
Johannes KnitzaPhilipps University of Marburg | PUM · Institute for Digital Medicine
Johannes Knitza
MD MHBA
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282
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Publications (282)
Prescribable digital health applications (DiGAs) present scalable solutions to improve patient self-management in rheumatology, however real-world evidence is scarce. Therefore, we aimed to assess the effectiveness, usage, and usability of DiGAs prescribed by rheumatologists, as well as patient satisfaction.
The DiGAReal registry includes adult pat...
Systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and idiopathic inflammatory myositis (IIM) are autoimmune diseases managed with long-term immunosuppressive therapies. Hu19-CD828Z, a fully human anti-CD19 chimeric antigen receptor (CAR) with a CD28 costimulatory domain, is engineered to potently deplete B-cells. In this study, we manuf...
Objective
Anti‐synthetase syndrome (ASSD) is a rare systemic autoimmune rheumatic disease (SARD) with significant heterogeneity and no shared classification criteria. We aimed to identify clinical and serological features associated with ASSD that may be suitable for inclusion in the data‐driven classification criteria for ASSD.
Methods
We used a...
Background
Spondyloarthritides (SpAs) are a group of common rheumatic diseases that often cause limited mobility and lower back pain. Physiotherapy is an integral part of treatment, but access to physiotherapy limits treatment success. Digital health applications (DHAs) enable home-based physiotherapy and could significantly improve access for SpAs...
Background
The development and potential of artificial intelligence (AI) is remarkable. Its application in all medical disciplines, including rheumatology, is attracting attention. To what extent AI is already used in clinical routine in rheumatology is unknown. In addition, the perceived barriers, potentials, and expectations regarding AI by rheum...
Patient education is an integral component of the treatment of axial spondyloarthritis (axSpA). However, the validated tools currently available for assessing disease-related knowledge are outdated and, in the case of axSpA, only available in English. The aims of this work were therefore (1) to develop a German-language tool for assessing disease-s...
Background
Therapeutic digital health applications (DiGAs) are expected to significantly enhance access to evidence-based care. Since 2020, German physicians and psychotherapists have been able to prescribe approved DiGAs, which are reimbursed by statutory health insurance. This study investigates the usage, knowledge and perception of DiGAs as wel...
Rheumatology faces a critical shortage of health-care professionals, exacerbated by an ageing patient population and escalating costs, resulting in widening gaps in care. Exponential advances in digital health technologies (DHTs) in the past 5 years offer new opportunities to address these challenges and could contribute to overall improved health...
Non-specific low back pain (NLBP) is prevalent among patients with rheumatic conditions. Digital health applications (DiGAs) provide reimbursed, personalized home treatment for patients, promising to overcome limitations of traditional healthcare systems. However, the adoption and effectiveness of back pain-specific DiGAs in rheumatology are not we...
Objective
The presence of comorbidities can substantially affect patients’ quality of life, but data regarding their impact on idiopathic inflammatory myopathies (IIMs) are limited.
Methods
We examined the prevalence of comorbidities in IIM patients, other autoimmune rheumatic diseases (oAIRDs), and healthy controls (HCs), using data from the self...
Background:
Axial spondyloarthritis (AS) is a chronic inflammatory rheumatic disease characterized by potentially disabling inflammation of the spine and adjacent joints. Regular exercise is a cornerstone of treatment. However, patients with AS currently have little support. YogiTherapy (MaD Lab) is an app developed to support patients with AS by...
Background: Previous studies have demonstrated telemedicine to be an effective tool to complement rheumatology care and address workforce shortage. With the COVID-19 outbreak, telemedicine experienced a massive upswing. An earlier analysis revealed that the motivation of patients with rheumatic and musculoskeletal diseases to use telemedicine is cl...
Zusammenfassung
Digitale Gesundheitsanwendungen (DiGA) revolutionieren die Patientenversorgung durch verbesserten Zugang zu evidenzbasierter Therapie und fördern aktives Selbstmanagement. Die kontinuierlich wachsende Anzahl an DiGA ermöglicht es Patient:innen, durch digitale Unterstützung eigenständiger zu handeln. Die budgetneutrale Verordnung und...
