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Adaptation and validation of the rheumatoid arthritis quality of life scale for use in Canada.

https://arctichealth.org/en/permalink/ahliterature193939
Source
J Rheumatol. 2001 Jul;28(7):1505-10
Publication Type
Article
Date
Jul-2001
Author
C. Neville
D. Whalley
S. McKenna
M. Le Comte
P R Fortin
Author Affiliation
Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada.
Source
J Rheumatol. 2001 Jul;28(7):1505-10
Date
Jul-2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid - psychology
Canada
Female
Health status
Health Surveys
Humans
Male
Middle Aged
Multilingualism
Quality of Life
Reproducibility of Results
Abstract
The Rheumatoid Arthritis Quality of Life questionnaire (RAQoL) was developed simultaneously in the UK and the Netherlands to measure quality of life in patients with RA. We adapted and validated the RAQoL for the English-Canadian and French-Canadian languages and culture.
The UK RAQoL was translated into French-Canadian by a bilingual translation panel. Separate lay panels were then used to ensure that this and the English-Canadian instruments were appropriate for use with Canadian patients. Interviews were conducted with 15 French-Canadian and 15 English-Canadian patients with RA to determine the content validity. Reliability and construct validity were established by means of test-retest mail surveys conducted with 92 French-Canadian and 87 English-Canadian RA patients. The survey consisted of the adapted RAQoL, the Health Assessment Questionnaire (HAQ), and a demographic questionnaire.
The RAQoL was successfully adapted for both the French and English-Canadian cultures. Field testing showed both versions to be well received by respondents. Of the French-Canadian patients included in the postal survey, 52 responded at Time 1 and 50 at Time 2. For the English-Canadian sample, 54 responded at both time points. Missing data rates for the RAQoL were low and floor and ceiling effects were minimal. Test-retest reliability was good for both versions: 0.87 for the French-Canadian and 0.95 for the English-Canadian. Alpha coefficients (0.92 for the French-Canadian, 0.93 for the English-Canadian) showed the items to be adequately interrelated and scores on the measure showed moderate to high correlations with the HAQ, confirming construct validity. Both versions of the RAQoL were also able to distinguish patient groups that differed according to perceived health status and perceived severity of RA. In addition, the French-Canadian version was able to distinguish patients who rated today as bad or very bad from those who rated today as good or very good.
The new versions of the RAQoL were well received by both French and English speaking Canadians. The psychometric quality of the adapted questionnaires means they are suitable for inclusion in clinical trials involving patients with RA.
PubMed ID
11469454 View in PubMed
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An international perspective on the well being and health care costs for patients with systemic lupus erythematosus. Tri-Nation Study Group.

https://arctichealth.org/en/permalink/ahliterature201483
Source
J Rheumatol. 1999 Jul;26(7):1500-11
Publication Type
Article
Date
Jul-1999
Author
A E Clarke
M A Petri
S. Manzi
D A Isenberg
C. Gordon
J L Senecal
Y. St Pierre
L. Joseph
J. Penrod
P R Fortin
N. Sutcliffe
J R Goulet
D. Choquette
T. Grodzicky
D S Danoff
V. Ho
J M Esdaile
Author Affiliation
Department of Medicine, Montreal General Hospital, McGill University, Quebec, Canada. annc@nil.mni.mcgill.ca
Source
J Rheumatol. 1999 Jul;26(7):1500-11
Date
Jul-1999
Language
English
Publication Type
Article
Keywords
Adult
Canada
England
Female
Health Care Costs
Health status
Humans
Lupus Erythematosus, Systemic - economics - psychology
Male
Patient satisfaction
United States
Abstract
To compare health care expenditure and health status for patients with systemic lupus erythematosus (SLE) between nations with distinct mechanisms for funding and delivering health care services.
Seven hundred eight patients with SLE from 2 centers in each of 3 countries (Canada 229, United States 268, United Kingdom 211) underwent physician assessment of disease activity and damage and reported on physical and psychosocial well being, satisfaction, social support, and health resource utilization. To compare overall utilization, constant prices (1997 Canadian dollars) were applied across countries for each service, enabling diverse resources to be collapsed into a single expression.
After adjusting for important patient covariates, Canadian, compared to American and British patients, reported significantly superior health status in 3 of 8 Medical Outcome Survey Short Form-36 (SF-36) subscales, the SF-36 physical component summary score, and the visual analog scale of general health status. There was no consistent trend in patient satisfaction. Overall annual resource utilization did not vary significantly, with mean annual per patient expenditures (adjusted for demographics, disease duration, activity, damage, social support, health status, patient satisfaction, and age and sex adjusted country-specific SF-36 general population norms) totalling $4853, $5285, and $4760 for Canada, US, and the UK, respectively. However, within each resource category, differences were observed. Canadians saw more specialists than the British, the British more generalists. Canadians and Americans were more frequent users of the emergency room; Americans of laboratory/imaging procedures. Canadians had higher hospital costs than Americans.
After adjustment, Canadian patients reported better well being than their counterparts. Despite considerable differences in the mechanisms of health care funding and service mixture, overall resource utilization did not vary significantly between the countries, although there was a trend towards more intense use of inpatient services in Canada and outpatient services in the United States.
PubMed ID
10405937 View in PubMed
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Association of LY9 in UK and Canadian SLE families.

