Skip to main content

Advertisement

SpringerLink
Log in

Mobile health technologies for the management of rheumatic diseases: a systematic review of online stores in Brazil

  • Review Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Rheumatic diseases are serious conditions with a low uptake of conservative treatments. Mobile health (mHealth) applications (apps) offer potential to assist the self-management of rheumatic diseases. Our goal was to perform a systematic review of available mHealth apps for rheumatic diseases in Brazil. We focused on the most prevalent rheumatic diseases: osteoarthritis, rheumatoid arthritis, fibromyalgia, systemic lupus erythematosus, osteoporosis, and axial spondylarthritis. Google Play Store and AppStore in Brazil were queried by two independent reviewers on September 2020, and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). Of the 3173 mHealth apps found, five were eligible for inclusion. Two for fibromyalgia and two for axial spondylarthritis offered exercise, educational content, and tools to track patient-reported symptoms; and one for osteoporosis offered educational content and tracking tools only. The included apps scored moderately on the MARS quality scale, with a mean score (SD) of 3.1 (0.7) on a 0–5 scale. Most apps scored poorly based on credibility, user interface and experience, and engagement. There is growing interest in the development of mHealth technologies to support rheumatic diseases patients. Although the majority of the included apps came from non-profit organizations, they are still of poor quality and limited functionality. This study is a call for to the development of new user-centered mHealth apps that can empower rheumatic diseases patients in Brazil, especially in the area of osteoarthritis, rheumatoid arthritis, and lupus, since no apps were found.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Salaffi F, Di Carlo M, Carotti M et al (2018) The impact of different rheumatic diseases on health-related quality of life: a comparison with a selected sample of healthy individuals using SF-36 questionnaire, EQ-5D and SF-6D utility values. Acta Biomed 89:541–557. https://doi.org/10.23750/abm.v89i4.7298

    Article  Google Scholar 

  2. Hunter DJ, Schofield D, Callander E (2014) The individual and socioeconomic impact of osteoarthritis. Nat Rev Rheumatol 10:437–441. https://doi.org/10.1038/nrrheum.2014.44

    Article  PubMed  Google Scholar 

  3. Stolwijk C, van Onna M, Boonen A, van Tubergen A (2016) Global prevalence of spondyloarthritis: a systematic review and meta-regression analysis. Arthritis Care Res 68:1320–1331. https://doi.org/10.1002/acr.22831

    Article  Google Scholar 

  4. Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos 8:136. https://doi.org/10.1007/s11657-013-0136-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Rees F, Doherty M, Grainge MJ, Lanyon P, Zhang W (2017) The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies. Rheumatology 56:1945–1961. https://doi.org/10.1093/rheumatology/kex260

    Article  PubMed  Google Scholar 

  6. Queiroz LP (2013) Worldwide epidemiology of fibromyalgia. Curr Pain Headache Rep 17:356. https://doi.org/10.1007/s11916-013-0356-5

    Article  PubMed  Google Scholar 

  7. Gabriel SE, Michaud K (2009) Epidemiological studies in incidence, prevalence, mortality, and comorbidity of the rheumatic diseases. Arthritis Res Ther 11:229. https://doi.org/10.1186/ar2669

    Article  PubMed  PubMed Central  Google Scholar 

  8. Dias CZ, dos Santos JBR, Almeida AM et al (2017) Perfil dos usuários com doenças reumáticas e fatores associados à qualidade de vida no sistema único de saúde, Brasil. Rev Méd Minas Gerais 27:1–7. https://doi.org/10.5935/2238-3182.20170089

    Article  Google Scholar 

  9. Assumpção A, Cavalcante AB, Capela CE, Sauer JF, Chalot SD, Pereira CAB, Marques AP (2009) Prevalence of fibromyalgia in a low socioeconomic status population. BMC Musculoskelet Disord 10:64. https://doi.org/10.1186/1471-2474-10-64

    Article  PubMed  PubMed Central  Google Scholar 

  10. Coimbra IB, Plapler PG, de Campos GC (2019) Generating evidence and understanding the treatment of osteoarthritis in Brazil: a study through Delphi methodology. Clinics 74:1–7. https://doi.org/10.6061/clinics/2019/e722

    Article  Google Scholar 

  11. Marinho BCG, Guerra LP, Drummond JB, Silva BC, Soares MMS (2014) The burden of osteoporosis in Brazil. Arq Bras Endocrinol Metabol 58:434–443. https://doi.org/10.1590/0004-2730000003203

