Arthritis and rheumatism
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Arthritis and rheumatism · Dec 2009
Meta AnalysisThe importance of allocation concealment and patient blinding in osteoarthritis trials: a meta-epidemiologic study.
To evaluate the association of adequate allocation concealment and patient blinding with estimates of treatment benefits in osteoarthritis trials. ⋯ Results of osteoarthritis trials may be affected by selection and detection bias. Adequate concealment of allocation and attempts to blind patients will minimize these biases.
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Arthritis and rheumatism · Dec 2009
Randomized Controlled TrialA patient's perspective on multidisciplinary treatment gain for fibromyalgia: an indicator for pre-post treatment effects?
Increasing attention is devoted to the patient's perspective in clinical research and practice. However, the relationship between the patient's view on treatment progress and standardized pre-post changes in health outcomes is not well understood. The objective of this study was to investigate whether the patient's perception of treatment gain converges with pre-post treatment effects of a multidisciplinary treatment as assessed by standardized self-report measures. ⋯ Results suggest that the patient's perception of treatment gain and pre-post changes in outcomes during treatment assess different aspects of the patient's treatment progress, particularly with regard to psychological functioning. Future research on clinical improvements should consider the patient's perception of treatment gain as an independent and clinically relevant outcome, in addition to standardized trial data of pre-post assessments of health outcomes.
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Arthritis and rheumatism · Dec 2009
Modeling the need for hip and knee replacement surgery. Part 1. A two-stage cross-cohort approach.
To explore inequalities in the need for hip/knee replacement surgery using a 2-stage cross-cohort approach. ⋯ This study provides evidence of greater variations of inequalities in need for hip/knee replacement than previous studies. Further research should explore geographic variation and produce small-area estimates of need to inform local health planning. It is important to complement data on need with willingness to undergo surgery.
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Arthritis and rheumatism · Dec 2009
Do mothers and fathers hold similar views about their child's arthritis?
Evaluations of the well-being of children with juvenile idiopathic arthritis (JIA) typically rely on parents as proxy respondents. An assumption of several studies appears to be that mothers' and fathers' ratings are interchangeable, as reports do not always specify which parent completed the assessments nor, in repeated measures, whether they were completed by the same parent. The aim of this study was to examine the level of agreement between mothers' and fathers' ratings of their child's quality of life (QOL) and to identify possible predictors of disagreement. ⋯ It should not be assumed that proxy ratings of a child's well-being can be generalized from one parent to the other. Studies that take repeated assessments should ensure that the same parent completes assessments at all time points. Other factors that may explain discordance between parents' ratings need to be explored.
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Arthritis and rheumatism · Dec 2009
Understanding the lack of understanding: invalidation from the perspective of the patient with fibromyalgia.
Patients with fibromyalgia have difficulty with the invisibility and medically unexplained character of the syndrome. Disbelief, lack of acceptance, and stigmatization by their spouse, family, colleagues, the health care system, and society are key issues in their lives. Nevertheless, the components of this phenomenon that we term "invalidation" are not clear. The aim of our study was to identify the definition and structure of invalidation as perceived by patients with fibromyalgia. ⋯ Invalidation as perceived by patients with fibromyalgia includes active negative social responses (denying, lecturing, and overprotecting) as well as a lack of positive social responses (supporting and acknowledging) with respect to the patient and the condition of the patient. This definition of invalidation provides a basis to quantify invalidation and to study its impact on symptom severity, quality of life, therapy adherence, therapy outcome, and other important aspects of fibromyalgia.