https://arctichealth.org/en/permalink/ahliterature159173
Source
Genes Immun. 2008 Mar;9(2):93-102
Publication Type
Article
Date
Mar-2008
Author
D S Cunninghame Graham
T J Vyse
P R Fortin
A. Montpetit
Y-c Cai
S. Lim
T. McKenzie
L. Farwell
B. Rhodes
L. Chad
T J Hudson
A. Sharpe
C. Terhorst
C M T Greenwood
J. Wither
J D Rioux
Author Affiliation
Section of Molecular Genetics and Rheumatology, Imperial College Faculty of Medicine, Hammersmith Hospital, London, UK. deborah.cunninghame-graham@imperial.ac.uk
Source
Genes Immun. 2008 Mar;9(2):93-102
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Alleles
Antigens, CD - genetics
Canada - epidemiology
Genetic Linkage - genetics
Genetic Predisposition to Disease
Great Britain - epidemiology
Humans
Lupus Erythematosus, Systemic - epidemiology - genetics
Membrane Glycoproteins - genetics
Pedigree
Polymorphism, Single Nucleotide - genetics
Abstract
Systemic lupus erythematosus (SLE) is a complex disease trait of unknown aetiology. Genome-wide linkage studies in human SLE identified several linkage regions, including one at 1q23, which contains multiple susceptibility genes, including the members of the signalling lymphocyte activation molecule (SLAM) locus. In mice there is a syntenic linkage region, Sle1. The SLAM genes are functionally related cell-surface receptors, which regulate signal transduction of cells in the immune system. Family-based association study in UK and Canadian SLE families identified variants in the promoter and coding region of SLAMF7 and LY9 contributing to SLE disease susceptibility. The strongest association was from rs509749, in exon 8 of LY9 (P=0.00209). rs509749 encodes a Val/Met nonsynonymous change in amino acid 602 in the cytoplasmic domain of LY9. In the parents and affected individuals from the Canadian SLE families, the risk allele of rs509049 skews the T-cell population by increasing the number of CD8+ memory T cells, while decreasing the proportion of CD4+ naïve T cells and activated T cells. Since rs509749 lies within the consensus binding site for SAP/SH2D1a, which influences downstream signalling events from LY9, the mechanism for increased CD8+ memory T cells may include differential binding SAP/SH2D1a to the cytoplasmic domain of LY9.
PubMed ID
18216865 View in PubMed
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The frequency of and associations with hospitalization secondary to lupus flares from the 1000 Faces of Lupus Canadian cohort.

https://arctichealth.org/en/permalink/ahliterature107146
Source
Lupus. 2013 Nov;22(13):1341-8
Publication Type
Article
Date
Nov-2013
Author
J. Lee
C A Peschken
C. Muangchan
E. Silverman
C. Pineau
C D Smith
H. Arbillaga
M. Zummer
A. Clarke
S. Bernatsky
M. Hudson
C. Hitchon
P R Fortin
J E Pope
Author Affiliation
1University of Western Ontario (UWO), Ontario, Canada.
Source
Lupus. 2013 Nov;22(13):1341-8
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Disease Progression
Female
Hospitalization - statistics & numerical data
Humans
Logistic Models
Lupus Erythematosus, Systemic - diagnosis - epidemiology - therapy
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Prognosis
Prospective Studies
Risk factors
Time Factors
Abstract
Hospitalization is a major factor in health care costs and a surrogate for worse outcomes in chronic disease. The aim of this study was to determine the frequency of hospitalization secondary to lupus flare, the causes of hospitalization, and to determine risk factors for hospitalization in patients with systemic lupus erythematosus (SLE).
Data were collected as part of the 1000 Canadian Faces of Lupus, a prospective cohort study, where annual major lupus flares including hospitalizations were recorded over a 3-year period.
Of 665 patients with available hospitalization histories, 68 reported hospitalization related to a SLE flare over 3 years of follow-up. The average annual hospitalization rate was 7.6% (range 6.6-8.9%). The most common reasons for hospitalization were: hematologic (22.1%), serositis (20.6%), musculoskeletal (MSK) (16.2%), and renal (14.7%). Univariate risk factors for lupus hospitalization included (OR [95% CI]; p?25?mm/hr (1.9 [1.1-3.4]), proteinuria >0.5?g/d (4.2 [1.9-9.3], and SLAM-2 score (1.1 [1.0-1.2]). After multivariate regression only BMI, number of ACR criteria, and psychosis were associated with hospitalization for lupus flare.
The mean annual rate of hospitalization attributed to lupus was lower than expected. Hematologic, serositis, MSK and renal were the most common reasons. In a regression model elevated BMI, more ACR criteria and psychosis were associated with hospitalization.
PubMed ID
24048215 View in PubMed
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Living with lupus: a prospective pan-Canadian study.