    Article  PubMed  Google Scholar 

  12. Singh JA, Saag KG, Bridges SL et al (2016) 2015 American College of Rheumatology Guideline for the treatment of rheumatoid arthritis. Arthritis Care Res 68:1–25. https://doi.org/10.1002/acr.22783

    Article  Google Scholar 

  13. Fanouriakis A, Kostopoulou M, Alunno A, Aringer M, Bajema I, Boletis JN, Cervera R, Doria A, Gordon C, Govoni M, Houssiau F, Jayne D, Kouloumas M, Kuhn A, Larsen JL, Lerstrøm K, Moroni G, Mosca M, Schneider M, Smolen JS, Svenungsson E, Tesar V, Tincani A, Troldborg A, van Vollenhoven R, Wenzel J, Bertsias G, Boumpas DT (2019) 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis 78:736–745. https://doi.org/10.1136/annrheumdis-2019-215089

    Article  CAS  PubMed  Google Scholar 

  14. Ward MM, Deodhar A, Gensler LS, Dubreuil M, Yu D, Khan MA, Haroon N, Borenstein D, Wang R, Biehl A, Fang MA, Louie G, Majithia V, Ng B, Bigham R, Pianin M, Shah AA, Sullivan N, Turgunbaev M, Oristaglio J, Turner A, Maksymowych WP, Caplan L (2019) 2019 update of the American College of Rheumatology/spondylitis Association of America/Spondyloarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol 71:1599–1613. https://doi.org/10.1002/art.41042

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, Callahan L, Copenhaver C, Dodge C, Felson D, Gellar K, Harvey WF, Hawker G, Herzig E, Kwoh CK, Nelson AE, Samuels J, Scanzello C, White D, Wise B, Altman RD, DiRenzo D, Fontanarosa J, Giradi G, Ishimori M, Misra D, Shah AA, Shmagel AK, Thoma LM, Turgunbaev M, Turner AS, Reston J (2020) 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res 72:149–162. https://doi.org/10.1002/acr.24131

    Article  Google Scholar 

  16. Macfarlane GJ, Kronisch C, Dean LE, Atzeni F, Häuser W, Fluß E, Choy E, Kosek E, Amris K, Branco J, Dincer F, Leino-Arjas P, Longley K, McCarthy GM, Makri S, Perrot S, Sarzi-Puttini P, Taylor A, Jones GT (2017) EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 76:318–328. https://doi.org/10.1136/annrheumdis-2016-209724

    Article  CAS  PubMed  Google Scholar 

  17. Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE (2019) OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthr Cartil 27:1578–1589. https://doi.org/10.1016/j.joca.2019.06.011

    Article  CAS  Google Scholar 

  18. Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, Towheed T, Welch V, Wells G, Tugwell P, American College of Rheumatology (2012) American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res 64:465–474. https://doi.org/10.1002/acr.21596

    Article  CAS  Google Scholar 

  19. Kanis JA, McCloskey EV, Johansson H et al (2013) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 24:23–57. https://doi.org/10.1007/s00198-012-2074-y

    Article  CAS  PubMed  Google Scholar 

  20. Iudici M, Pantano I, Fasano S, Pierro L, Charlier B, Pingeon M, Dal Piaz F, Filippelli A, Izzo V (2018) Health status and concomitant prescription of immunosuppressants are risk factors for hydroxychloroquine non-adherence in systemic lupus patients with prolonged inactive disease. Lupus 27:265–272. https://doi.org/10.1177/0961203317717631

    Article  CAS  PubMed  Google Scholar 

  21. Yeam CT, Chia S, Tan HCC, Kwan YH, Fong W, Seng JJB (2018) A systematic review of factors affecting medication adherence among patients with osteoporosis. Osteoporos Int 29:2623–2637. https://doi.org/10.1007/s00198-018-4759-3

    Article  CAS  PubMed  Google Scholar 

  22. Curtis JR, Bykerk VP, Aassi M, Schiff M (2016) Adherence and persistence with methotrexate in rheumatoid arthritis: a systematic review. J Rheumatol 43:1997–2009. https://doi.org/10.3899/jrheum.151212

    Article  CAS  PubMed  Google Scholar 

  23. Thomas EN, Blotman F (2010) Aerobic exercise in fibromyalgia: a practical review. Rheumatol Int 30:1143–1150. https://doi.org/10.1007/s00296-010-1369-6

