Quality of life and functional health of primary care patients.


:Quality of life and functional health were measured cross-sectionally for 314 adult ambulatory primary care patients in a rural clinic and found to be much better for patients with low severity of illness who required no confinement to home because of health problems, than for patients with high severity of illness who required confinement. Severity of illness was the strongest predictor for patient-reported physical health function and for patient quality of life when assessed by the health provider. Confinement was the strongest predictor for patient quality of life when assessed by the patient. There was very little agreement between patient-assessed and provider-assessed quality of life. Family stress was the strongest predictor of function in terms of mental health, social health, general health, self-esteem, anxiety, and depression. These data suggest that clinicians should direct increased attention to patient-assessed quality of life, patient-reported functional health status, and psychosocial factors such as family stress in an effort to improve medical outcomes.


J Clin Epidemiol


Parkerson GR Jr,Broadhead WE,Tse CK




Has Abstract


1992-11-01 00:00:00














  • Pain and pain treatment were associated with traffic accident involvement in a cohort of middle-aged workers.

    abstract:BACKGROUND AND OBJECTIVE:To assess the influence of medical conditions on road traffic accidents among a cohort of middle-aged workers and pensioners. STUDY DESIGN AND SETTING:A longitudinal study of 13,548 participants from a cohort study of French workers. Follow-up data covered the 1989-2000 period. Adjusted hazard...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Lagarde E,Chastang JF,Lafont S,Coeuret-Pellicer M,Chiron M

    更新日期:2005-05-01 00:00:00

  • Nutrition guidelines vary widely in methodological quality: an overview of reviews.

    abstract:OBJECTIVES:To identify, describe, and map contemporary nutrition guidelines (NGs) from reviews that used the Appraisal of Guidelines, Research and Evaluation (AGREE) tool. STUDY DESIGN AND SETTING:We performed an overview of reviews that systematically assessed the quality of NGs using the AGREE tool. We searched MEDL...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Rabassa M,Garcia-Ribera Ruiz S,Solà I,Pardo-Hernandez H,Alonso-Coello P,Martínez García L

    更新日期:2018-12-01 00:00:00

  • Present-at-admission diagnoses improved mortality risk adjustment among acute myocardial infarction patients.

    abstract:OBJECTIVE:Hospital mortality outcomes for acute myocardial infarction (AMI) patients are a focus of quality improvement programs conducted by government agencies. AMI mortality risk-adjustment models using administrative data typically adjust for baseline differences in mortality risk with a limited set of common and d...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Stukenborg GJ,Wagner DP,Harrell FE Jr,Oliver MN,Heim SW,Price AL,Han CK,Wolf AM,Connors AF Jr

    更新日期:2007-02-01 00:00:00

  • The qualification period.

    abstract::For randomized trials that do not require prompt onset of therapy, a pre-admission preparation, called the qualification period, can deal with certain customary difficulties in design, analysis, and ethics. For the patients' baseline state, the qualification period can be used to "wash out" effects of previous treatme...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Knipschild P,Leffers P,Feinstein AR

    更新日期:1991-01-01 00:00:00

  • Characteristics of stroke victims associated with early cardiovascular mortality in their children.

    abstract::We assessed the relationship between characteristics of stroke victims and the risk of early death from coronary or cerebrovascular disease (CCVD) among their children. For each of 55 stroke patients selected from a registry which enrolled patients between 1969 and 1973, an index of their progeny's survival was calcul...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Howard G,Evans GW,Toole JF,Tell G,Rose LA,Espeland M,Truscott BL

    更新日期:1990-01-01 00:00:00

  • The level of alcohol consumption at which all-cause mortality is least.

    abstract::Moderate consumers of alcohol have lower mortality than either nondrinkers or heavy drinkers. This systematic review aimed to quantify the level of alcohol consumption (termed the nadir) at which the lowest mortality occurs. Twenty cohort studies reported analyses of all-cause mortality for at least three categories o...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,meta分析


    authors: White IR

    更新日期:1999-10-01 00:00:00

  • False discovery rate control is a recommended alternative to Bonferroni-type adjustments in health studies.

