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The 1000 Canadian faces of lupus: determinants of disease outcome in a large multiethnic cohort.

https://arctichealth.org/en/permalink/ahliterature151515
Source
J Rheumatol. 2009 Jun;36(6):1200-8
Publication Type
Article
Date
Jun-2009
Author
Christine A Peschken
Steven J Katz
Earl Silverman
Janet E Pope
Paul R Fortin
Christian Pineau
C Douglas Smith
Hector O Arbillaga
Dafna D Gladman
Murray Urowitz
Michel Zummer
Ann Clarke
Sasha Bernatsky
Marie Hudson
Author Affiliation
Department of Medicine, University of Manitoba Arthritis Center, RR149-800 Sherbrook Street, Winnipeg, Manitoba R3A 1M4, Canada. cpeschken@exchange.hsc.mb.ca
Source
J Rheumatol. 2009 Jun;36(6):1200-8
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Adult
Canada - epidemiology
Continental Population Groups
Female
Health status
Humans
Income
Lupus Erythematosus, Systemic - economics - ethnology - physiopathology
Male
Middle Aged
Outcome Assessment (Health Care) - statistics & numerical data
Prospective Studies
Questionnaires
Severity of Illness Index
Social Class
Abstract
To describe disease expression and damage accrual in systemic lupus erythematosus (SLE), and determine the influence of ethnicity and socioeconomic factors on damage accrual in a large multiethnic Canadian cohort.
Adults with SLE were enrolled in a multicenter cohort. Data on sociodemographic factors, diagnostic criteria, disease activity, autoantibodies, treatment, and damage were collected using standardized tools, and results were compared across ethnic groups. We analyzed baseline data, testing for differences in sociodemographic and clinical factors, between the different ethnic groups, in univariate analyses; significant variables from univariate analyses were included in multivariate regression models examining for differences between ethnic groups, related to damage scores.
We studied 1416 patients, including 826 Caucasians, 249 Asians, 122 Afro-Caribbeans, and 73 Aboriginals. Although the overall number of American College of Rheumatology criteria in different ethnic groups was similar, there were differences in individual manifestations and autoantibody profiles. Asian and Afro-Caribbean patients had more frequent renal involvement and more exposure to immunosuppressives. Aboriginal patients had high frequencies of antiphospholipid antibodies and high rates of comorbidity, but disease manifestations similar to Caucasians. Asian patients had the youngest age at onset and the lowest damage scores. Aboriginals had the least education and lowest incomes. The final regression model (R2=0.27) for higher damage score included older age, longer disease duration, low income, prednisone treatment, higher disease activity, and cyclophosphamide treatment.
There are differences in lupus phenotypes between ethnic populations. Although ethnicity was not found to be a significant independent predictor of damage accrual, low income was.
PubMed ID
19369456 View in PubMed
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Access and perceived need for physical and occupational therapy in chronic arthritis.

https://arctichealth.org/en/permalink/ahliterature144640
Source
Disabil Rehabil. 2010;32(22):1827-32
Publication Type
Article
Date
2010
Author
Debbie Ehrmann Feldman
Sasha Bernatsky
Jean Frédéric Lévesque
My Tram Van
Michelle Houde
Karine Toupin April
Author Affiliation
Université de Montréal, Ecole de Réadaptation, C.P. 6128, Succ. Centre-Ville, Pavillon 7077 du Parc, Montreal, Quebec, Canada H3C3J7. debbie.feldman@umontreal.ca
Source
Disabil Rehabil. 2010;32(22):1827-32
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid - rehabilitation
Attitude of Health Personnel
Chronic Disease - rehabilitation
Health Care Surveys
Health Services Accessibility
Health services needs and demand
Humans
Interviews as Topic
Male
Middle Aged
Occupational therapy
Odds Ratio
Physical Therapy Modalities
Physicians, Family
Quebec
Referral and Consultation
Rheumatology
Abstract
Physical and occupational therapy are beneficial for persons with chronic arthritis; however, access is problematic. The goal was to examine issues related to access to these services for patients with chronic arthritis.
