The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jan 2004
Unremitting health-care-utilization outcomes of tertiary rehabilitation of patients with chronic musculoskeletal disorders.
Unremitting health-care-seeking behaviors have only infrequently been addressed in the literature as an outcome of treatment for chronic disabling work-related musculoskeletal disorders. The limited research has never focused on the patient as the "driver" of health-care utilization, to our knowledge. As a result, little attention has been paid to the differences between treated patients who seek additional health care from a new provider and those who do not. The purpose of this project was to examine the demographic and socioeconomic outcome variables that characterize patients with a chronic disabling work-related musculoskeletal disorder who pursue additional health-care services from a new provider following the completion of a tertiary rehabilitation treatment program. A prospective comparison cohort design was employed to assess characteristics and outcomes of these patients, all of whom were treated with the same interdisciplinary protocol. ⋯ Prognostic study, Level I-1 (prospective study). See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jan 2004
Response bias: effect on outcomes evaluation by mail surveys after total knee arthroplasty.
Mail survey questionnaires are increasingly being used for follow-up evaluations to gauge satisfaction and performance after total joint arthroplasty. Responses to questionnaires are subject to a variety of possible biases. We evaluated response behavior in a mail survey of patients who had had a total knee arthroplasty. ⋯ Patients who do not respond to mail surveys used for follow-up are unique in that they report significantly poorer outcomes than do responders. This potential response bias should be considered in all follow-up analyses. Because it may be difficult to attain 100% response rates in very large series of patients, division of the study cohort into more manageable segments is advised to achieve a more complete response rate. The assessment of patients who are lost to follow-up is an important and necessary component in the accurate analysis of outcomes after arthroplasty.
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J Bone Joint Surg Am · Dec 2003
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized trial comparing the limited contact dynamic compression plate with the point contact fixator for forearm fractures.
The most effective type of plate fixation for diaphyseal forearm fractures has not been defined. We performed a prospective, randomized trial in which the limited contact dynamic compression plate (LC-DCP) was compared with the Point Contact Fixator (PC-Fix) for the treatment of forearm fractures at one center. ⋯ Despite the differences in the concept of fracture fixation, these two implants appear to be equally effective for the treatment of diaphyseal forearm fractures.