https://arctichealth.org/en/permalink/ahliterature192522
Source
J Rheumatol. 2001 Nov;28(11):2442-8
Publication Type
Article
Date
Nov-2001
Author
P L Dobkin
D. Da Costa
P R Fortin
S. Edworthy
S. Barr
J M Esdaile
J L Senécal
J R Goulet
D. Choquette
E. Rich
A. Beaulieu
A. Cividino
S. Ensworth
D. Smith
M. Zummer
D. Gladman
A E Clarke
Author Affiliation
Division of Clinical Epidemiology, Montreal General Hospital Research Institute, Quebec, Canada. patricia.dobkin@mcgill.ca
Source
J Rheumatol. 2001 Nov;28(11):2442-8
Date
Nov-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Fatigue - etiology
Female
Health status
Humans
Lupus Erythematosus, Systemic - complications - physiopathology - psychology
Middle Aged
Prospective Studies
Quality of Life
Questionnaires
Severity of Illness Index
Sick Role
Sickness Impact Profile
Social Behavior
Social Support
Abstract
To portray life with lupus for women affected by this disease and to identify predictors of fatigue, a common symptom that compromises patients' quality of life.
A sample of 120 female patients (mean age 42.5 yrs) with systemic lupus erythematosus (SLE) from 9 rheumatology clinics across Canada were followed prospectively for 15 months. Assessments of psychosocial functioning took place at baseline, and at 3, 9, and 15 months. Physician examinations were conducted at baseline and 15 months.
Significant time effects were found for: global psychological distress (p
Notes
Comment In: J Rheumatol. 2002 Jul;29(7):1574; author reply 157412136924
PubMed ID
11708416 View in PubMed
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Mortality related to cerebrovascular disease in systemic lupus erythematosus.

https://arctichealth.org/en/permalink/ahliterature165748
Source
Lupus. 2006;15(12):835-9
Publication Type
Article
Date
2006
Author
S. Bernatsky
A. Clarke
D D Gladman
M. Urowitz
P R Fortin
S G Barr
J L Senécal
M. Zummer
S. Edworthy
J. Sibley
J. Pope
S. Ensworth
R. Ramsey-Goldman
J G Hanly
Author Affiliation
Division of Clinical Epidemiology, Montreal General Hospital, Montreal, Quebec, Canada.
Source
Lupus. 2006;15(12):835-9
Date
2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Brain Ischemia - mortality
Canada - epidemiology
Cerebral Hemorrhage - mortality
Cerebrovascular Disorders - mortality
Cohort Studies
Female
Follow-Up Studies
Humans
Lupus Erythematosus, Systemic - mortality
Male
Risk factors
Vasculitis - mortality
Abstract
The objective of this study was to examine mortality rates related to cerebrovascular disease in systemic lupus erythematosus (SLE) compared to the general population. Our sample was a multisite Canadian SLE cohort (10 centres, n = 2688 patients). Deaths due to cerebrovascular disease were ascertained by vital statistics registry linkage using ICD diagnostic codes. Standardized mortality ratio (SMR, ratio of deaths observed to expected) estimates were calculated. The total SMR for death due to cerebrovascular disease was 2.0 (95% confidence interval [CI] 1.0, 3.7). When considering specific types of events, the category with the greatest increased risk was that of ill-defined cerebrovascular events (SMR 44.9 95% CI 9.3, 131.3) and other cerebrovascular disease (SMR 8.4, 95% CI 2.3, 21.6). Deaths due to cerebral infarctions appeared to be less common than hemorrhages and other types of cerebrovascular events. Our data suggest an increase in mortality related to cerebrovascular disease in SLE patients compared to the general population. The large increase in ill-defined cerebrovascular events may represent cases of cerebral vasculitis or other rare forms of nervous system disease; alternately, it may reflect diagnostic uncertainty regarding the etiology of some clinical presentations in SLE patients. The suggestion that more deaths are attributed to cerebral hemorrhage, as opposed to infarction, indicates that inherent or iatrogenic factors (eg, thrombocytopenia or anticoagulation) may be important. In view of the paucity of large-scale studies of mortality attributed to neuropsychiatric outcomes in SLE, our findings highlight the need for additional research in large SLE cohorts.
PubMed ID
17211987 View in PubMed
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The needs of persons with lupus and health care providers: a qualitative study aimed toward the development of the Lupus Interactive Navigator™.