We used two data sources: 1) questionnaires sent to a random sample of 600 family physicians and to all 85 rheumatologists in the province of Quebec; and 2) interviews of 211 patients with physician-confirmed chronic arthritis recruited from 34 primary care settings in Quebec.
Only 11.5% of family physicians and 31.7% of rheumatologists referred patients with rheumatoid arthritis (RA) to rehabilitation, whereas 60.4% of family doctors referred patients with osteoarthritis. Only 26.1% of patients felt that they required rehabilitation and this was associated with lower self-efficacy (OR: 0.84, 95% CI: 0.72, 0.99) and higher educational level (OR: 2.10, 95% CI: 1.01, 4.36).
Family physicians are less likely to refer patients with RA to therapy. Only about a quarter of patients with chronic arthritis treated in primary care perceived the need for these services. Efforts to improve arthritis care should address education of physicians and patients regarding the benefits of rehabilitation and there should be efforts to increase therapy resources in order to enhance access.
PubMed ID
20345251 View in PubMed
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The accuracy of administrative data diagnoses of systemic autoimmune rheumatic diseases.

https://arctichealth.org/en/permalink/ahliterature134892
Source
J Rheumatol. 2011 Aug;38(8):1612-6
Publication Type
Article
Date
Aug-2011
Author
Sasha Bernatsky
Tina Linehan
John G Hanly
Author Affiliation
Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre (MUHC), Montreal, Quebec, Canada. sasha.bernatsky@mail.mcgill.ca
Source
J Rheumatol. 2011 Aug;38(8):1612-6
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Autoimmune Diseases - diagnosis - immunology
Databases, Factual - standards
Hospital Administration - standards
Humans
Nova Scotia
Organization and Administration - standards
Reproducibility of Results
Rheumatic Diseases - diagnosis - immunology
Sensitivity and specificity
Abstract
To examine the validity of case definitions for systemic autoimmune rheumatic diseases [SARD; systemic lupus erythematosus (SLE), systemic sclerosis (SSc), myositis, Sjögren's syndrome, vasculitis, and polymyalgia rheumatica] based on administrative data, compared to rheumatology records.
A list of rheumatic disease diagnoses was generated from population-based administrative billing and hospitalization databases. Subjects who had been seen by an arthritis center rheumatologist were identified, and the medical records reviewed.
We found that 844 Nova Scotia residents had a diagnosis of one of the rheumatic diseases of interest, based on administrative data, and had had = 1 rheumatology assessment at a provincial arthritis center. Charts were available on 824 subjects, some of whom had been identified in the administrative database with > 1 diagnosis. Thus a total of 1136 diagnoses were available for verification against clinical records. Of the 824 subjects, 680 (83%) had their administrative database diagnoses confirmed on chart review. The majority of subjects who were "false-positive" for a given rheumatic disease on administrative data had a true diagnosis of a similar rheumatic disease. Most sensitivity estimates for specific administrative data-based case definitions were > 90%, although for SSc, the sensitivity was 80.5%. The specificity estimates were also > 90%, except for SLE, where the specificity was 72.5%.
Although health administrative data may be a valid resource, there are potential problems regarding the specificity and sensitivity of case definitions, which should be kept in mind for future studies.
PubMed ID
21532057 View in PubMed
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Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists.

https://arctichealth.org/en/permalink/ahliterature114676
Source
Arthritis Care Res (Hoboken). 2013 Oct;65(10):1582-91
Publication Type
Article
Date
Oct-2013
Author
Jessica Widdifield
Sasha Bernatsky
J Michael Paterson
Karen Tu
Ryan Ng
J Carter Thorne
Janet E Pope
Claire Bombardier
Author Affiliation
University of Toronto, Toronto, Ontario, Canada.
