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    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Myo-Spain&#58; Registro de pacientes con miopat&#237;a inflamatoria idiop&#225;tica de Espa&#241;a&#46; Metodolog&#237;a"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Idiopathic inflammatory myopathies &#40;IIM&#41; form part of a heterogeneous group of diseases of autoimmune origin characterised by non-suppurative inflammation of the skeletal muscles&#44; progressive muscle weakness and variable expressivity in different organs and systems&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> IIM are rare&#44; with a mean incidence ranging from 1 to 19 cases&#47;million inhabitants&#47;year&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> and vary according to geographical area&#44; methodology and classification criteria&#46; A study on the estimated incidence in Spain between 1997&#8211;2004 showed an incidence rate of 8&#46;9 new cases&#47;million inhabitants&#47;year &#40;95&#37; confidence interval &#91;CI&#93; 8&#46;6&#8211;9&#46;2&#41;&#44; with a higher incidence of dermatomyositis &#40;DM&#41; than polymyositis &#40;PM&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The aetiology and predisposing factors for developing IIM are still not entirely clear&#46; They are currently considered immune-mediated disorders&#44; possibly triggered by environmental factors in genetically predisposed individuals&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> IIM presents with a wide variety of clinical manifestations&#59; muscle weakness secondary to chronic inflammation of striated muscle is characteristic&#46; Other organs affected include the skin&#44; joints&#44; lung&#44; gastrointestinal tract&#44; and heart&#46; Complications include infections and cancers&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;8</span></a> Although the prognosis has improved substantially in recent decades&#44; mortality has increased with respect to the general population&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Furthermore&#44; at least one third of patients are moderately or severely disabled&#44; mainly due to pulmonary involvement&#44; the development of calcinosis and muscle weakness&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The identification of specific and associated antibodies&#44; access to imaging techniques such as magnetic resonance imaging and ultrasound&#44; improvements in the interpretation of muscle biopsy and the development of new classification criteria in recent decades have given us a better understanding of this group of diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">However&#44; the heterogeneity of their clinical manifestations&#44; their evolution and prognosis&#44; along with their low prevalence and incidence&#44; make study of these diseases difficult&#46; In Spain&#44; prospective studies are limited&#44; especially those that include all IIM subtypes&#46; No information is available on disease activity&#44; severity&#44; disability&#44; quality of life&#44; treatment management or prognostic factors&#46; In addition&#44; it has not been studied whether the disease behaves differently when comparing patients who meet the new American College of Rheumatology and European League Against Rheumatism &#40;ACR&#47;EULAR&#41; classification criteria at diagnosis with those who meet them during follow-up&#44; or those who never meet them&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Therefore&#44; the Myo-Spain project &#40;Spanish Registry of patients with idiopathic inflammatory myopathy &#40;IIM&#41;&#41; was set up with the main objective of analysing the evolution and management of a cohort of patients with IIM attended in rheumatology departments in Spain&#46; This paper describes the project&#8217;s methodology and potential strengths and limitations&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Methodology</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">General design</span><p id="par0025" class="elsevierStylePara elsevierViewall">An observational&#44; longitudinal&#44; ambispective and multicentre study&#46; An initial follow-up of two years has been proposed&#44; which is expected to be longer to achieve the project&#8217;s main objective &#40;to study the evolution and management of IIM&#41;&#46; The full study protocol is available at <a href="https://myospain.ser.es">https&#58;&#47;&#47;myospain&#46;ser&#46;es</a>&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Reference population</span><p id="par0030" class="elsevierStylePara elsevierViewall">Patients diagnosed with any type of IIM under routine follow-up by rheumatology services&#44; regardless of age at onset&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Two groups of patients have been considered according to time of diagnosis&#46; Incident cases will be all patients who at the start of the study in each centre have been diagnosed for less than 12 months and prevalent cases&#44; all those diagnosed for more than 12 months&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study population&#46; Inclusion and exclusion criteria</span><p id="par0040" class="elsevierStylePara elsevierViewall">1&#46; Inclusion criteria<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0045" class="elsevierStylePara elsevierViewall">Patients with a diagnosis of IIM&#44; according to the judgement of the attending physician&#44; and under active follow-up&#46; Types of IIM can be DM&#44; PM&#44; amyopathic DM&#44; hypomyopathic DM&#44; inclusion body myositis &#40;IBM&#41;&#44; immune-mediated necrotising myopathy &#40;IMNM&#41;&#44; juvenile myopathies&#44; anti-synthetase syndrome&#44; other overlapping syndromes with myositis and unclassifiable&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0050" class="elsevierStylePara elsevierViewall">No age group is excluded from the study&#46; The questionnaires will be answered by the parents or guardians of non-mature minors&#46;</p></li></ul></p><p id="par0055" class="elsevierStylePara elsevierViewall">2&#46; Exclusion criteria<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0060" class="elsevierStylePara elsevierViewall">Patients who&#44; in the opinion of the investigator&#44; have difficulties in attending the visits or completing the forms&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall">Individuals diagnosed with myopathies of toxic or infectious cause or secondary to neuromuscular disease&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">When complete data required for the classification criteria&#44; or a final medical diagnosis are not available&#46;</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Selection of participating centres</span><p id="par0075" class="elsevierStylePara elsevierViewall">All hospitals with specialist rheumatology care belonging to the Spanish Society of Rheumatology Systemic Autoimmune Diseases Working Group &#40;GT EASSER&#41; and interested members of the Spanish Society of Rheumatology &#40;SER&#41; were invited to participate&#46; An online survey was conducted &#40;June 2017&#41; that obtained information on the experience and casuistry of IIM&#46; A pre-selection was then made using an application form sent by interested centres &#40;7 March to 10 April 2018&#41;&#44; detailing recruitment capacity and experience in the management of IIM&#46; The centres were selected over the month of June 2018&#46; A total of 32 centres are eventually participating in the project &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Patient recruitment</span><p id="par0080" class="elsevierStylePara elsevierViewall">The recruitment period is 23 months&#46; The aim is to recruit all patients with a diagnosis of IIM who meet the inclusion criteria with none of the exclusion criteria&#46; All patients must provide their informed consent prior to entering the study&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Patients are invited to participate consecutively at one of their regular visits to the rheumatologist&#46; Patient access to rheumatology services for diagnosis and follow-up is as routine &#40;emergency department&#44; primary care and interconsultation with other specialties such as dermatology&#44; pulmonology&#44; or neurology&#41;&#46; The study has been opened to collaborating researchers from other specialties such as neurology and internal medicine&#44; although rheumatology will coordinate in each centre&#46; The recruitment period began in June 2019&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The electronic Data Collection Form &#40;DCF&#41; allocates an identification code in the study to each of the participants&#44; to maintain data confidentiality&#44; in accordance with current legislation &#40;EU Regulation 2016&#47;679 of the European Parliament and of the Council of 27 April 2016 on Data Protection &#91;RGPD&#93;&#41;&#44; as well as all applicable Spanish and European legislation on privacy and personal data protection&#46; The study has been approved by the reference &#40;Hospital La Paz&#44; Madrid&#41; clinical research ethics committee &#40;CREC&#41; and by each of the CEICs of the participating centres&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Data collection</span><p id="par0095" class="elsevierStylePara elsevierViewall">An electronic DCF specific to Myo-Spain has been created to which each participating centre has access&#46; Clinical information is collected retrospectively &#40;prevalent cases&#41; from the clinical history&#44; and prospectively &#40;prevalent and incident cases&#41;&#44; obtained from baseline and follow-up visits&#44; after one and two years&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Variables and measurements</span><p id="par0100" class="elsevierStylePara elsevierViewall">Multiple analyses with different outcome variables are necessary to meet the objectives of the project&#44; and therefore no specific primary outcome variable has been defined&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Variables and measurements will be collected on the online DCF&#44; both at baseline and at the follow-up visit&#44; after one and two years&#46;<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">1</span><p id="par0110" class="elsevierStylePara elsevierViewall">General&#44; inclusion and sociodemographic data</p></li></ul></p><p id="par0115" class="elsevierStylePara elsevierViewall">These variables include date of birth&#44; sex&#44; race&#44; educational level&#44; the patient&#8217;s IIM classification criteria&#44; type of IIM&#44; date of onset of IIM symptoms&#44; data of diagnosis of IIM&#44; and date of visit&#46; In addition&#44; the date and reason for loss to follow-up will be recorded at the follow-up visits of year 1 and year 2 for patients who drop out of the study&#46;<ul class="elsevierStyleList" id="lis0020"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">2</span><p id="par0120" class="elsevierStylePara elsevierViewall">Classification criteria</p></li></ul></p><p id="par0125" class="elsevierStylePara elsevierViewall">Variables relating to the classification criteria are recorded&#44; such as the form of onset of IIM &#40;acute &#91;0&#8211;14 days from onset&#93;&#44; subacute &#91;&#62;14 