    Article  PubMed  Google Scholar 

  24. Costedoat-Chalumeau N, Amoura Z, Hulot JS, Aymard G, Leroux G, Marra D, Lechat P, Piette JC (2007) Very low blood hydroxychloroquine concentration as an objective marker of poor adherence to treatment of systemic lupus erythematosus. Ann Rheum Dis 66:821–824. https://doi.org/10.1136/ard.2006.067835

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Najm A, Nikiphorou E, Kostine M, Richez C, Pauling JD, Finckh A, Ritschl V, Prior Y, Balážová P, Stones S, Szekanecz Z, Iagnocco A, Ramiro S, Sivera F, Dougados M, Carmona L, Burmester G, Wiek D, Gossec L, Berenbaum F (2019) EULAR points to consider for the development, evaluation and implementation of mobile health applications aiding self-management in people living with rheumatic and musculoskeletal diseases. RMD Open 5:1–7. https://doi.org/10.1136/rmdopen-2019-001014

    Article  Google Scholar 

  26. Azevedo ARP, de Sousa HML, Monteiro JAF, Lima ARNP (2015) Future perspectives of smartphone applications for rheumatic diseases self-management. Rheumatol Int 35:419–431. https://doi.org/10.1007/s00296-014-3117-9

    Article  PubMed  Google Scholar 

  27. Piga M, Cangemi I, Mathieu A, Cauli A (2017) Telemedicine for patients with rheumatic diseases: systematic review and proposal for research agenda. Semin Arthritis Rheum 47:121–128. https://doi.org/10.1016/j.semarthrit.2017.03.014

    Article  PubMed  Google Scholar 

  28. El Miedany Y (2015) e-Rheumatology: are we ready? Clin Rheumatol 34:831–837. https://doi.org/10.1007/s10067-015-2897-y

    Article  PubMed  Google Scholar 

  29. Yin Y, Chen H (2019) Letter to the editor: mobile applications for patients with gout in China. Clin Rheumatol 38:2281–2282. https://doi.org/10.1007/s10067-019-04622-1

    Article  PubMed  Google Scholar 

  30. Kuijpers W, Groen WG, Aaronson NK, van Harten WH (2013) A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors. J Med Internet Res 15:e37. https://doi.org/10.2196/jmir.2281

    Article  PubMed  PubMed Central  Google Scholar 

  31. Risling T, Martinez J, Young J, Thorp-Froslie N (2017) Evaluating patient empowerment in association with eHealth technology: scoping review. J Med Internet Res 19:e329. https://doi.org/10.2196/jmir.7809

    Article  PubMed  PubMed Central  Google Scholar 

  32. Najm A, Lempp H, Gossec L, Berenbaum F, Nikiphorou E (2020) Needs, experiences, and views of people with rheumatic and musculoskeletal diseases on self-management mobile health apps: mixed methods study. JMIR mHealth uHealth 8:1–12. https://doi.org/10.2196/14351

    Article  Google Scholar 

  33. Knitza J, Simon D, Lambrecht A, Raab C, Tascilar K, Hagen M, Kleyer A, Bayat S, Derungs A, Amft O, Schett G, Hueber AJ (2020) Mobile health usage, preferences, barriers, and eHealth literacy in rheumatology: patient survey study. JMIR mHealth uHealth 8:e19661. https://doi.org/10.2196/19661

    Article  PubMed  PubMed Central  Google Scholar 

  34. Nussbaum R, Kelly C, Quinby E, Mac A, Parmanto B, Dicianno BE (2019) Systematic review of mobile health applications in rehabilitation. Arch Phys Med Rehabil 100:115–127. https://doi.org/10.1016/j.apmr.2018.07.439

    Article  PubMed  Google Scholar 

  35. Najm A, Gossec L, Weill C, Benoist D, Berenbaum F, Nikiphorou E (2019) Mobile health apps for self-management of rheumatic and musculoskeletal diseases: systematic literature review. J Med Internet Res 21:1–10. https://doi.org/10.2196/14730

    Article  Google Scholar 

  36. Choi W, Zheng H, Franklin P, Tulu B (2017) mHealth technologies for osteoarthritis self-management and treatment: a systematic review. Health Informatics J 146045821773567:984–1003. https://doi.org/10.1177/1460458217735676