Source
Arthritis Care Res (Hoboken). 2013 Oct;65(10):1582-91
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Algorithms
Arthritis, Rheumatoid - diagnosis - epidemiology
Data Mining - statistics & numerical data
Databases, Factual - statistics & numerical data
Drug Prescriptions - statistics & numerical data
Fees and Charges - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Humans
Male
Medical Records Systems, Computerized - statistics & numerical data
Middle Aged
Ontario - epidemiology
Reproducibility of Results
Retrospective Studies
Rheumatology - statistics & numerical data
Single-Payer System - statistics & numerical data
Abstract
Health administrative data can be a valuable tool for disease surveillance and research. Few studies have rigorously evaluated the accuracy of administrative databases for identifying rheumatoid arthritis (RA) patients. Our aim was to validate administrative data algorithms to identify RA patients in Ontario, Canada.
We performed a retrospective review of a random sample of 450 patients from 18 rheumatology clinics. Using rheumatologist-reported diagnosis as the reference standard, we tested and validated different combinations of physician billing, hospitalization, and pharmacy data.
One hundred forty-nine rheumatology patients were classified as having RA and 301 were classified as not having RA based on our reference standard definition (study RA prevalence 33%). Overall, algorithms that included physician billings had excellent sensitivity (range 94-100%). Specificity and positive predictive value (PPV) were modest to excellent and increased when algorithms included multiple physician claims or specialist claims. The addition of RA medications did not significantly improve algorithm performance. The algorithm of "(1 hospitalization RA code ever) OR (3 physician RA diagnosis codes [claims] with =1 by a specialist in a 2-year period)" had a sensitivity of 97%, specificity of 85%, PPV of 76%, and negative predictive value of 98%. Most RA patients (84%) had an RA diagnosis code present in the administrative data within ±1 year of a rheumatologist's documented diagnosis date.
We demonstrated that administrative data can be used to identify RA patients with a high degree of accuracy. RA diagnosis date and disease duration are fairly well estimated from administrative data in jurisdictions of universal health care insurance.
PubMed ID
23592598 View in PubMed
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Assessing process of care in rheumatoid arthritis at McGill University hospitals.

https://arctichealth.org/en/permalink/ahliterature113935
Source
J Clin Rheumatol. 2013 Jun;19(4):175-9
Publication Type
Article
Date
Jun-2013
Author
Lisa Marina Li
Basile Tessier-Cloutier
Yafei Wang
Sasha Bernatsky
Evelyne Vinet
Henri André Ménard
Pantelis Panopalis
Elizabeth Hazel
Michael Stein
Martin Cohen
Michael Starr
Christian Pineau
Marie-Ève Veilleux
Inés Colmegna
Author Affiliation
Division of Rheumatology, McGill University, Montréal, Quebec, Canada.
Source
J Clin Rheumatol. 2013 Jun;19(4):175-9
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon - utilization
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - epidemiology - therapy
Blood Sedimentation
C-Reactive Protein - analysis
Clinical Audit
Diphosphonates - therapeutic use
Female
Foot Bones - radiography
Glucocorticoids - therapeutic use
Hand Bones - radiography
Humans
Male
Middle Aged
Multivariate Analysis
Pain Measurement
Physical Examination - statistics & numerical data
Prednisone - administration & dosage
Quality Indicators, Health Care
Quebec
Radiography - utilization
Referral and Consultation - statistics & numerical data
Time-to-Treatment - statistics & numerical data
Abstract
In rheumatoid arthritis (RA), quality indicators (QIs) are tools used to measure process of care. This study aimed to assess performance of selected QIs from the 2004 Arthritis Foundation's QI Set at 2 major sites of a university network of teaching hospitals.
The charts and electronic hospital records of 76 RA patients were audited to determine adherence to QIs. Logistic multivariate regression analyses were performed to investigate potential determinants of nonadherence and propose measures to facilitate better QI compliance, as a potential strategy towards RA care improvement.
We identified consistent observance of QIs mandating prescription of disease-modifying antirheumatic drug therapy for all patients, drug adjustment with disease activity, prednisone tapering, and bisphosphonate therapy if indicated for patients on glucocorticoids. However, there was either lack of documentation or true inconsistent adherence to QIs dealing with radiograph performance, functional capacity assessment, and screening for hepatitis and tuberculosis before commencement of methotrexate and biologic agents, respectively. For the specific QIs analyzed, we did not find any definite independent associations with the studied variables.
Our findings indicate that while there is frequent evidence for adherence to certain RA quality care standards at our centers, there is less compliance to others. Strategies to optimize the performance or documentation of those found most lacking, namely, functional capacity and screening for specific drug contraindications, could improve patient care. Radiographic disease monitoring, while lacking, may represent a move toward other more sensitive methods of RA progression detection, such as joint ultrasound. The inclusion of patient- and physician-derived information could help elucidate the reasons underlying nonadherence.
PubMed ID
23669798 View in PubMed
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Assessment of reproductive history in systemic sclerosis.

https://arctichealth.org/en/permalink/ahliterature154487
Source
Arthritis Rheum. 2008 Nov 15;59(11):1661-4
Publication Type
Article
Date
Nov-15-2008
Author
Sasha Bernatsky
Marie Hudson
Janet Pope
Evelyne Vinet
Janet Markland
David Robinson
Niall Jones
Peter Docherty
Maysan Abu-Hakima
Sharon Leclercq
James Dunne
Douglas Smith
Jean-Pierre Mathieu
Nader Khalidi
Evelyn Sutton
Murray Baron
Author Affiliation
McGill University, Montreal, Quebec, Canada. sasha.bernatsky@mail.mcgill.ca
Source
Arthritis Rheum. 2008 Nov 15;59(11):1661-4
Date
Nov-15-2008
Language
English
Publication Type
Article
Keywords
Adult
Antirheumatic Agents - therapeutic use
Birth rate
Canada
Cohort Studies
Cyclophosphamide - therapeutic use
Female
Follow-Up Studies
Humans
Reproduction - physiology
Reproductive history
Scleroderma, Systemic - drug therapy - physiopathology
Abstract
To assess the number of live births in women whose systemic sclerosis (SSc) onset occurred during their reproductive years, and to compare this with general population rates.
Within the Canadian Scleroderma Research Group cohort, we identified 320 women whose SSc symptoms began prior to age 50 years. We determined the number of children born in the years following first onset of symptoms. We summed the years of followup from the time of first symptoms in subjects up to age 50 years (or oldest age attained, if the subject was age
PubMed ID
18975360 View in PubMed
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Associations between ambient fine particulate levels and disease activity in patients with systemic lupus erythematosus (SLE).

https://arctichealth.org/en/permalink/ahliterature140513
Source
Environ Health Perspect. 2011 Jan;119(1):45-9
Publication Type
Article
Date
Jan-2011
Author
Sasha Bernatsky
Michel Fournier
Christian A Pineau
Ann E Clarke
Evelyne Vinet
Audrey Smargiassi
Author Affiliation
Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada.
Source
Environ Health Perspect. 2011 Jan;119(1):45-9
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Air Pollution - analysis - statistics & numerical data
Autoantibodies - metabolism
Cohort Studies
Environmental Exposure - analysis - statistics & numerical data
Female
Humans
Kidney Diseases - epidemiology - immunology - metabolism
Lupus Erythematosus, Systemic - epidemiology - immunology - metabolism
Male
Middle Aged
Particle Size
Particulate Matter - analysis
Quebec - epidemiology
Severity of Illness Index
Young Adult
Abstract
Systemic lupus erythematosus (SLE) is a chronic disease of unclear etiology, characterized by an overactive immune system and the production of antibodies that may target normal tissues of many organ systems, including the kidneys. It can arise at any age and occurs mainly in women.