days to &#8804;2 months&#93; or insidious &#91;&#62;2 months to years&#93;&#41;&#44; weakness in the limbs and in the flexor-extensor musculature of the neck&#44; muscle pain on pressure or spontaneous muscle pain&#44; elevated muscle enzyme levels&#44; presence of typical DM rash&#44; joint&#44; digestive and systemic manifestations&#44; muscle biopsy&#44; electromyography and magnetic resonance imaging results&#46;<ul class="elsevierStyleList" id="lis0025"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">3</span><p id="par0130" class="elsevierStylePara elsevierViewall">Disease activity</p></li></ul></p><p id="par0135" class="elsevierStylePara elsevierViewall">This includes the Myositis Disease Activity Assessment &#40;MYOACT&#41; where the physician assesses disease activity over the last four weeks using a 10-cm visual analogue scale &#40;VAS&#41; in seven organs&#47;systems &#40;constitutional&#44; cutaneous&#44; skeletal&#44; gastrointestinal&#44; pulmonary&#44; cardiac&#44; and muscular&#41;&#46; It also includes global extramuscular assessment and global MYOACT assessment &#40;muscular and extramuscular&#41; in the last four weeks on a 0&#8722;10-cm VAS<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; It also includes the presence of specific variables at cutaneous &#40;ulceration&#44; panniculitis&#44; erythematous rash&#44; periungual capillary changes&#44; alopecia&#44; mechanic&#8217;s hands&#44; cutaneous vasculitis&#44; sclerodactyly &#91;localised thickening and hardening of the skin of the fingers and toes&#93;&#44; Raynaud&#8217;s phenomenon and others&#41;&#44; skeletal &#40;arthritis and arthralgia&#41;&#44; gastrointestinal &#40;dysphagia or dysmotility&#41;&#44; pulmonary &#40;diffusing capacity for carbon monoxide &#91;DLCO&#93;&#44; forced vital capacity &#91;FVC&#93;&#44; interstitial lung disease patterns on high-resolution computed tomography &#91;HRCT&#93;&#44; chronic home oxygen requirement&#41; and cardiac &#40;pericarditis&#44; myocarditis and arrhythmias&#41; levels&#46; Finally&#44; it includes the physician and patient&#47;parent or guardian global disease assessment at the time of the visit &#40;0&#8722;10-cm VAS&#41;&#44; and Manual Muscle Testing in eight muscle groups &#40;MMT-8&#41;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a>&#46;<ul class="elsevierStyleList" id="lis0030"><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">4</span><p id="par0140" class="elsevierStylePara elsevierViewall">Functional capacity</p></li></ul></p><p id="par0145" class="elsevierStylePara elsevierViewall">The scores are collected of the Health Assessment Questionnaire for functional status in adults&#44; and of the childhood HAQ &#40;CHAQ relating to the week prior to the visit<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a>&#46;<ul class="elsevierStyleList" id="lis0035"><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">5</span><p id="par0150" class="elsevierStylePara elsevierViewall">Damage</p></li></ul></p><p id="par0155" class="elsevierStylePara elsevierViewall">Damage means persistent changes in anatomy&#44; physiology&#44; pathology&#44; or function of any cause since the onset of myositis and present for at least six months&#46; The Myositis Damage Index &#40;MDI&#41; is included&#44; used by the clinician to assess the severity of damage by 10-cm VAS in 11 organs&#47;systems &#40;muscular&#44; skeletal&#44; cutaneous&#44; gastrointestinal&#44; pulmonary&#44; cardiovascular&#44; peripheral vascular&#44; endocrine&#44; ocular&#44; infection&#44; and malignancy&#41;&#46; The global assessment of the severity of damage &#40;0&#8722;10-cm VAS&#41; of the MDI is also recorded<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; The presence and date of diagnosis of specific variables of damage at cutaneous &#40;calcinosis&#44; lipodystrophy&#41;&#44; pulmonary &#40;pulmonary arterial hypertension&#41;&#44; cardiovascular &#40;arterial hypertension&#44; ischaemic heart disease&#41;&#44; peripheral vascular &#40;venous or arterial thrombosis&#41;&#44; endocrine &#40;diabetes mellitus&#41;&#44; serious infection &#40;including location&#41;&#44; malignant neoplasms &#40;including type&#41;&#44; mortality &#40;including cause&#41; levels are recorded&#46; Finally&#44; the physician and patient&#47;parent or guardian global assessment of damage at the time of the visit &#40;0&#8722;10&#160;cm VAS&#41; is included&#41;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a>&#46;<ul class="elsevierStyleList" id="lis0040"><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">6</span><p id="par0160" class="elsevierStylePara elsevierViewall">Laboratory</p></li></ul></p><p id="par0165" class="elsevierStylePara elsevierViewall">Muscle enzyme levels &#40;CPK&#44; GOT&#44; GPT and LDH&#41;&#44; erythrocyte sedimentation rate &#40;ESR&#41;&#44; C-reactive protein &#40;CRP&#41; and ferritin are collected&#46;<ul class="elsevierStyleList" id="lis0045"><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">7</span><p id="par0170" class="elsevierStylePara elsevierViewall">Antibodies</p></li></ul></p><p id="par0175" class="elsevierStylePara elsevierViewall">Information is collected on the presence of specific myositis-associated antibodies &#40;anti-synthetase&#44; anti-MDA5&#44; anti-Mi-2&#44; anti-SRP&#44; anti-TIF1-&#947;&#44; anti-NXP2&#44; anti-HMG-CoA reductase&#44; anti-SAE&#44; anti-Ku&#44; anti-Ro&#44; anti-RNP&#44; anti-PM&#47;SCL&#41;&#46;<ul class="elsevierStyleList" id="lis0050"><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">8</span><p id="par0180" class="elsevierStylePara elsevierViewall">Other comorbidities</p></li></ul></p><p