title: Interactions between rheumatologists and cardio-/pulmonologists in the assessment and use of outcome measures in pulmonary arterial hypertension related to systemic sclerosis.
abstract: OBJECTIVE
  Pulmonary arterial hypertension in patients with systemic sclerosis is a disease involving multiple organ systems. We investigated the differences in perceptions of how to measure PAH-SSc among cardiologists, pulmonologists and rheumatologists. We also examined how a Delphi exercise can improve agreement among these subspecialties.
  
  
  METHODS
  The outcome measures derived from the recent Delphi survey were used for a detailed analysis of the contribution of the various specialties contributing to it. We compared rheumatologists and cardiologist/pulmonologists with regards to preferences and ratings of various endpoints and the actual use of tools to measure these outcomes. We also examined the effects of the Delphi process among these groups.
  
  
  RESULTS
  We could show that the different expert groups each tended to contribute differently to the development of the core set of measures and that interactions in the Delphi process resulted in convergence of rankings. Despite agreement on the high importance of the domains in the Delphi, the use of tools within those domains was sometimes divergent and dependent on specialty.
  
  
  CONCLUSIONS
  Based on these results, use of differing tools in the diagnosis and treatment of PAH-SSc can be anticipated. Further, the convergence of results provides evidence, for the first time, for the ability of various approaches in these disciplines to reach harmonious endpoints of care for PAHSSc patients. A collaborative, interdisciplinary approach is advantageous for PAH-SSc patients.
authors.affiliation: German Rheumatism Research Centre, Epidemiology, Berlin, Germany.
authors.forename: Doerte
authors.initials: D
authors.lastname: Huscher
authors.forename: David
authors.initials: D
authors.lastname: Pittrow
authors.forename: Oliver
authors.initials: O
authors.lastname: Distler
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Denton
authors.forename: Ivan
authors.initials: I
authors.lastname: Foeldvari
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
authors.forename: Marco
authors.initials: M
authors.lastname: Matucci-Cerinic
authors.forename: Otylia
authors.initials: O
authors.lastname: Kowal-Bielecka
authors.forename: Jerome
authors.initials: J
authors.lastname: Avouac
authors.forename: Frank
authors.initials: F
authors.lastname: Behrens
authors.forename: Peter
authors.initials: P
authors.lastname: Nash
authors.forename: Christian F
authors.initials: CF
authors.lastname: Opitz
authors.forename: Lewis J
authors.initials: LJ
authors.lastname: Rubin
authors.forename: James R
authors.initials: JR
authors.lastname: Seibold
authors.forename: Vibeke
authors.initials: V
authors.lastname: Strand
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Furst
mesh_terms: D002309:Cardiology; D003697:Delphi Technique; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D010348:Patient Care Team / Q000458:organization & administration*; D015272:Pulmonary Medicine; D012219:Rheumatology; D012595:Scleroderma, Systemic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy