Abstract:
:Patient assessment in rheumatology is characterized by an important paradox: many extensively-characterized quantitative measures and indices have been developed for rheumatoid arthritis (RA), psoriatic arthritis, systemic lupus erythematosus (SLE), ankylosing spondylitis, vasculitis, osteoarthritis, fibromyalgia, and other rheumatic diseases. However, most regular rheumatology care is guided largely by qualitative clinical impressions, without such measures or indices or any quantitative data other than laboratory tests to assess patient status and/or quality of care. This paradox may be explained in part by regarding the development of measures primarily as clinical research activities, while viewing the application of measurements in regular clinical care as continuous quality improvement (CQI) activities. The development of measures has emphasized validity and reliability, but generally ignored feasibility and acceptability to patients and health professionals, both of which are needed for application in regular clinical care. A summary of the application of clinical measurement in patients with RA over 25 years between 1982 and 2007 at a weekly academic rheumatology clinic conducted by the senior author is presented as 20 often contemporaneous CQI cycles. These cycles include development of a user-friendly modified health assessment questionnaire (MHAQ); assessment of psychological status; monitoring of mortality outcomes; comparisons of joint counts, radiographic scores, and laboratory tests to the MHAQ; a 28-joint count; prospective study of the MHAQ to predict mortality when joint counts, radiographic scores, and laboratory tests are available; development of a multidimensional HAQ (MDHAQ) with complex activities; a fatigue scale; a self-report joint count; scoring templates; a computerized data management system; flow sheets to monitor MDHAQ status; visual analog scales as 21 circles rather than 10 cm lines; composite RAPID3 (rheumatology assessment patient index data) scores for 3 patient measures; and defining RAPID categories for high, moderate and low severity, and near remission. The latter cycles remain under study as ongoing CQI activities.
journal_name
Clin Exp Rheumatoljournal_title
Clinical and experimental rheumatologyauthors
Pincus T,Maclean R,Yazici Y,Harrington JTsubject
Has Abstractpub_date
2007-11-01 00:00:00pages
69-81issue
6 Suppl 47eissn
0392-856Xissn
1593-098Xpii
2159journal_volume
25pub_type
杂志文章abstract:OBJECTIVE:The present study aimed to investigate the interactions among salivary S. mutans colonisation, serum mannose binding lectin level (MBL), oral ulcer activity and disease course in patients with Behçet's disease (BD). METHODS:One hundred and six BD patients, 25 patients with rheumatoid arthritis (RA) and 42 he...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVE:A paleopathological study was carried out on the she skeletal remains of Cardinal Carlo de' Medici (1595-1666), son of the Grand Duke Ferdinando I (1549-1609) and Cristina from Lorraine (1565-1636), to investigate the articular pathology described in the archival sources. METHODS:The skeletal remains of Carl...
journal_title:Clinical and experimental rheumatology
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2009-07-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2009-05-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2017-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2011-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2004-07-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,多中心研究
doi:
更新日期:1996-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2015-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2018-05-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2005-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2008-09-01 00:00:00
abstract::Ankylosing spondylitis (A.Sp.) and diffuse idiopatic skeletal hyperostosis (DISH), represent the most common inflammatory and degenerative enthesopathies, respectively. Despite their rather frequent occurrence in the rheumatic disease care setting, few case reports of their simultaneous presence in the same patient ha...
journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:1990-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2013-05-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2020-01-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2006-11-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2016-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
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pub_type: 杂志文章
doi:
更新日期:2018-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2005-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:2020-12-02 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2017-05-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章
doi:
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journal_title:Clinical and experimental rheumatology
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doi:
更新日期:2014-07-01 00:00:00
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journal_title:Clinical and experimental rheumatology
pub_type: 杂志文章,评审
doi:
更新日期:2009-07-01 00:00:00