id="par0185" class="elsevierStylePara elsevierViewall">Information is added on comorbidities that are not included in the damage variables &#40;dyslipidaemia&#44; smoking and association with other autoimmune diseases&#46;<ul class="elsevierStyleList" id="lis0055"><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">9</span><p id="par0190" class="elsevierStylePara elsevierViewall">Hospitalisation</p></li></ul></p><p id="par0195" class="elsevierStylePara elsevierViewall">This includes information on hospitalisations and admissions to intensive care units &#40;date and cause&#41;&#46;<ul class="elsevierStyleList" id="lis0060"><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">10</span><p id="par0200" class="elsevierStylePara elsevierViewall">Treatment</p></li></ul></p><p id="par0205" class="elsevierStylePara elsevierViewall">The main treatments used for this disease and their indication are included&#58; glucocorticoids&#44; antimalarials&#44; synthetic immunosuppressants&#44; biological and synthetic targeted immunosuppressants&#44; intravenous immunoglobulins and plasmapheresis &#40;start date&#44; end date and reason for discontinuation&#41;&#46; Other less common treatments such as lung transplantation or direct haemoperfusion with polymyxin B are also included&#46;<ul class="elsevierStyleList" id="lis0065"><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">11</span><p id="par0210" class="elsevierStylePara elsevierViewall">Quality of life</p></li></ul></p><p id="par0215" class="elsevierStylePara elsevierViewall">Information from the 12-Item Short-Form Health Survey &#40;SF-12&#41; quality of life measure is collected<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a>&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the measures taken at each visit of the study&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Sample size</span><p id="par0225" class="elsevierStylePara elsevierViewall">The sample size was not estimated&#44; taking the objectives of the registry into account&#46; All patients from each participating centre who meet the inclusion criteria are anticipated to be included in the study&#46; Based on a previous study of interested centres&#44; the total number of patients is estimated to be around 400&#46; One hundred and eighty-six patients have been included in the first year of recruitment&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Quality control of the database</span><p id="par0230" class="elsevierStylePara elsevierViewall">Annual online monitoring will take place&#46; Each year&#44; the consistency of all new data recorded in the data collection platform will be reviewed&#44; paying special attention to the variables that gather information relating to the study objectives&#46; Only patients who meet &#62;80&#37; of the visit variables will be considered eligible for analysis&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">The procedures have been standardised in addition to the monitoring process&#46; This standardisation has been included in a Myo-Spain investigator&#39;s manual available to all investigators participating in the study&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Visit reminder</span><p id="par0240" class="elsevierStylePara elsevierViewall">Periodic &#40;every two to three months&#41; reminder and project status emails are sent to all participating centres during the inclusion period &#40;V0&#41;&#46; In addition&#44; a reminder email is sent systematically from the online DCF to each centre&#8217;s investigators&#44; notifying them closely in advance &#40;in the month prior to the theoretical date&#41; of the follow-up visits &#40;V1 and V2&#41;&#44; to ensure that the visits take place and patient information is gathered&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0245" class="elsevierStylePara elsevierViewall">This paper describes the methodology of the Myo-Spain registry&#46; The project represents the creation of a Spanish multicentre cohort of incident and prevalent patients with any type of IIM&#44; with a prospective two-year follow-up&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">Several registries have been established at the international level to investigate different aspects of IIM&#46; The multicentre EuroMyositis registry was created in 1999 and currently involves more than 20 countries&#44; primarily in Europe&#46; The registry seeks to obtain uniform longitudinal data on juvenile and adult myositis to gain a better understanding of the course and prognosis of the disease&#46; There is a mandatory data collection area containing basic information present at some time over the duration of the myositis&#44; and another area&#44; which is not mandatory to complete&#44; corresponding to individual visits to monitor the course of the disease &#40;activity and damage&#44; muscle weakness&#44; treatment&#44; antibodies&#44; and biopsy results&#41;&#46; The registry has more than 3000 participants and publications have studied associations between clinical subtypes&#44; extramuscular involvement&#44; environmental exposure&#44; antibodies&#44; and drugs<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a>&#46; In addition&#44; this cohort together with the UK and Ireland cohort&#44; the Juvenile Dermatomyositis Research Group &#40;JDRG&#41;&#44; validated the new EULAR&#47;ACR classification criteria<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;16</span></a>&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">The American Myositis Patient Association launched the MYOVISION national registry in 2010&#46; From December 2010 to July 2012&#44; 