Our aim was to evaluate the potential influence of particulate matter (PM) air pollution on clinical aspects of SLE.
We studied a clinic cohort of SLE patients living on the island of Montreal, followed annually with a structured clinical assessment. We assessed the association between ambient levels of fine PM [median aerodynamic diameter = 2.5 µm (PM2.5)] measured at fixed-site monitoring stations and SLE disease activity measured with the SLE Disease Activity Index, version 2000 (SLEDAI-2K), which includes anti-double-stranded DNA (anti-dsDNA) serum-specific autoantibodies and renal tubule cellular casts in urine, which reflects serious renal inflammation. We used mixed effects regression models that we adjusted for daily ambient temperatures and ozone levels.
We assessed 237 patients (223 women) who together had 1,083 clinic visits from 2000 through 2007 (mean age at time of first visit, 41.2 years). PM2.5 levels were associated with anti-dsDNA and cellular casts. The crude and adjusted odds ratios (reflecting a 10-µg/m3 increase in PM2.5 averaged over the 48 hr prior to clinical assessment) were 1.26 [95% confidence interval (CI), 0.96-1.65] and 1.34 (95% CI, 1.02-1.77) for anti-dsDNA antibodies and 1.43 (95% CI, 1.05-1.95) and 1.28 (0.92-1.80) for cellular casts. The total SLEDAI-2K scores were not associated with PM2.5 levels.
We provide novel data that suggest that short-term variations in air pollution may influence disease activity in established autoimmune rheumatic disease in humans. Our results add weight to concerns that pollution may be an important trigger of inflammation and autoimmunity.
Notes
Cites: Allergy. 1978 Feb;33(1):42-9306211
Cites: J Rheumatol. 2002 Feb;29(2):288-9111838846
Cites: Arthritis Rheum. 1997 Sep;40(9):17259324032
Cites: J Rheumatol. 2006 Apr;33(4):695-716583471
Cites: Arthritis Rheum. 2006 Nov;54(11):3623-3217075807
Cites: Lupus. 2006;15(11):728-3617153843
Cites: J Toxicol Environ Health A. 2007 Oct;70(20):1731-4417885930
Cites: Rheumatology (Oxford). 2007 Dec;46(12):1814-818032538
Cites: Inhal Toxicol. 2008 Mar;20(5):499-50618368620
Cites: Clin Sci (Lond). 2008 Sep;115(6):175-8718691154
Cites: J Leukoc Biol. 2009 Aug;86(2):303-1219406832
Cites: Environ Health Perspect. 2009 Jul;117(7):1065-919654914
Cites: J Asthma. 2009 Oct;46(8):777-8519863280
Cites: Clin Exp Rheumatol. 2009 Sep-Oct;27(5):877-8419917177
Cites: Am J Respir Cell Mol Biol. 2000 Aug;23(2):182-710919984
Cites: Am J Respir Crit Care Med. 2000 Sep;162(3 Pt 1):981-810988117
Cites: Am J Respir Crit Care Med. 2001 Sep 1;164(5):826-3011549540
Cites: Circulation. 2002 Jan 29;105(4):411-411815420
Cites: Arthritis Rheum. 1982 Nov;25(11):1271-77138600
PubMed ID
20870568 View in PubMed
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Cancer risk in systemic lupus: an updated international multi-centre cohort study.