Background: Seronegative spondyloarthropathies (SpA) are a group of common rheumatic diseases that often cause limited mobility and lower back pain. Physiotherapy is an integral part of treatment, but access to physiotherapy limits treatment success. Digital health applications (DHAs) enable home-based physiotherapy and could significantly improve...
Cognitive behavioral therapy improves psychosocial outcomes in rheumatoid arthritis (RA), but access is limited. We conducted a randomized controlled trial to evaluate the efficacy of a cognitive-behavioral digital therapeutic, reclarit , on psychosocial outcomes in adult RA patients with impaired health-related quality of life. Participants were r...
Objective
To determine the occurrence of breakthrough COVID-19 infections (BIs) in patients with systemic lupus erythematosus (SLE) compared with patients with other rheumatic autoimmune diseases (rAIDs), patients with non-rheumatic autoimmune diseases (nrAIDs), and healthy controls (HCs).
Methods
The study was based on data from 7035 fully vaccin...
Background
The complex nature of rheumatic diseases poses considerable challenges for clinicians when developing individualized treatment plans. Large language models (LLMs) such as ChatGPT could enable treatment decision support.
Objective
To compare treatment plans generated by ChatGPT-3.5 and GPT-4 to those of a clinical rheumatology board (RB)...
Background
The diagnosis of inflammatory rheumatic diseases (IRDs) is often delayed due to unspecific symptoms and a shortage of rheumatologists. Digital diagnostic decision support systems (DDSSs) have the potential to expedite diagnosis and help patients navigate the health care system more efficiently.
Objective
The aim of this study was to ass...
BACKGROUND
Mobile Health (mHealth), which refers to health care facilitated by mobile devices, offers a promising strategy for enhancing disease management and treatment for patients with chronic conditions. However, there is limited information on how patients with inflammatory bowel disease (IBD) utilize mHealth and their digital preferences.
OB...
Notwithstanding the wealth of literature on COVID-19, studies focusing on young adults with autoimmune diseases (AD) are lacking. To determine early (within 7 days) and late (after 7 days) anti-SARS-CoV-2 vaccine-related adverse events (AEs), post-vaccine disease flares, COVID-19 severity and breakthrough infections (B-INFs) in young people with rh...
Background
Psoriasis vulgaris (PsV) and psoriatic arthritis (PsA) are complex, multifactorial diseases significantly impacting health and quality of life. Predicting treatment response and disease progression is crucial for optimizing therapeutic interventions, yet challenging. Automated machine learning (AutoML) technology shows promise for rapidl...
Background
Patients with rheumatic musculoskeletal diseases (RMDs) face an increased risk of cardiovascular (CV) diseases, cancer and infections. In Germany, general practitioners (GPs) are in charge of the general health of patients, as they are much more accessible than rheumatologists and see their patients in shorter intervals.
Objectives
To a...
Background
Rheumatic? is an online symptom checker developed collaboratively by designers, engineers, clinical experts and patients. It is designed to identify individuals at high risk of developing rheumatic diseases and patients with immune-mediated rheumatic diseases (IRD). After completion of the questionnaire, Rheumatic? gives a weighted score...
Background
Digital Health Technologies (DHTs) are increasingly expanding conventional rheumatology care, offering new modalities for patient engagement and treatment management. Understanding the factors influencing their adoption and usage among patients in rheumatology care is crucial for optimizing their implementation and effectiveness.
Object...
Background
Axial spondyloarthritis (axSpA) is an inflammatory autoimmune disease that can lead to restricted mobility, spinal deformities and pain, especially in the lower back. In addition to treatment with anti-inflammatory and pain-relieving medications, physical therapy is considered the gold standard for reducing pain and improving patient`s m...
Background
Artificial intelligence (AI) is revolutionizing all medical disciplines, including rheumatology. It is unclear to what extent AI is already used in rheumatology in clinical routine. Additionally, the perceived barriers, potentials, and expectations regarding AI by rheumatologists have not yet been studied.
Objectives
The study investiga...
Background
Axial Spondyloarthritis (axSpA) is a common chronic inflammatory rheumatic disease primarily affecting the axial skeleton, and potentially other joints and organs [1]. Considerable time still elapses between the onset of initial symptoms of axSpA and the final diagnosis [2]. The journey to diagnosis and accurate management of axSpA is of...
Background
Musculoskeletal (MSK) symptoms are the leading contributor to various diseases and disability, affecting around 1.7 billion people globally. Early disease stratification is important to ensure appropriate and timely care (most suited healthcare provider and best treatment choice). Currently the patient journey to diagnosis and effective...
Background
Quantification of spinal mobility in chronic axial spondyloarthritis (axSpA) is an important component of disease assessment and is currently assessed using the clinical Bath Ankylosing Spondylitis Metrology Index (BASMI). Functional movement-based outcome measures are dependent on a number of secondary factors and, in particular, the im...
Background
Systemic lupus erythematosus is a rare multisystemic disease that often requires lifelong treatment and affects various aspects of life. Patient education is an essential pillar of disease management but is often impaired by physician’s lack of time and staff. To provide high quality patient information, the initiative Lupus100.org was l...
Background
In light of much needed functional assessments to monitor disease activity and functional status in spondyloarthritis (SpA), gait analysis is gaining interest. While it is generally known that the functional status and gait kinematics are closely related, it is unclear how fear of movement (kinesiophobia) affects gait kinematics in SpA p...
Background
Psychosocial wellbeing significantly contributes to the overall health experiences of individuals with systemic lupus erythematosus (SLE). Mental health is often influenced by the intricate interplay between multifaceted factors, including the impact of disease on quality of life, pain, fatigue, drug-related side effects, and disease-spe...
Background
Pain plays an essential role in therapeutic decision-making in autoimmune rheumatic diseases (AIRDs). However, it may persist in patients in disease remission, thus impacting quality of life and leading to unnecessary escalation of therapy.
Objectives
Using the COVAD2 global database, we aimed to explore the self-reported pain landscape...
Background
Patients with axial spondyloarthritis (axSpA) suffer from progressive spinal stiffness which can significantly restrict the range of movement [1]. Quantifying spinal mobility is a cornerstone of clinical assessment [2] and is currently achieved by the Bath Ankylosing Spondylitis Metrology Index (BASMI) [3]. This assessment is based on ma...
Background
Idiopathic inflammatory myopathies (IIM) encompass a group of disorders characterized by muscle inflammation, weakness, and varying levels of systemic involvement. These conditions profoundly impact patients’ quality of life (QoL) due to their chronic nature, physical impairments, and accompanying mental health challenges. Recent literat...
Purpose
This study investigated the concordance of five different publicly available Large Language Models (LLM) with the recommendations of a multidisciplinary tumor board regarding treatment recommendations for complex breast cancer patient profiles.
Methods
Five LLM, including three versions of ChatGPT (version 4 and 3.5, with data access until...
Workforce shortage and the increasing burden of rheumatic and musculoskeletal diseases lead to extreme time constraints in rheumatology outpatient care. Digital services promise to facilitate care by relieving employees and unleash new capacities. This study aims to explore the perspectives of early adopter health care professionals (HCP) on digita...
Background
Despite the overall safety and efficacy of COVID‐19 vaccinations, rare cases of systemic autoimmune diseases (SAIDs) have been reported post‐vaccination. This study used a global survey to analyze SAIDs in susceptible individuals' post‐vaccination.
Methods
A cross‐sectional study was conducted among participants with self‐reported new‐o...
Emerging digital technologies promise to improve breast cancer care, however lack of awareness among clinicians often prevents timely adoption. This study aims to investigate current awareness and intention-to-use of three technologies among breast cancer healthcare professionals (HCP): (1) digital health applications (DHA), (2) artificial intellig...
Background
The pandemic presented unique challenges for individuals with autoimmune and rheumatic diseases (AIRDs) due to their underlying condition, the effects of immunosuppressive treatments, and increased vaccine hesitancy.
Objectives
The COVID‐19 vaccination in autoimmune diseases (COVAD) study, a series of ongoing, patient self‐reported surv...
Introduction
The growing recognition of holistic patient care highlights the various factors shaping the quality of life of individuals with autoimmune and rheumatic diseases (AIRDs). Beyond the traditional disease measures, there is an emerging acknowledgment of the less-explored aspects, including subjective well-being, social determinants of hea...
Patients with axial spondyloarthritis (axSpA) require close monitoring to achieve the goal of sustained disease remission. Telehealth can facilitate continuous care while relieving scarce healthcare resources. In a mixed-methods proof-of-concept study, we investigated a hybrid telehealth care axSpA pathway in patients with stable disease over 6 mon...