1806 patients with IIM &#40;PM&#44; DM&#44; IBM&#41; were included in this registry and agreed to complete a paper or online survey with 83 questions on demographics&#44; work or school&#44; leisure activities&#44; environmental exposure&#44; disease exposure and health-related quality of life&#46; Several cross-sectional studies on environmental exposure and quality of life have been published<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a>&#46; From the US multicentre Childhood Arthritis and Rheumatology Research Alliance &#40;CARRA&#41; registry&#44; which included patients with childhood rheumatic diseases between 2010 and 2014&#44; cross-sectional studies of the 688-patient juvenile DM cohort have been published on clinical characteristics and the association between exposure to ultraviolet radiation and disease severity<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a>&#46; Because of the limitations in the number of variables&#44; in the information on treatments&#44; and in the data collection process that was not systematic at each visit&#44; the new CARRA registry&#44; which was limited to juvenile idiopathic arthritis&#44; was created in 2015<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">The American and European NEtwork of Antisynthetase Syndrome &#40;AENEAS&#41; collaborative cohort is part of an international&#44; multicentre&#44; retrospective study&#44; started in 2014&#44; which includes patients with antisynthetase syndrome with at least six months&#8217; follow-up&#46; The publications in this cohort have focused on the form of presentation of the disease&#44; progression&#44; outcomes&#44; and its specific behaviour&#44; according to the presence of the different anti-synthetase antibodies or specific manifestations such as arthritis<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#8211;24</span></a>&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">We should highlight three initiatives at the national level&#46; The first was internal medicine&#8217;s registry of patients with anti-synthetase syndrome of the Systemic Autoimmune Diseases Study Group &#40;GEAS&#41;&#44; which provided information on manifestations and long-term outcomes in patients with anti-jo1 antibodies<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46; The second was the registry of patients with inflammatory myopathy of the Madrid Rheumatology Society &#40;REMICAM&#41;&#44; with the participation of 12 rheumatology units of the Community of Madrid and retrospective collection of clinical and mortality data for patients under follow-up at some point between 1980 and December 2014&#46; This registry has provided information on mortality&#44; long-term pulmonary outcomes&#44; overlap syndromes with myositis and juvenile forms<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#8211;29</span></a>&#46; Finally&#44; the national registry of patients with MDA5 syndrome &#40;MEDRA5&#41;&#44; a multicentre and multidisciplinary registry that aims to understand the natural history of MDA5 syndrome&#44; and has collected clinical data on these patients retrospectively until December 2019&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">As a strength of the project&#44; and unlike most of the abovementioned registries&#44; Myo-Spain will carry out a prospective protocolised follow-up with annual visits of all patients&#46; This was initially planned for two years&#44; but is expected to be longer&#44; given that IIM are infrequent and heterogeneous diseases and greater follow-up is required to determine their progression and management &#40;the main objective of the project&#41;&#46; All registry variables have been standardised&#44; the data will be strictly monitored and patients who do not reach 80&#37; of the required variables will be excluded from analysis&#46; Although data from follow-up visits can also be collected prospectively in the EuroMyositis registry&#44; this is not mandatory&#44; and the incidence of new manifestations over time may be underestimated&#46; In addition&#44; in the early years of the registry&#44; not all current subtypes of IIM&#44; such as IMNM&#44; had been established and some myositis-specific antibodies had not been discovered&#44; and therefore a percentage of patients may be incorrectly classified&#46; Another strength of Myo-Spain is that from the outset it was designed with two cohorts&#44; one with incident patients &#40;&#60;12 months from diagnosis&#41; and another with prevalent patients &#40;&#62;12 months from diagnosis&#41;&#44; in which all patients must be alive and under active follow-up to be included&#46; As this is a rare disease&#44; we decided on an extended recruitment period&#44; increasing the likelihood of including incident cases&#46; At the same time&#44; we aimed to determine disease activity&#44; damage&#44; disability&#44; muscle strength and quality of life using validated indices and questionnaires to assess disease status and look for associations in a more objective way&#46; Furthermore&#44; by including all the subtypes of IIM&#44; we will be able to make comparisons and identify differences in our population&#46; We will also be able to study the diagnostic usefulness of the new classification criteria in this cohort of the future classification criteria for anti-synthetase syndrome and to determine the differences between patients with complete and incomplete forms at onset of the disease&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">However&#44; our registry also has a few limitations&#46; First&#44; it was not designed to be representative of the geographical distribution