https://arctichealth.org/en/permalink/ahliterature116317
Source
J Autoimmun. 2013 May;42:130-5
Publication Type
Article
Date
May-2013
Author
Sasha Bernatsky
Rosalind Ramsey-Goldman
Jeremy Labrecque
Lawrence Joseph
Jean-Francois Boivin
Michelle Petri
Asad Zoma
Susan Manzi
Murray B Urowitz
Dafna Gladman
Paul R Fortin
Ellen Ginzler
Edward Yelin
Sang-Cheol Bae
Daniel J Wallace
Steven Edworthy
Soren Jacobsen
Caroline Gordon
Mary Anne Dooley
Christine A Peschken
John G Hanly
Graciela S Alarcón
Ola Nived
Guillermo Ruiz-Irastorza
David Isenberg
Anisur Rahman
Torsten Witte
Cynthia Aranow
Diane L Kamen
Kristjan Steinsson
Anca Askanase
Susan Barr
Lindsey A Criswell
Gunnar Sturfelt
Neha M Patel
Jean-Luc Senécal
Michel Zummer
Janet E Pope
Stephanie Ensworth
Hani El-Gabalawy
Timothy McCarthy
Lene Dreyer
John Sibley
Yvan St Pierre
Ann E Clarke
Author Affiliation
McGill University Health Centre, 687 Pine Avenue, V Building, Montreal, Quebec H3A 1A1, Canada. sasha.bernatsky@mail.mcgill.ca
Source
J Autoimmun. 2013 May;42:130-5
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Asia - epidemiology
Breast Neoplasms - epidemiology
Canada - epidemiology
Cohort Studies
Europe - epidemiology
Female
Follow-Up Studies
Humans
Incidence
International Cooperation
Lupus Erythematosus, Systemic - epidemiology
Lymphoma, Non-Hodgkin - epidemiology
Male
Neoplasms - epidemiology
Ovarian Neoplasms - epidemiology
Risk
United States - epidemiology
Abstract
To update estimates of cancer risk in SLE relative to the general population.
A multisite international SLE cohort was linked with regional tumor registries. Standardized incidence ratios (SIRs) were calculated as the ratio of observed to expected cancers.
Across 30 centres, 16,409 patients were observed for 121,283 (average 7.4) person-years. In total, 644 cancers occurred. Some cancers, notably hematologic malignancies, were substantially increased (SIR 3.02, 95% confidence interval, CI, 2.48, 3.63), particularly non-Hodgkin's lymphoma, NHL (SIR 4.39, 95% CI 3.46, 5.49) and leukemia. In addition, increased risks of cancer of the vulva (SIR 3.78, 95% CI 1.52, 7.78), lung (SIR 1.30, 95% CI 1.04, 1.60), thyroid (SIR 1.76, 95% CI 1.13, 2.61) and possibly liver (SIR 1.87, 95% CI 0.97, 3.27) were suggested. However, a decreased risk was estimated for breast (SIR 0.73, 95% CI 0.61-0.88), endometrial (SIR 0.44, 95% CI 0.23-0.77), and possibly ovarian cancers (0.64, 95% CI 0.34-1.10). The variability of comparative rates across different cancers meant that only a small increased risk was estimated across all cancers (SIR 1.14, 95% CI 1.05, 1.23).
These data estimate only a small increased risk in SLE (versus the general population) for cancer over-all. However, there is clearly an increased risk of NHL, and cancers of the vulva, lung, thyroid, and possibly liver. It remains unclear to what extent the association with NHL is mediated by innate versus exogenous factors. Similarly, the etiology of the decreased breast, endometrial, and possibly ovarian cancer risk is uncertain, though investigations are ongoing.
