Healthcare disparities in telemedicine for rheumatology care
被引:9
作者:
Jackson, Lesley E.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Alabama Birmingham, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USAUniv Alabama Birmingham, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA
Jackson, Lesley E.
[1
]
Danila, Maria, I
论文数: 0引用数: 0
h-index: 0
机构:
Univ Alabama Birmingham, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USAUniv Alabama Birmingham, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA
Danila, Maria, I
[1
]
机构:
[1] Univ Alabama Birmingham, Div Clin Immunol & Rheumatol, Birmingham, AL 35294 USA
health disparities;
rheumatology;
telemedicine;
LUPUS NEPHRITIS;
DISEASE;
OUTCOMES;
ACCESS;
D O I:
10.1097/BOR.0000000000000869
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Purpose of review We summarize the recent literature published in the last 2 years on healthcare disparities observed in the delivery of rheumatology care by telemedicine. We highlight recent research dissecting the underpinnings of healthcare disparities and identify potentially modifiable contributing factors. Recent findings The COVID-19 pandemic has had major impacts on care delivery and has led to a pronounced increase in telemedicine use in rheumatology practice. Telemedicine services are disproportionately underutilized by racial/ethnic minority groups and among patients with lower socioeconomic status. Disparities in telemedicine access and use among vulnerable populations threatens to exacerbate existing outcome inequalities affecting people with rheumatic disease. Telemedicine has the potential to expand rheumatology services by reaching traditionally underserved communities. However, some areas lack the infrastructure and technology to engage in telemedicine. Addressing health equity and the digital divide may help foster more inclusive telemedicine care.
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Chevallard, Michel
Belloli, Laura
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Belloli, Laura
Ughi, Nicola
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Ughi, Nicola
Adinolfi, Antonella
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Adinolfi, Antonella
Casu, Cinzia
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Casu, Cinzia
Di Cicco, Maria
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Di Cicco, Maria
Filippini, Davide Antonio
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Filippini, Davide Antonio
Muscara, Marina
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Muscara, Marina
Schito, Emanuela
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Schito, Emanuela
Verduci, Elisa
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Verduci, Elisa
Gentile, Maria Giovanna
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Gentile, Maria Giovanna
Di Rosa, Bartolomeo
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Di Rosa, Bartolomeo
Zoppini, Laura
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Zoppini, Laura
Carli, Cristina
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Carli, Cristina
Destefani, Chiara
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Destefani, Chiara
Luisi, Angela
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Luisi, Angela
Vincenti, Emanuela Marta
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Vincenti, Emanuela Marta
Epis, Oscar Massimiliano
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
机构:
NYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
NYU, Dept Biostat, Sch Global Publ Hlth, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Chunara, Rumi
Zhao, Yuan
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Epidemiol, Sch Global Publ Hlth, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Zhao, Yuan
Chen, Ji
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Populat Hlth, Grossman Sch Med, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Chen, Ji
Lawrence, Katharine
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Populat Hlth, Grossman Sch Med, New York, NY USA
NYU Langone Hlth, Med Ctr Informat Technol, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Lawrence, Katharine
Testa, Paul A.
论文数: 0引用数: 0
h-index: 0
机构:
NYU Langone Hlth, Med Ctr Informat Technol, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Testa, Paul A.
Nov, Oded
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Technol Management & Innovat, Tandon Sch Engn, Brooklyn, NY 11201 USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Nov, Oded
Mann, Devin M.
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Populat Hlth, Grossman Sch Med, New York, NY USA
NYU Langone Hlth, Med Ctr Informat Technol, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
机构:
Henry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USAHenry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USA
Darrat, Ilaaf
Tam, Samantha
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USAHenry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USA
Tam, Samantha
Boulis, Marwan
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USAHenry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USA
Boulis, Marwan
Williams, Amy M.
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USAHenry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USA
机构:
Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Feldman, Candace H.
Hicks, LeRoi S.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Massachusetts, Mem Med Ctr, Div Hosp Med, Worcester, MA 01605 USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Hicks, LeRoi S.
Norton, Tabatha L.