of IIM at the national level&#46; This cohort does not include patients from all autonomous communities&#59; to be specific&#44; there are no data from centres in Arag&#243;n&#44; Asturias&#44; Cantabria&#44; Castilla La Mancha&#44; La Rioja&#44; and Navarra&#46; Another possible limitation is patient selection bias&#44; including patients who may have an easier follow-up or who have fewer comorbidities&#46; To avoid this bias&#44; the need to recruit all patients who meet the inclusion criteria per centre was considered&#44; which also becomes a necessity due to the prevalence and incidence data of IIM&#46; Recruitment of all patients meeting the inclusion criteria has been reinforced through regular communication with participating investigators and at meetings at the start of the study and follow-up&#46; Although this is a project of the Spanish Society of Rheumatology and the principal investigators at each centre are rheumatologists&#44; to minimise possible recruitment bias&#44; it was opened for the participation of collaborating investigators from other specialties such as internal medicine and neurology&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusions</span><p id="par0280" class="elsevierStylePara elsevierViewall">The Myo-Spain study represents a cohort of patients with any type of IIM recruited in rheumatology units throughout Spain&#46; This is the first prospective study of these characteristics that the SER has promoted in a rare disease&#46; The cohort will include a group of incident patients and a group of prevalent patients&#44; which will allow detailed assessment of the clinical characteristics of the disease at different times&#46; It is expected that the comprehensive information collected at the visits will provide a valuable source of data for future analysis and research&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0285" class="elsevierStylePara elsevierViewall">Myo-Spain is funded by <span class="elsevierStyleGrantSponsor" id="gs0005">Kern Pharma</span> &#40;Spain&#41;&#44; <span class="elsevierStyleGrantSponsor" id="gs0010">Nordic Pharma</span> &#40;Spain&#41;&#44; <span class="elsevierStyleGrantSponsor" id="gs0015">Sandoz</span> &#40;Spain&#41; and <span class="elsevierStyleGrantSponsor" id="gs0020">Bristol-Myers Squibb</span> &#40;Spain&#41;&#46; None of these companies were involved in the study design&#44; data collection or analysis&#44; or in drafting this article&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interests</span><p id="par0290" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">To describe the methods of the Spanish Registry of patients with idiopathic inflammatory myopathy &#40;IIM&#41; &#40;Myo-Spain&#41;&#44; as well as its strengths and limitations&#46; The main objective of the project is to analyse the evolution and clinical management of a cohort of patients with IIM&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; longitudinal&#44; ambispective and multicentre study of a cohort of patients with IIM seen in rheumatology units in Spain&#46; All patients with a diagnosis of IMM will be included in the regular follow-up of the participating centres&#44; regardless of age on initiation of the process&#46; Incident cases will be all patients who at the beginning of the study have been diagnosed for less than 12 months and prevalent cases for more than 12 months&#46; The registry will include data from the visit at baseline&#44; one year and two years&#46; Socio-demographic&#44; clinical&#44; analytical variables&#44; complications&#44; comorbidities&#44; association with other rheumatic diseases&#44; hospital admissions&#44; mortality and treatments will be collected&#46; In addition&#44; indices&#44; scales and questionnaires of activity&#44; muscle involvement&#44; damage&#44; disability&#44; and quality of life will be determined&#46; The recruitment period will be 23 months&#46; The purpose is to obtain a cohort of 400 patients with IMM&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusions</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Myo-Spain registry provides the opportunity to develop a cohort of incident and prevalent patients with IMM in Spain&#46; Myo-Spain will be able to assess in detail the clinical characteristics of the disease at different times&#46; The comprehensive information collected during the visits is expected to provide a broad source of data for future analysis&#46;</p></span>"
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        "resumen" => "<span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Describir la metodolog&#237;a del Registro de pacientes con miopat&#237;a inflamatoria idiop&#225;tica &#40;MII&#41; de Espa&#241;a &#40;Myo-Spain&#41;&#44; as&#237; como sus fortalezas y limitaciones&#46; El objetivo principal del proyecto es analizar la evoluci&#243;n y el manejo cl&#237;nico de una cohorte de pacientes con MII&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Material y m&#233;todo</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; longitudinal&#44; ambispectivo y multic&#233;ntrico de una cohorte de pacientes con MII atendidos en servicios de Reumatolog&#237;a de Espa&#241;a&#46; Se incluir&#225;n todos los pacientes con diagn&#243;stico de MII en seguimiento habitual por los centros participantes&#44; sin tener en cuenta la edad de inicio del proceso&#46; Los casos incidentes ser&#225;n todos los pacientes que al inicio del estudio en cada centro est&#233;n diagnosticados desde hace menos de 12 meses y casos prevalentes desde hace m&#225;s de 12 meses&#46; Se construir&#225; un registro en el que se incluir&#225;n los