    abstract:OBJECTIVES:Procedures for controlling the false positive rate when performing many hypothesis tests are commonplace in health and medical studies. Such procedures, most notably the Bonferroni adjustment, suffer from the problem that error rate control cannot be localized to individual tests, and that these procedures d...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Glickman ME,Rao SR,Schultz MR

    更新日期:2014-08-01 00:00:00

  • Combining ecological and individual variables to reduce confounding by indication: case study--subarachnoid hemorrhage treatment.

    abstract::Ecological studies may reduce the problem of confounding by indication; however, these studies introduce new biases not present in individual-level analyses. To study the potential for ecological variables to reduce confounding by indication, we used a large database of admissions for ruptured cerebral aneurysms to ev...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,多中心研究


    authors: Johnston SC

    更新日期:2000-12-01 00:00:00

  • Quantifying the potential benefit of CA 125 screening for ovarian cancer.

    abstract::We develop a stochastic model of screening for ovarian cancer with serum levels of the CA 125 radioimmunoassay, a tumor-specific marker. The natural history of the disease is constructed using a four stage model characterized by a multivariate distribution for duration in each stage. Preserving its important features,...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Skates SJ,Singer DE

    更新日期:1991-01-01 00:00:00

  • A critical review of methods for the assessment of patient-level interactions in individual participant data meta-analysis of randomized trials, and guidance for practitioners.

    abstract:OBJECTIVE:Treatments may be more effective in some patients than others, and individual participant data (IPD) meta-analysis of randomized trials provides perhaps the best method of investigating treatment-covariate interactions. Various methods are used; we provide a comprehensive critique and develop guidance on meth...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Fisher DJ,Copas AJ,Tierney JF,Parmar MK

    更新日期:2011-09-01 00:00:00

  • Nonrandomized studies using causal-modeling may give different answers than RCTs: a meta-epidemiological study.

    abstract:OBJECTIVES:To evaluate how estimated treatment effects agree between nonrandomized studies using causal modeling with marginal structural models (MSM-studies) and randomized trials (RCTs). STUDY DESIGN:Meta-epidemiological study. SETTING:MSM-studies providing effect estimates on any healthcare outcome of any treatmen...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Ewald H,Ioannidis JPA,Ladanie A,Mc Cord K,Bucher HC,Hemkens LG

    更新日期:2020-02-01 00:00:00

  • Improving task comprehension in the measurement of health state preferences. A trial of informational cartoon figures and a paired-comparison task.

    abstract::Information concerning people's relative preferences for health care outcomes is usually obtained using questionnaires which ask subjects to imagine health states of various kinds. When using illness- or treatment-specific states, elaborate descriptions of patients' quality of life may adequately convey to the rater a...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Hadorn DC,Hays RD,Uebersax J,Hauber T

    更新日期:1992-03-01 00:00:00

  • The "Lost NNT" can be used to represent uncertainty surrounding number needed to treat.

    abstract:OBJECTIVES:The uncertainty around number needed to treat (NNT) is often represented through a confidence interval (CI). However, it is not clear how the CI can help inform treatment decisions. We developed decision-theoretic measures of uncertainty for the NNT. STUDY DESIGN AND SETTING:We build our argument on the bas...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Sadatsafavi M,Ganjizadeh S,Hatala R,Marra C,FitzGerald M

    更新日期:2012-08-01 00:00:00

  • Both clinical epidemiology and population health perspectives can define the role of health care in reducing health disparities.

    abstract:OBJECTIVE:To compare and contrast clinical epidemiology and population health perspectives on the role of health care in reducing socioeconomic disparities in health. STUDY DESIGN AND SETTING:A review of concepts outlined in selected articles on population health and clinical epidemiology and a systematic literature s...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Anderson GM,Bronskill SE,Mustard CA,Culyer A,Alter DA,Manuel DG

    更新日期:2005-08-01 00:00:00

  • Interaction between a single exposure and age in cohort-based hazard rate models impacted the statistical distribution of age at onset.

