in remiss - higher BMI, longer duration, higher resource utilization, worse PRO No clear diff bw remission & VLDA #ACR24 @RheumNow https://t.co/ut7c52JVDr

Choose Rheum! Hart & Kumar interviewed trainees about picking rheumatology... major themes: ▶️ exposure prior to medical training ▶️ mentorship/sponsorship ▶️ long-term self-reflection ▶️ chance! How can we optimize first 3 to build our workforce? @RheumNow #ACR24 Abst 1738

RheumNow’s expanded coverage of #ACR24 is sponsored in part by Novartis. All content is chosen by RheumNow & its faculty.

2023 @ACRheum guidance recommends #MediterraneanDiet in RA What are barriers/facilitators to following the diet? Many pts are willing to try but don't follow it Barriers➡️ food insecurity & aversions Many are unaware Do you talk to your pts about diet? Ab1673 #ACR24 @RheumNow

The Joint Project is a community-based, barangay health worker-led screening program that aims to increase MSK dse awareness, timely referral & treatment or rehab. The figure below illustrates the conceptual framework for the program @RheumNow #ACR24 abs0979 https://t.co/yxXsASl2GJ

https://x.com/RHEUMarampa/status/1858198191830700125/photo/1

Ultrasound guided injections on cadavers improve rheumatology trainees ability to do #joint #injections 17 trainees -a couple of hrs of cadaver inj ▶️ joint injection confidence improved esp uncommon / difficult areas Elbow Ankle Wrist @RheumNow #ACR24 @ACRheum abst#1310 https://t.co/ZcER4s8QcR

https://x.com/Janetbirdope/status/1858195483681816832/photo/1

The idea of patient-initiated follow-up for RA is enticing: patient & physician time is already stretched minimize unnecessary visits/improve access but what actually needs to go into the design, to make it safe/workable? A: plenty. 🇨🇦 pilot underway #ACR24 ABST1041 @RheumNow https://t.co/03u4bhnQ0v

https://x.com/drdavidliew/status/1858184151306047682/photo/1

Is participation in RISE assoc with improved quality of care? ➡️Enrolment assoc w ⬆️performance in several quality measures ➡️Most marked in practices with lower baseline performance ⏩Registry participation has potential to improve quality of rheum care Ab1644 #ACR24 @RheumNow

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Taking AI Out of AutoImmunity: Predicting disease before it develops

ACR 2024 - Day 2 Report

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