datos de la visita basal&#44; del a&#241;o y dos a&#241;os&#46; Se recoger&#225;n variables socio-demogr&#225;ficas&#44; cl&#237;nicas&#44; anal&#237;ticas&#44; complicaciones&#44; comorbilidad&#44; asociaci&#243;n con otras enfermedades reum&#225;ticas&#44; ingresos hospitalarios&#44; mortalidad y tratamientos&#46; Adem&#225;s&#44; se determinar&#225;n &#237;ndices&#44; escalas y cuestionarios de actividad&#44; afectaci&#243;n muscular&#44; da&#241;o&#44; discapacidad y calidad de vida&#46; El periodo de reclutamiento ser&#225; de 23 meses&#46; El prop&#243;sito es conseguir una cohorte de 400 pacientes con MII&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">El estudio Myo-Spain constituye la oportunidad para desarrollar una cohorte de pacientes incidentes y prevalentes con MII en Espa&#241;a&#46; Myo-Spain permitir&#225; evaluar en detalle las caracter&#237;sticas cl&#237;nicas de la enfermedad en diferentes momentos&#46; Se espera que la informaci&#243;n exhaustiva recogida en las visitas suponga una amplia fuente de datos para futuros an&#225;lisis&#46;</p></span>"
        "secciones" => array:3 [
          0 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Material y m&#233;todo"
          ]
          2 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Cobo-Ib&#225;&#241;ez T&#44; S&#225;nchez-Piedra C&#44; Nu&#241;o-Nu&#241;o L&#44; Castellv&#237; I&#44; Carri&#243;n-Barber&#224; I&#44; Romero-Bueno F&#44; et al&#46; Myo-Spain&#58; Registro de pacientes con miopat&#237;a inflamatoria idiop&#225;tica de Espa&#241;a&#46; Metodolog&#237;a&#46; Reumatol Cl&#237;n&#46; 2022&#59;18&#58;253&#8211;259&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Participating hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Autonomous community&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario de Badajoz&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Extremadura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario de la Santa Creu i Sant Pau&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catalonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complejo Asistencial Universitario de Salamanca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Castilla y Le&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario 12 de Octubre&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital del Mar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catalonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital General Universitario Gregorio Mara&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Comminity of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Puerta de Hierro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital General Universitario de Alicante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Valencian Community&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario de Bellvitge&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catalonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital General Universitario de Elda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Valencian Community&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Virgen del Roc&#237;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Andalusia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complejo Hospitalario Universitario A Coru&#241;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Galicia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Ram&#243;n y Cajal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario de la Princesa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario de Basurto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Basque Country&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Germans Trias i Pujol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catalonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital General de Granollers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catalonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario de Gran Canaria Doctor Negr&#237;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Canary Islands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Infanta Sof&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario la Paz&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Fundaci&#243;n Jim&#233;nez D&#237;az&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario HM Sanchinarro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complejo Hospitalario Universitario de Vigo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Galicia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Son Ll&#224;tzer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Balearic Islands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Virgen de la Arrixaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Murcia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario de Canarias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Canary Islands&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Donostia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Basque Country&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Reina Sof&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Andalusia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Cl&#237;nico Universitario de Valencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Valencian Community&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Complejo Hospitalario Universitario de Santiago&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Galicia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Vall d&#8217;Hebron&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Catalonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Pr&#237;ncipe