Notes
Cites: J Intern Med. 2012 Feb;271(2):193-20321973261
Cites: J Rheumatol. 2011 Sep;38(9):1891-721724695
Cites: Ann Rheum Dis. 2008 Jan;67(1):74-917545189
Cites: Br J Cancer. 2002 Jul 1;87(1):49-5312085255
Cites: J Environ Pathol Toxicol Oncol. 2002;21(2):193-20112086406
Cites: J Rheumatol. 2002 Dec;29(12):2551-412465150
Cites: Lupus. 2004;13(6):469-7215303575
Cites: Ann Intern Med. 1978 Dec;89(6):888-92102228
Cites: Ann Rheum Dis. 1992 Apr;51(4):437-91586239
Cites: J Natl Cancer Inst. 1995 May 17;87(10):732-417563150
Cites: Arthritis Rheum. 1996 Jun;39(6):1050-48651970
Cites: Arthritis Rheum. 2005 May;52(5):1481-9015880596
Cites: Ann Rheum Dis. 2005 Oct;64(10):1507-916162903
Cites: Arthritis Rheum. 2005 Oct 15;53(5):781-416208671
Cites: Arch Intern Med. 2005 Nov 14;165(20):2337-4416287762
Cites: J Rheumatol. 2006 Jan;33(1):45-916331804
Cites: Arthritis Rheum. 2006 Aug;54(8):2550-716868977
Cites: Lung Cancer. 2007 Jun;56(3):303-617291624
Cites: Ann Rheum Dis. 2007 Jun;66(6):815-717204564
Cites: Clin Rev Allergy Immunol. 2007 Jun;32(3):265-7417992593
Cites: Arthritis Res Ther. 2008;10(2):R4518433475
Cites: J Clin Invest. 2008 Dec;118(12):3837-4019033653
Cites: Haematologica. 2008 Dec;93(12):1773-619050067
Cites: Anticancer Drugs. 2009 Sep;20(8):736-4519584707
Cites: J Clin Endocrinol Metab. 2010 Jan;95(1):314-819906791
Cites: Metabolism. 2010 Jun;59(6):896-90020005534
Cites: Endocr Pract. 2011 Mar-Apr;17(2):201-920841310
Cites: Br J Cancer. 2011 Apr 26;104(9):1478-8121487409
Cites: Nat Rev Rheumatol. 2011 Jun;7(6):360-821637317
Cites: Ann N Y Acad Sci. 2011 Jul;1229:176-8321793853
Cites: Ann Rheum Dis. 2013 May;72(5):659-6422589375
PubMed ID
23410586 View in PubMed
Less detail

Care partnerships between family physicians and rheumatologists.

https://arctichealth.org/en/permalink/ahliterature133685
Source
J Rheumatol. 2011 Sep;38(9):1981-5
Publication Type
Article
Date
Sep-2011
Author
Benjamin Lou
Mirella DE Civita
Debbie Ehrmann Feldman
Asvina Bissonauth
Sasha Bernatsky
Author Affiliation
Montreal General Hospital, Clinical Epidemiology, 1650 Cedar Ave., L10-424, Montreal H3G 1A4, Quebec, Canada.
Source
J Rheumatol. 2011 Sep;38(9):1981-5
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Adult
Family Practice - organization & administration - trends
Female
Humans
Interdisciplinary Communication
Male
National Health Programs - organization & administration - trends
Partnership Practice - organization & administration - trends
Patient Care Team - organization & administration - trends
Physician's Practice Patterns - organization & administration - trends
Quality of Health Care - trends
Quebec
Questionnaires - standards
Referral and Consultation - organization & administration - trends
Rheumatology - organization & administration - trends
Abstract
To describe care partnerships between family physicians and rheumatologists.
A random sample (20%, n = 478) of family physicians was mailed a questionnaire, asking if there was at least 1 particular rheumatologist to whom the physician tended to refer patients. If the answer was affirmative, the physician would be considered as having a "care partnership" with that rheumatologist. The family physician then rated, on a 5-point scale, factors of importance regarding the relationship with that rheumatologist.
The questionnaire was completed by 84/462 (18.2%) of family physicians; 52/84 (61.9%) reported having rheumatology care partnerships according to our definition. Regarding interactions with rheumatologists, most respondents rated the following as important (score = 4): adequate communication and information exchange (44/50, 88.0%); waiting time for new patients (40/50, 80.0%); clear and appropriate balance of responsibilities (39/49, 79.6%); and patient feedback and preferences (34/50, 68%). Male family physicians were more likely than females to accord high importance to personal knowledge of the rheumatologist, and to physical proximity of the rheumatologist's practice. Regarding relationships with rheumatologists, 30/50 (60.0%) of respondents felt communication and information exchange were adequate, and 35/50 (70.0%) felt they had a clear balance of responsibilities.