https://arctichealth.org/en/permalink/ahliterature256913
Source
Lupus. 2014 Feb;23(2):176-82
Publication Type
Article
Date
Feb-2014
Author
C. Neville
D. Da Costa
C. Mill
M. Rochon
J A Aviña-Zubieta
C A Pineau
D. Eng
P R Fortin
Author Affiliation
1Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Quebec, Canada.
Source
Lupus. 2014 Feb;23(2):176-82
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Allied Health Personnel
Canada
Female
Focus Groups
Health Personnel
Humans
Internet
Lupus Erythematosus, Systemic - therapy
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Navigation
Physicians
Rheumatology
Self Care
Young Adult
Abstract
Systemic lupus erythematosus is an inflammatory autoimmune disease associated with high morbidity and unacceptable mortality. A major challenge for persons with lupus is coping with their illness and complex care. Our objective was to identify the informational and resource needs of persons with lupus, rheumatologists, and allied health professionals treating lupus. Our findings will be applied toward the development of an innovative web-based technology, the Lupus Interactive Navigator (LIN™), to facilitate and support engagement and self-management for persons with lupus.
Eight focus groups were conducted: four groups of persons with lupus (n=29), three groups of rheumatologists (n=20), and one group of allied health professionals (n=8). The groups were held in British Columbia, Ontario, and Quebec. All sessions were audio-recorded and transcribed verbatim. Qualitative analysis was performed using grounded theory. The transcripts were reviewed independently and coded by the moderator and co-moderator using 1) qualitative data analysis software developed by Provalis Research, Montreal, Canada, and 2) manual coding.
Four main themes emerged: 1) specific information and resource needs; 2) barriers to engagement in health care; 3) facilitators of engagement in health care; and 4) tools identified as helpful for the self-management of lupus.
These findings will help guide the scope of LIN™ with relevant information topics and specific tools that will be most helpful to the diverse needs of persons with lupus and their health care providers.
PubMed ID
24335012 View in PubMed
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The persistence of anticardiolipin antibodies is associated with an increased risk of the presence of lupus anticoagulant and anti-beta2-glycoprotein I antibodies.

https://arctichealth.org/en/permalink/ahliterature170437
Source
Rheumatology (Oxford). 2006 Sep;45(9):1116-20
Publication Type
Article
Date
Sep-2006
Author
C. Neville
J. Rauch
J. Kassis
S. Solymoss
L. Joseph
P. Belisle
R. Subang
E R Chang
P R Fortin
Author Affiliation
Division of Clinical Epidemiology, Montreal General Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
Source
Rheumatology (Oxford). 2006 Sep;45(9):1116-20
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Adult
Antibodies, Anticardiolipin - blood
Antiphospholipid Syndrome - blood - immunology
Autoantibodies - blood
Female
Follow-Up Studies
Glycoproteins - immunology
Humans
Logistic Models
Lupus Coagulation Inhibitor - blood
Male
Middle Aged
Prospective Studies
Quebec
Risk
Thrombosis - blood - immunology
Time Factors
beta 2-Glycoprotein I
Abstract
We studied antiphospholipid antibodies (aPL) in blood samples from a cohort of individuals followed for thrombosis to determine whether the persistent presence of anticardiolipin antibodies (aCL) is associated with a greater likelihood of having lupus anticoagulant and/or anti-beta2-glycoprotein I antibodies (LA/abeta2GPI).
Blood samples from 353 individuals who had been tested for aCL on at least two occasions were tested for abeta2GPI and LA. Two groups were defined: aCL-persistent, who tested aCL-positive on at least two occasions, and aCL non-persistent, who tested aCL-positive on fewer than two occasions. Multivariate logistic regressions were performed using LA/abeta2GPI, LA and abeta2GPI as outcome variables and the percentage of aCL-positive tests as the predictor variable, adjusted for age, gender, family history of cardiovascular disease (CVD), systemic lupus erythematosus (SLE), smoking and number of venous (VT) and arterial thromboses (AT).
Sixty-eight (19%) individuals were aCL persistent and 285 (81%) were aCL non-persistent. LA/abeta2GPI was found in 36 (53%) of the aCL persistent group and 38 (13%) of the aCL non-persistent group. The two groups were similar for age, gender and smoking. Family history of CVD, SLE, VT and AT were more frequent in the aCL persistent group. Multivariate analyses revealed that odds ratios for LA/abeta2GPI, LA and abeta2GPI were 1.34 [95% confidence interval (CI) = 1.22-1.47], 1.36 (95% CI = 1.24-1.50) and 1.47 (95% CI = 1.31-1.65) respectively for each 10% increase in aCL-positive tests vs 0% positive tests.
Persistence of aCL positivity is associated with an increased risk of LA/abeta2GPI.
Notes
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PubMed ID
16510527 View in PubMed
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Recruitment strategies in superiority trials in SLE: lessons from the study of methotrexate in lupus erythematosus (SMILE).