    Article  Google Scholar 

  37. Knitza J, Tascilar K, Messner E-M, Meyer M, Vossen D, Pulla A, Bosch P, Kittler J, Kleyer A, Sewerin P, Mucke J, Haase I, Simon D, Krusche M (2019) German mobile apps in rheumatology: review and analysis using the mobile application rating scale (MARS). JMIR mHealth uHealth 7:e14991. https://doi.org/10.2196/14991

    Article  PubMed  PubMed Central  Google Scholar 

  38. McDougall JA, Ferucci ED, Glover J, Fraenkel L (2017) Telerheumatology: a systematic review. Arthritis Care Res 69:1546–1557. https://doi.org/10.1002/acr.23153

    Article  Google Scholar 

  39. Higgins JPT GS (2011) Cochrane handbook for systematic reviews of interventions Version 5.1.0 [updated March 2011]. The cochrane collaboration, 2011. Available from https://www.handbook.cochrane.org. Cochrane Collab. Accessed 02 Sept 2020

  40. Moher D, Liberati A, Tetzlaff J, Altman DG (2011) Systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269. https://doi.org/10.1371/journal.pmed1000097

    Article  Google Scholar 

  41. StatCounter 1999-2019., All rights reserved. Mobile Operating System Market Share Worldwide

  42. Apps B of. App Stores List. https://www.businessofapps.com/guide/app-stores-list/. Accessed 02 Sept 2020

  43. Andrade A, de Azevedo Klumb Steffens R, Sieczkowska SM et al (2018) A systematic review of the effects of strength training in patients with fibromyalgia: clinical outcomes and design considerations. Adv Rheumatol 58:36. https://doi.org/10.1186/s42358-018-0033-9

    Article  PubMed  Google Scholar 

  44. Sosa-Reina MD, Nunez-Nagy S, Gallego-Izquierdo T, Pecos-Martín D, Monserrat J, Álvarez-Mon M (2017) Effectiveness of therapeutic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomized clinical trials. Biomed Res Int 2017:14. https://doi.org/10.1155/2017/2356346

    Article  Google Scholar 

  45. Nayak S, Greenspan SL (2018) How can we improve osteoporosis care? A systematic review and meta-analysis of the efficacy of quality improvement strategies for osteoporosis. J Bone Miner Res 33:1585–1594. https://doi.org/10.1002/jbmr.3437

    Article  PubMed  PubMed Central  Google Scholar 

  46. Verhoeven F, Guillot X, Prati C, Mougin F, Tordi N, Demougeot C, Wendling D (2019) Aerobic exercise for axial spondyloarthritis - its effects on disease activity and function as compared to standard physiotherapy: a systematic review and meta-analysis. Int J Rheum Dis 22:234–241. https://doi.org/10.1111/1756-185X.13385

    Article  CAS  PubMed  Google Scholar 

  47. Dantas LO, Weber S, Osani MC, Bannuru RR, McAlindon TE, Kasturi S (2020) Mobile health technologies for the management of systemic lupus erythematosus: a systematic review. Lupus 29:144–156. https://doi.org/10.1177/0961203319897139

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M (2015) Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR mHealth uHealth 3:e27. https://doi.org/10.2196/mhealth.3422

    Article  PubMed  PubMed Central  Google Scholar 

  49. Machado GC, Pinheiro MB, Lee H, Ahmed OH, Hendrick P, Williams C, Kamper SJ (2016) Smartphone apps for the self-management of low back pain: a systematic review. Best Pract Res Clin Rheumatol 30:1098–1109. https://doi.org/10.1016/j.berh.2017.04.002

    Article  PubMed  Google Scholar 

  50. Grainger R, Townsley H, White B, Langlotz T, Taylor WJ (2017) Apps for people with rheumatoid arthritis to monitor their disease activity: a review of apps for best practice and quality. JMIR mHealth uHealth 5:e7. https://doi.org/10.2196/mhealth.6956

    Article  PubMed  PubMed Central  Google Scholar 

  51. Dantas LO, Salvini T d F, McAlindon TE (2020) Knee osteoarthritis: key treatments and implications for physical therapy. Brazilian J Phys Ther 24:1029–1048. https://doi.org/10.1016/j.bjpt.2020.08.004