Almost two-thirds of family physicians have rheumatology care partnerships, according to our definition. In this partnership, establishing adequate communication and shorter waiting time seem of paramount importance to family physicians. A balanced sharing of responsibilities and patients' preferences are also valued. Although many physicians reported adequate communication and clear and appropriate balance of responsibilities in their current interactions with rheumatologists, there appears to be room for improvement.
PubMed ID
21677002 View in PubMed
Less detail

Care pathways in early rheumatoid arthritis.

https://arctichealth.org/en/permalink/ahliterature165304
Source
Can Fam Physician. 2006 Nov;52(11):1444-5
Publication Type
Article
Date
Nov-2006
Author
Sasha Bernatsky
Debbie Feldman
Ian Shrier
Karine Toupin
Jeannie Haggerty
Pierre Tousignant
Michel Zummer
Author Affiliation
Department of Medicine, Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada.
Source
Can Fam Physician. 2006 Nov;52(11):1444-5
Date
Nov-2006
Language
English
Publication Type
Article
Keywords
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - diagnosis - drug therapy
Attitude of Health Personnel
Clinical Competence
Diagnosis, Differential
Drug Utilization - statistics & numerical data
Female
Humans
Male
Middle Aged
Physician's Practice Patterns
Physicians, Family
Quebec
Questionnaires
Referral and Consultation
Abstract
To determine the proportion of family physicians who diagnose rheumatoid arthritis (RA) correctly and to note how they report they would manage RA patients.
Mailed survey (self-administered questionnaire) requesting comments on vignettes.
Province of Quebec.
Computer-generated random sample of family physicians registered with the Quebec College of Family Physicians.
The proportion of family physicians who recognized RA and their reported management strategies.
Most respondents recognized the vignette presentation as a case of RA; 133/138 (96.4%) indicated RA as their provisional diagnosis, and all but 1 of the remaining respondents listed RA as a differential diagnosis. Of those who considered RA as a provisional or possible diagnosis, 107 (77.5% of all respondents) suggested referring the patient to a rheumatologist. Among the physicians who suggested referral, none indicated they would initiate disease-modifying antirheumatic drugs (DMARDs).
Almost all respondents considered RA as a provisional or differential diagnosis. Although many suggested referring the patient to a rheumatologist, almost a quarter did not. Initiating DMARDs before referring patients to rheumatologists appears to be rare. Since DMARDs given during the early stages of RA are known to decrease damage and dysfunction, ways to increase their use and optimize care pathways for new-onset inflammatory arthritis are urgently needed.
Notes
Cites: Am J Infect Control. 2006 May;34(4):164-916679171
Cites: Acad Radiol. 2006 Jun;13(6):678-8516679269
Cites: Urol Int. 2006;76(4):314-2016679832
Cites: Best Pract Res Clin Rheumatol. 2001 Mar;15(1):139-7011358420
Cites: Am J Med. 2001 Oct 15;111(6):446-5111690569
Cites: Ann Rheum Dis. 2002 Apr;61(4):290-711874828
Cites: Rheumatology (Oxford). 2002 Aug;41(8):953-5; author reply 95512154222
Cites: Arch Pediatr Adolesc Med. 2002 Dec;156(12):1263-712444841
Cites: CMAJ. 1996 Sep 15;155(6):679-878823213
Cites: Med Care. 1998 Apr;36(4):513-229544591
Cites: CMAJ. 1998 Apr 21;158(8):1037-409580733
Cites: Int J Qual Health Care. 1999 Jun;11(3):187-9210435838
Cites: Arthritis Rheum. 2005 Apr 15;53(2):241-815818655
Cites: Med Care. 2006 May;44(5):421-816641660
Cites: J Emerg Med. 2006 Apr;30(3):263-816677975
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