论文数: 0引用数: 0
h-index: 0
机构:
Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Norton, Tabatha L.
Freeman, Elmer
论文数: 0引用数: 0
h-index: 0
机构:
Ctr Community Hlth Educ Res & Serv Inc, Boston, MA USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Freeman, Elmer
Solomon, Daniel H.
论文数: 0引用数: 0
h-index: 0
机构:
Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Brigham & Womens Hosp, Div Pharmacoepidemiol, Boston, MA 02115 USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Chevallard, Michel
Belloli, Laura
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Belloli, Laura
Ughi, Nicola
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Ughi, Nicola
Adinolfi, Antonella
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Adinolfi, Antonella
Casu, Cinzia
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Casu, Cinzia
Di Cicco, Maria
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Di Cicco, Maria
Filippini, Davide Antonio
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Filippini, Davide Antonio
Muscara, Marina
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Muscara, Marina
Schito, Emanuela
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Schito, Emanuela
Verduci, Elisa
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Verduci, Elisa
Gentile, Maria Giovanna
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Gentile, Maria Giovanna
Di Rosa, Bartolomeo
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Di Rosa, Bartolomeo
Zoppini, Laura
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Zoppini, Laura
Carli, Cristina
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Carli, Cristina
Destefani, Chiara
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Destefani, Chiara
Luisi, Angela
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Luisi, Angela
Vincenti, Emanuela Marta
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
Vincenti, Emanuela Marta
Epis, Oscar Massimiliano
论文数: 0引用数: 0
h-index: 0
机构:
ASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, ItalyASST Grande Osped Metropolitano Niguarda, Multispecialist Med Dept, Div Rheumatol, Milan, Italy
机构:
NYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
NYU, Dept Biostat, Sch Global Publ Hlth, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Chunara, Rumi
Zhao, Yuan
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Epidemiol, Sch Global Publ Hlth, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Zhao, Yuan
Chen, Ji
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Populat Hlth, Grossman Sch Med, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Chen, Ji
Lawrence, Katharine
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Populat Hlth, Grossman Sch Med, New York, NY USA
NYU Langone Hlth, Med Ctr Informat Technol, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Lawrence, Katharine
Testa, Paul A.
论文数: 0引用数: 0
h-index: 0
机构:
NYU Langone Hlth, Med Ctr Informat Technol, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Testa, Paul A.
Nov, Oded
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Technol Management & Innovat, Tandon Sch Engn, Brooklyn, NY 11201 USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
Nov, Oded
Mann, Devin M.
论文数: 0引用数: 0
h-index: 0
机构:
NYU, Dept Populat Hlth, Grossman Sch Med, New York, NY USA
NYU Langone Hlth, Med Ctr Informat Technol, New York, NY USANYU, Dept Comp Sci & Engn, Tandon Sch Engn, Brooklyn, NY 11201 USA
机构:
Henry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USAHenry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USA
Darrat, Ilaaf
Tam, Samantha
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USAHenry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USA
Tam, Samantha
Boulis, Marwan
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USAHenry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USA
Boulis, Marwan
Williams, Amy M.
论文数: 0引用数: 0
h-index: 0
机构:
Henry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USAHenry Ford Hosp, Dept Otolaryngol Head & Neck Surg, 2799 W Grand Blvd, Detroit, MI 48202 USA
机构:
Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Feldman, Candace H.
Hicks, LeRoi S.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Massachusetts, Mem Med Ctr, Div Hosp Med, Worcester, MA 01605 USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Hicks, LeRoi S.
Norton, Tabatha L.
论文数: 0引用数: 0
h-index: 0
机构:
Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Norton, Tabatha L.
Freeman, Elmer
论文数: 0引用数: 0
h-index: 0
机构:
Ctr Community Hlth Educ Res & Serv Inc, Boston, MA USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Freeman, Elmer
Solomon, Daniel H.
论文数: 0引用数: 0
h-index: 0
机构:
Brigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA
Brigham & Womens Hosp, Div Pharmacoepidemiol, Boston, MA 02115 USABrigham & Womens Hosp, Div Rheumatol Immunol & Allergy, Boston, MA 02115 USA