Digital transformation is shaping the future of orthopedics and trauma surgery. Telemedicine, digital health applications, electronic patient records and artificial intelligence play a central role in this. These technologies have the potential to improve medical care, enable individualized patient treatment plans and reduce the burden on the treat...
Objectives:
The CLASS (Classification Criteria of Anti-Synthetase Syndrome) project is a large international multicentre study that aims to create the first data-driven anti-synthetase syndrome (ASSD) classification criteria. Identifying anti-aminoacyl tRNA synthetase antibodies (anti-ARS) is crucial for diagnosis, and several commercial immunoass...
Objective
The management of systemic lupus erythematosus (SLE) relies on accurately evaluating disease activity. However discordance between physician and patient perceptions of disease activity are frequently observed. With the increasing prevalence of virtual consultations, understanding factors contributing to this discordance in patient perceiv...
Objective
Lupus is a rare and complex disease that affects almost all aspects of life. Inevitably, patients are constantly confronted with questions about their disease. Nevertheless, the shortage of rheumatology expert care often stands in contrast with the patients’ demand for sufficient information. To provide reliable disease-related informatio...
COVID-19 has been suggested as a possible trigger of disease flares in patients with rheumatoid arthritis (RA). However, factors associated with disease flares remain unknown. This study aimed to identify factors associated with breakthrough infection (BIs) and disease flares in patients with RA following COVID-19. We analysed data from RA patients...
Objectives
To investigate health-related quality of life in patients with idiopathic inflammatory myopathies (IIMs) compared with those with non-IIM autoimmune rheumatic diseases (AIRDs), non-rheumatic autoimmune diseases (nrAIDs), and without autoimmune diseases (controls), using Patient-Reported Outcome Measurement Information System (PROMIS) ins...
Objectives
To explore prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIM) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.
Methods
A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-...
BACKGROUND
The exponential growth of telehealth is revolutionizing healthcare delivery, but its evaluation has not matched the pace of its uptake. Various forms of assessment, from single-item to more-extensive questionnaires, have been used to assess telehealth and digital therapeutics and their usability. The most-frequently used questionnaire is...
Background
The exponential growth of telehealth is revolutionizing health care delivery, but its evaluation has not matched the pace of its uptake. Various forms of assessment, from single-item to more extensive questionnaires, have been used to assess telehealth and digital therapeutics and their usability. The most frequently used questionnaire i...
Fibroblasts are important regulators of inflammation, but whether fibroblasts change phenotype during resolution of inflammation is not clear. Here we use positron emission tomography to detect fibroblast activation protein (FAP) as a means to visualize fibroblast activation in vivo during inflammation in humans. While tracer accumulation is high i...
Background:
Treatment for autoimmune diseases such as systemic lupus erythematosus (SLE), idiopathic inflammatory myositis, and systemic sclerosis often involves long-term immune suppression. Resetting aberrant autoimmunity in these diseases through deep depletion of B cells is a potential strategy for achieving sustained drug-free remission.
Met...
BACKGROUND
Axial spondyloarthritis (AS) is a chronic inflammatory rheumatic disease characterized by potentially disabling inflammation of the spine and adjacent joints. Regular exercise is a cornerstone of treatment. However, AS patients currently have little support. YogiTherapy is an app developed to support AS patients by providing instructions...
Objective
Patients referred to rheumatologists are currently facing months of inefficient waiting time due to the increasing demand and rising workforce shortage. We piloted a pre-assessment of patients with suspected axial spondyloarthritis (axSpA) combining student-led clinics and telemedicine (symptom assessment, symptom monitoring and at-home c...
Background
Emergency departments (EDs) are frequently overcrowded and increasingly used by nonurgent patients. Symptom checkers (SCs) offer on-demand access to disease suggestions and recommended actions, potentially improving overall patient flow. Contrary to the increasing use of SCs, there is a lack of supporting evidence based on direct patient...
Telemedicine (TM) has augmented healthcare by enabling remote consultations, diagnosis, treatment, and monitoring of patients, thereby improving healthcare access and patient outcomes. However, successful adoption of TM depends on user acceptance, which is influenced by technical, socioeconomic, and health-related factors. Leveraging machine learni...
