Objectives: 1. to assess the validity of an electronically comorbidity assessment strategy to identify comorbid conditions among inflammatory arthritis patients in standard practice. 2. To evaluate the impact of e-comorbidity assessment on the patients' care and adherence to therapy. Methods:A cohort of 112 RA and 111 PsA subjects diagnosed according to RA ACR/EULAR criteria and PsA CASPAR criteria were followed longitudinally for 36 months. The patients were classified into a study group (112 patients) whose electronic patient-reported comorbidities were compared to a control group of 111 patients who were managed according to standard protocols. The sensitivity, specificity, positive and negative predictive values of the electronic data entry were compared to ICD-10 medical record (reference standard) and rheumatology clinic visits outcomes. Results:The sensitivity for identifying comorbidities using the electronic approach (median, 99.2%; interquartile range [IQR]: 96%-100%) outperformed those recorded using using ICD-10 codes (median, 66%; IQR: 50%-74%); and those recorded using clinic letters (median, 38%; IQR: 32%-54%). The median PPV and NPV were 97.7% (IQR: 96-100%) and 99.6% (IQR: 99-100%) for the e-comorbidity tool Vs 61.8% (IQR: 41%-76%) and 97.4% (IQR: 91%-98%) for the ICD-10 codes, physician recorded comorbidity respectively. The patients' adherence to antirheumatic therapy was significantly (p<0.1) higher in the studied group.Conclusions: e-comorbidity assessment offered a specific and dynamic approach tailored to the patient's needs over the 3-years study period, which is applicable in standard practice. Patient reported e-comorbidity outperformed the standard medical recording systems and can have a role in healthcare management and research.

Objectives: To develop and assess the psychometric properties of an instrument/questionnaire for evaluation of ''motivation'' amongst children and adolescents living with inflammatory arthritic conditions. Methods:Based on content analysis, semi structured group discussion and Rasch analysis, ten domains were identified, hence, the questionnaire was developed including: 10-items scale (0-10 on VAS scale). Each item was supported by illustrations explaining both ends of the measure. Construct validity was assessed by correlating the score of the questionnaire to disease activity scores; patient reported outcomes; as well as adherence to therapy. Reliability and comprehensibility and sensitivity to change were also assessed. Results:The questionnaire was assessed in 142 children (43 JIA, 33 systemic arthritis, 34 enthesitis related arthritis, 32 cSLE) Results revealed that the developed illustrated questionnaire mean score correlated significantly (p<0.001) with disease activity measures: JADAS-27, SLEDAI-2K and JSpADA, reflecting its validity. It also correlated significantly (p<0.001) with the scores of functional disabilities, health related quality of life and medication adherence. The questionnaire was reliable (Cronbach's alpha 0.946) and had no mis fitting items. The illustrations were well received, and this was reflected on the questionnaire comprehensibility (97.2) and sensitivity to change (p<0.01). Conclusions:The illustrated children motivation measure, is a patient-centered unidimensional scale that is valid, reliable and comprehensible. The measure has good psychometric properties and can be used at the individual child's level to tailor management and monitor changes in response to therapy. The illustrations enhanced the questionnaire perception by the children as well as the parents.