    Article  Google Scholar 

  52. Nixon A, Kerr C, Doll H, Naegeli AN, Shingler SL, Breheny K, Burge R, Gold DT, Silverman S (2014) Osteoporosis assessment questionnaire-physical function (OPAQ-PF): a psychometrically validated osteoporosis-targeted patient reported outcome measure of daily activities of physical function. Osteoporos Int 25:1775–1784. https://doi.org/10.1007/s00198-014-2695-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Williams DA, Kratz AL (2016) Patient-reported outcomes and fibromyalgia. Rheum Dis Clin N Am 42:317–332. https://doi.org/10.1016/j.rdc.2016.01.009

    Article  Google Scholar 

  54. Nhan DT, Caplan L (2016) Patient-reported outcomes in axial spondyloarthritis. Rheum Dis Clin N Am 42:285–299. https://doi.org/10.1016/j.rdc.2016.01.011

    Article  Google Scholar 

  55. Holloway L, Humphrey L, Heron L, Pilling C, Kitchen H, Højbjerre L, Strandberg-Larsen M, Hansen BB (2014) Patient-reported outcome measures for systemic lupus erythematosus clinical trials: a review of content validity, face validity and psychometric performance. Health Qual Life Outcomes 12:116. https://doi.org/10.1186/s12955-014-0116-1

    Article  PubMed  PubMed Central  Google Scholar 

  56. Yuan SLK (2019) Desenvolvimento de aplicativo móvel para promoção do autocuidado de pacientes com fibromialgia. Universidade de São Paulo

  57. Mendiola MF, Kalnicki M, Lindenauer S (2015) Valuable features in Mobile health apps for patients and consumers: content analysis of apps and user ratings. JMIR mHealth uHealth 3:e40. https://doi.org/10.2196/mhealth.4283

    Article  PubMed  PubMed Central  Google Scholar 

  58. Miller AS, Cafazzo JA, Seto E (2014) A game plan: gamification design principles in mHealth applications for chronic disease management. Health Informatics J 22:184–193. https://doi.org/10.1177/1460458214537511

    Article  PubMed  Google Scholar 

  59. Deterding S, Khaled R, Nacke LE, Dixon D (2011) Gamification: toward a definition. 1–4. http://hci.usask.ca/uploads/219-02-Deterding,-Khaled,-Nacke,-Dixon.pdf. Accessed 13 Oct 2020

  60. Coster S, Norman I (2009) Cochrane reviews of educational and self-management interventions to guide nursing practice: a review. Int J Nurs Stud 46:508–528. https://doi.org/10.1016/j.ijnurstu.2008.09.009

    Article  PubMed  Google Scholar 

  61. Friedman AJ, Cosby R, Boyko S, Hatton-Bauer J, Turnbull G (2011) Effective teaching strategies and methods of delivery for patient education: a systematic review and practice guideline recommendations. J Cancer Educ 26:12–21. https://doi.org/10.1007/s13187-010-0183-x

    Article  PubMed  Google Scholar 

  62. Bashi N, Fatehi F, Fallah M, Walters D, Karunanithi M (2018) Self-management education through mhealth: review of strategies and structures. JMIR mHealth uHealth 6. https://doi.org/10.2196/10771

  63. Salazar A, de Sola H, Failde I, Moral-Munoz JA (2018) Measuring the quality of mobile apps for the management of pain: systematic search and evaluation using the mobile app rating scale. JMIR mHealth uHealth 6:e10718. https://doi.org/10.2196/10718

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

L.O. Dantas and C. Carvalho are Ph.D. researchers from the São Paulo Research Foundation (FAPESP, Process number #2015/ 21422-6 and #2017/20057-8).

Author information

Authors and Affiliations

  1. Physical Therapy Department, Federal University of São Carlos, São Carlos, 13565-905, Brazil

    Lucas Ogura Dantas, Cristiano Carvalho, Beatriz Cardinal Prando & Paula Regina Mendes da Silva Serrão

  2. Division of Rheumatology, Tufts Medical Center, Boston, MA, USA

    Timothy E. McAlindon

Authors
  1. Lucas Ogura Dantas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristiano Carvalho
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Beatriz Cardinal Prando
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Timothy E. McAlindon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paula Regina Mendes da Silva Serrão
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paula Regina Mendes da Silva Serrão.

Ethics declarations

Disclosures

None.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Prospero registration

CRD42020212615

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dantas, L.O., Carvalho, C., Prando, B.C. et al. Mobile health technologies for the management of rheumatic diseases: a systematic review of online stores in Brazil. Clin Rheumatol 40, 2601–2609 (2021). https://doi.org/10.1007/s10067-020-05561-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-020-05561-y

Keywords

Search

Navigation