BACKGROUND
Psoriasis vulgaris (PsV) and Psoriatic arthritis (PsA) are intertwined multifactorial diseases with significant impact on health and quality of life, which can be debilitating due to chronicity and treatment complexity. Predicting treatment response and disease progression in these conditions is challenging, but crucial for optimising th...
Dear Editor, We read with great interest the comment by Ruffer et al. [1] on our report on successful treatment of a patient with anti-synthetase syndrome (ASS) with CD19-targeted chimeric antigen receptor (CAR) T cells after having failed treatment with several different B cell–depleting antibodies. Ruffer et al. [1] describe two ASS patients char...
BACKGROUND
The diagnosis of inflammatory rheumatic diseases (IRDs) is often delayed due to unspecific symptoms and a shortage of rheumatologists. Digital diagnostic decision support systems (DDSSs) have the potential to expedite diagnosis and help patients navigate the health care system more efficiently.
OBJECTIVE
The aim of this study was to ass...
Background
Mobile eHealth apps have been used as a complementary treatment to increase the quality of life of patients and provide new opportunities for the management of rheumatic diseases. Telemedicine, particularly in the areas of prevention, diagnostics, and therapy, has become an essential cornerstone in the care of patients with rheumatic dis...
To investigate the frequency, profile, and severity of COVID-19 breakthrough infections (BI) in patients with type I diabetes mellitus (T1DM) compared to healthy controls (HC) after vaccination. The second COVID-19 Vaccination in Autoimmune Diseases (COVAD-2) survey is a multinational cross-sectional electronic survey which has collected data on pa...
Remote patient monitoring (RPM) leverages advanced technology to monitor and manage patients’ health remotely and continuously. In 2022 European Alliance of Associations for Rheumatology (EULAR) points-to-consider for remote care were published to foster adoption of RPM, providing guidelines on where to position RPM in our practices. Sample papers...
Background:
Rapid digitalization in health care has led to the adoption of digital technologies; however, limited trust in internet-based health decisions and the need for technical personnel hinder the use of smartphones and machine learning applications. To address this, automated machine learning (AutoML) is a promising tool that can empower hea...
Background: CD19-targeting chimeric antigen receptor (CAR) T cells are highly efficient in B cell malignancies. However, CD19 CAR T cells also target autoreactive B cells that trigger autoimmune diseases (AID) including systemic lupus erythematosus (SLE), idiopahtic inflammatory myositis (IIM) and systemic sclerosis (SSc). Achieving long-term remis...
Purpose of Review
This article serves as a comprehensive review, focusing on digital approaches utilized in the diagnosis, monitoring, and treatment of patients with idiopathic inflammatory myopathies (IIM). The authors critically assess the literature published in the last three years, evaluating the advancements and progress achieved in this spec...
Chronic inflammatory rheumatic diseases mostly run an undulating course and with unspecific symptoms. The initial clarification and timely initiation of treatment are challenging, which is additionally exacerbated by the lack of specialized physicians. Digital approaches, including artificial intelligence (AI), should be of assistance and enable an...
Objectives
We aimed to investigate gender-based differences in idiopathic inflammatory myopathies (IIMs), with a particular focus on patient-reported outcomes, utilizing data obtained through the international COVID-19 vaccination in autoimmune disease (COVAD) e-survey.
Methods
Patient-reported outcomes including fatigue, pain, and physical functi...
Pre-clinical studies suggest that large language models (i.e., ChatGPT) could be used in the diagnostic process to distinguish inflammatory rheumatic (IRD) from other diseases. We therefore aimed to assess the diagnostic accuracy of ChatGPT-4 in comparison to rheumatologists. For the analysis, the data set of Gräf et al. (2022) was used. Previous p...
BACKGROUND
In recent years, healthcare has undergone a rapid and unprecedented digital transformation. In many fields of specialty care, such as rheumatology, this shift is driven by the growing number of patients and limited resources, leading to increased use of digital health technologies (DHT) to maintain high-quality clinical care. Prior studi...
Background
In recent years, health care has undergone a rapid and unprecedented digital transformation. In many fields of specialty care, such as rheumatology, this shift is driven by the growing number of patients and limited resources, leading to increased use of digital health technologies (DHTs) to maintain high-quality clinical care. Previous...