https://arctichealth.org/en/permalink/ahliterature200264
Source
Lupus. 1999;8(8):606-11
Publication Type
Article
Date
1999
Author
D. Ferland
P R Fortin
Author Affiliation
Division of Clinical Epidemiology.
Source
Lupus. 1999;8(8):606-11
Date
1999
Language
English
Publication Type
Article
Keywords
Canada
Clinical Protocols
Double-Blind Method
Folic Acid - therapeutic use
Humans
Immunosuppressive Agents - therapeutic use
Lupus Erythematosus, Systemic - drug therapy
Methotrexate - therapeutic use
Patient Selection
Research Design
Abstract
The task of recruiting patients for a research project can prove to be the most difficult aspect of the entire research process. A large portion of the work of research is devoted to the identification of strategies which ensure a successful recruitment of patients. Every researcher has learned from experience the many methods needed to enhance patient enrollment into trials. Superiority trials in SLE have not been frequent in previous years. This paper describes the challenges encountered with the multicentre SMILE trial in progress across Canada. We identify areas where patient recruitment is a problem, potential reasons for the problem, and the results of tactics used to increase enrollment.
PubMed ID
10568896 View in PubMed
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The relationship between health status, social support and satisfaction with medical care among patients with systemic lupus erythematosus.

https://arctichealth.org/en/permalink/ahliterature201240
Source
Int J Qual Health Care. 1999 Jun;11(3):201-7
Publication Type
Article
Date
Jun-1999
Author
D. Da Costa
A E Clarke
P L Dobkin
J L Senecal
P R Fortin
D S Danoff
J M Esdaile
Author Affiliation
Division of Clinical Epidemiology, The Montreal General Hospital, McGill University, Québec, Canada. Deborah@vax2.concordia.ca
Source
Int J Qual Health Care. 1999 Jun;11(3):201-7
Date
Jun-1999
Language
English
Publication Type
Article
Keywords
Adult
Analysis of Variance
Health status
Humans
Linear Models
Lupus Erythematosus, Systemic - epidemiology - psychology
Patient Satisfaction - statistics & numerical data
Quebec - epidemiology
Social Support
Socioeconomic Factors
Abstract
To examine the effect of physical and mental health status and social support on patient satisfaction with health care in patients with systemic lupus erythematosus (SLE).
Using a cross-sectional design, 220 SLE patients were recruited from rheumatology departments in two hospitals in the Montreal (Canada) area. Data comprised physician-rated indices of health status and patient-completed questionnaires.
Independent variables included demographics, disease duration, physician-rated indices of disease activity (SLAM-R) and disease damage (SLICC/ACR), patient self-reported health status (SF-36), and perceived social support (ISEL). Patient satisfaction with medical care (PSQ-IV) was the dependent variable.
Univariate analyses were performed to describe the sample and examine univariate associations between the independent variables and patient satisfaction with medical care. A hierarchical multiple linear regression analysis was computed to determine the relative importance of physician-rated indices of health status, self-reported physical and mental health status and social support on patient satisfaction after controlling for demographic variables.
A multivariate hierarchical regression computed to predict patient satisfaction included the following variables in the equation: age, education, income (step 1), disease duration, SLAM-R, SLICC/ACR (step 2), mental and physical health status (step 3), and perceived social support (step 4). Less education (P
Notes
Comment In: Int J Qual Health Care. 2001 Jun;13(3):267-911476152
PubMed ID
10435840 View in PubMed
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14 records – page 1 of 2.