ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Understanding, description, and classification of musculoskeletal pain syndromes have been further substantiated, but linking them to physical and psychological variables remains problematic. Core tools to measure disability in a population context forms a stable, well validated set of instruments, which increasingly has been translated, tested, and applied in socio cultural settings and in outcome research. Evidence for a declining incidence of rheumatoid arthritis seems established, and paleopathologic evidence indirectly provides some support for a possible causative environmental agent. Within an epidemiologic framework, immunogenetic studies continue to suggest an increasing number of subsets of rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis variants. Studies in which the overuse hypothesis was tested as a cause in the etiology of osteoarthritis have provided conflicting results. Increasing evidence shows a secular trend in loss of bone mineral density, resulting in an increased fracture incidence. However, validated methods to safely prevent osteoporosis and fracture are also being established. Finally, although they are now well recognized and scientifically productive, large long-term epidemiologic studies should be critically examined.

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Important progress has been reported over the past year on evaluation and standardization of disease activity variables in rheumatoid arthritis and their relation to outcome measures. Core sets of variables have been established both in the United States and Europe, showing a high degree of resemblance. A recently proposed classification of antirheumatic drugs seeks to make a clear distinction between drugs that modify symptoms and those that actually control the disease. This classification may have a definite impact on design and methodology of future clinical trials.

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Health care research in rheumatology has traditionally underemphasized economic studies, but the advent of health care reform makes this type of research more important than ever. This paper reviews studies relating to economics and rheumatology as well as methodologic issues relating to the conduct of such studies. The topics covered include data collection in health services research, problems in the use of traditional measures of health-related quality of life and rheumatology, cost-effectiveness analyses, cost studies, studies documenting changes in utilization, and the merits of using contingent valuation methods as the outcome variable in rheumatologic cost-effectiveness studies. It is important for researchers in rheumatology to continue investigation into the most efficient means of providing care to our patients.

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

In this review, recent research on educational and psychosocial issues in rheumatology are, interpreted in light of the prospects for reforms in health care delivery in the United States. Increased emphasis on primary care will prompt a reappraisal of the training of medical students and primary care residents in the diagnosis, management, and referral of patients with rheumatologic conditions. Evidence of the economic benefits of arthritis self-care education has begun to appear and, if it continues to accumulate, will help assure the availability of such interventions for arthritis patients. Finally, further understanding of the psychosocial impact of musculoskeletal pain and impairment will better enable us to prevent the disability that is a large and growing drain on the American economy.

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

All industrialized nations are facing a crisis in health care financing. Rising expectations coupled with increasing specialization and technologic capacities have forced health care payers to examine their assumptions and to seek data on the outcomes of medical interventions. Clinical investigators who have been taught to use randomized controlled trials that evaluate efficacy under experimental conditions have been redirected toward studies that can help answer health policy questions. Such studies examine the effectiveness of interventions in more realistic settings on a richer array of patient-centered outcomes such as function and consider cost effectiveness and relative cost effectiveness. Rehabilitation interventions, which are by and large pragmatic, have never had a strong scientific basis grounded in controlled trials, and this lack of evidence has put tremendous pressure on clinicians to justify their practices. In this article, we review the recent literature on effectiveness of rehabilitation interventions in rheumatic disorders.

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1994

数据来源: OVID