de Asturias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Community of Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">cHAQ&#58; child HAQ&#59; HAQ&#58; Health Assessment Questionnaire&#59; MDI&#58; Myositis Damage Index&#59; MYOACT&#58; Myositis Disease Activity Assessment&#59; MMT-8&#58; Manual Muscle Testing of eight muscle groups&#59; SF-12&#58; 12-Item Short-Form Health Survey&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Visits&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Measures</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Informed consent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inclusion and sociodemographic data&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Loss to follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">General data&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Classification criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Disease activity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MYOACT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Variables at cutaneous&#44; joint&#44; gastrointestinal&#44; pulmonary&#44; and cardiac levels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Physician global damage assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patient&#47;parent or guardian global damage assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MMT-8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HAQ or cHAQ&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Damage&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MDI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Variables at the cutaneous&#44; pulmonary&#44; cardiovascular&#44; peripheral vascular&#44; endocrine levels&#44; severe infection&#44; malignant neoplasms&#44; and mortality&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Physician global damage assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patient&#47;parent or guardian global damage assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Laboratory&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antibodies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other comorbidities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospitalization&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SF-12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Measures taken at each visit of the study&#46;</p>"
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                    0 => array:2 [
                      "titulo" => "Polymyositis and dermatomyositis &#40;second of two parts&#41;"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
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                      "titulo" => "Idiopathic inflammatory myopathies&#58; epidemiology&#44; classification&#44; and diagnostic criteria"
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                          "etal" => false
                          "autores" => array:2 [
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                      "Revista" => array:5 [
                        "tituloSerie" => "Rheum Dis Clin North Am"
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                          "autores" => array:6 [
                            0 => "A&#46; Meyer"
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                            2 => "M&#46; Schaeffer"
                            3 => "J&#46;E&#46; Gottenberg"
                            4 => "B&#46; Geny"
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                      "titulo" => "&#91;Polymyositis-dermatomyositis&#58; incidence in Spain &#40;1997-2004&#41;&#93;"
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                          "etal" => true
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                            3 => "E&#46; Hermosilla P&#233;rez"
                            4 => "J&#46;M&#46; Grau-Junyent"
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                            2 => "D&#46;D&#46; Fraser"
                            3 => "I&#46;N&#46; Targoff"
                            4 => "M&#46; Dalakas"
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                            2 => "Y&#46;J&#46; Wu"
                            3 => "S&#46;F&#46; Luo"
                            4 => "H&#46;H&#46; Ho"
                            5 => "L&#46;B&#46; Liou"
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                      "Revista" => array:5 [
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                          "autores" => array:6 [
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Journal Information
Vol. 18. Issue 5.
Pages 253-259 (May 2022)
Visits
3447
Vol. 18. Issue 5.
Pages 253-259 (May 2022)
Special Article
Full text access
Myo-Spain: Spanish Registry of patients with idiopathic inflammatory myopathy. Methodology
Myo-Spain: Registro de pacientes con miopatía inflamatoria idiopática de España. Metodología
Visits
3447
Tatiana Cobo-Ibáñeza, Carlos Sánchez-Piedrab,
Corresponding author
carlos.sanchez@ser.es

Corresponding author.
, Laura Nuño-Nuñoc, Iván Castellvíd, Irene Carrión-Barberàe, Fredeswinda Romero-Buenof, Javier Narváezg, Ernesto Trallero-Araguásh, Eva Tomeroi, María Esther Ruiz-Luceaj, Carmen Larenak, Carmen Carrasco Cuberol, Vega Jovaním, Carmen Barbadillon, Francisca Siverao, Joaquín Belzuneguip, Ana Pérez Gómezq, Alejandro Gómez Gómeza, Esmeralda Delgado-Fríasr, José María Pego-Reigosas..., Beatriz Jovent, Mónica Ibáñezu, Olga Martínez-Gonzálezv, Alberto Ruiz-Románw, Jordi Cami