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Health Fair Identification of Undiagnosed Rheumatoid Arthritis

Project Description

Rheumatoid arthritis (RA) is an autoimmune disease that affects the joints, leading to substantial morbidity and even increased mortality. Recent research has shown that earlier identification and treatment of RA can lead to improved long-term outcomes, and even drug-free disease remission. Therefore, a major goal of rheumatology practitioners to identify and treat patients with early symptoms of RA. However, there are many barriers to the early identification of subjects with early RA including subtle onset of symptoms, and lack of primary care knowledge of appropriate tests to diagnose RA. I have sought to overcome these barriers by developing a community-based method for identifying undiagnosed RA through the Colorado-based 9Health Fair. At this Fair, I and my fellow investigators administer questionnaires, and perform joint examinations and blood-based biomarker testing to identify with a high degree of accuracy individuals that have undiagnosed RA. Furthermore, because RA has a period of disease development during which there are abnormalities of blood-based biomarkers, through this health-fair screening we can also identify individuals who are at-risk for future onset of RA. We have performed these RA evaluations on over 9000 subjects at health-fairs annually since 2008, and we have identified a substantial number of subjects that have either undiagnosed RA that requires immediate therapy, or who are at sufficiently high-risk for future onset of RA that they would potentially benefit from enrollment in a clinical trial designed to prevent RA. The long-term goal of this project is to establish a robust, reproducible methodology that can be used nationally to identify individuals with early, undiagnosed RA as well as to identify subjects that may be candidates for preventive interventions for RA. To reach this goal, the next steps of this project are to reach the following objectives: 1) To identify the optimal screening methodology to maximize the number of individuals with undiagnosed RA identified through a health-fair screening program. The findings from this objective would allow us to have a specific screening methodology with a known diagnostic accuracy that could be widely implemented to identify undiagnosed RA. 2) To identify the longer-term outcomes of this Fair screening in terms of improved time-to-diagnosis of RA and overall health. The findings from this objective would allow us to determine the overall health-benefit and cost-effectiveness of health-fair screening for undiagnosed RA. A student would work with us on this project to address the objectives above. Specifically, they would work with us in questionnaire design and testing, direct subject contact for screening at the health-fairs, as well as work with us to perform subject follow-up, data analyses and presentation of data in abstract and manuscript form. Furthermore, we are anticipating as of Sept 2012 to initiate a clinical trial for the prevention of RA in high-risk individuals identified in part through this health-fair screening method. As such, a student working with us on this project could gain familiarity with clinical trial design and implementation.  

Area of Study

Immunology and Autoimmune Diseases




Biomolecular Structure and Biochemistry; Surveys, Questionnaires, and Psychological Testing

Disease or Symptom




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Mentor Name

Deane, Kevin

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Created at 8/5/2018 12:10 PM by Hom, Patrick H
Last modified at 8/5/2018 12:10 PM by Hom, Patrick H