    abstract:OBJECTIVE:Statistical interaction between a single, instantaneous exposure and attained age (age during follow-up; attained age = age at exposure + time since exposure) is used in risk analyses to assess potential effect modification by unmeasured factors correlated with age. However, the impact of such interaction on ...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Izumi S,Sakata R,Yamada M,Cologne J

    更新日期:2016-03-01 00:00:00

  • An approach to measuring quality of midwifery care.

    abstract::In perinatology "Outcome" is almost always defined in terms of mortality or serious morbidity. Evaluation of care for normal pregnancy and midwifery care in particular cannot rely only on outcome measures per se, but must also take the means and interventions by which these are achieved into account. Perinatal Backgro...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Wiegers TA,Keirse MJ,Berghs GA,van der Zee J

    更新日期:1996-03-01 00:00:00

  • Minimal important change (MIC) based on a predictive modeling approach was more precise than MIC based on ROC analysis.

    abstract:OBJECTIVES:To present a new method to estimate a "minimal important change" (MIC) of health-related quality of life (HRQOL) scales, based on predictive modeling, and to compare its performance with the MIC based on receiver operating characteristic (ROC) analysis. To illustrate how the new method deals with variables t...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Terluin B,Eekhout I,Terwee CB,de Vet HC

    更新日期:2015-12-01 00:00:00

  • Assessment of vibration of effects due to model specification can demonstrate the instability of observational associations.

    abstract:OBJECTIVES:Model specification-what adjusting variables are analytically modeled-may influence results of observational associations. We present a standardized approach to quantify the variability of results obtained with choices of adjustments called the "vibration of effects" (VoE). STUDY DESIGN AND SETTING:We estim...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Patel CJ,Burford B,Ioannidis JP

    更新日期:2015-09-01 00:00:00

  • The increasing complexity of the core outcomes landscape.

    abstract::In this project, we set out to identify ways to increase the uptake of core outcome sets in clinical research. In doing so, we uncovered a growing recognition, across many different health care sectors, of the need for common, relevant outcomes to improve the quality of decision-making. This has led to a plethora of p...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Moloney RM,Messner DA,Tunis SR

    更新日期:2019-12-01 00:00:00

  • The true treatment benefit is unpredictable in clinical trials using surrogate outcome measured with diagnostic tests.

    abstract:BACKGROUND AND OBJECTIVES:Clinical trials increasingly use results of diagnostic tests as surrogate outcomes. Our objective was to answer the following questions: (1) is the parameter measured by the reference standard a valid surrogate? (2) How does the tests accuracy influence the estimate of the treatment benefit on...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Kassaï B,Shah NR,Leizorovicza A,Cucherat M,Gueyffier F,Boissel JP

    更新日期:2005-10-01 00:00:00

  • Larger effect sizes in nonrandomized studies are associated with higher rates of EMA licensing approval.

    abstract:OBJECTIVES:The aim of this study was to evaluate how often the European Medicines Agency (EMA) has authorized drugs based on nonrandomized studies and whether there is an association between treatment effects and EMA preference for further testing in randomized clinical trials (RCTs). STUDY DESIGN AND SETTING:We revie...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Djulbegovic B,Glasziou P,Klocksieben FA,Reljic T,VanDenBergh M,Mhaskar R,Ioannidis JPA,Chalmers I

    更新日期:2018-06-01 00:00:00

  • A minimal clinically important difference was derived for the Roland-Morris Disability Questionnaire for low back pain.

    abstract:OBJECTIVE:To compare methods commonly used to derive minimal important differences and recommend a rule for defining patients as clinically improved on the low back pain-specific Roland-Morris Disability Questionnaire (RMDQ). METHODS:447 primary care low back pain consulters completed a questionnaire at consultation a...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Jordan K,Dunn KM,Lewis M,Croft P

    更新日期:2006-01-01 00:00:00

  • Brief alcohol intervention trials conducted by higher prestige authors and published in higher impact factor journals are cited more frequently.

    abstract:OBJECTIVE:To examine the relationships between study quality, author prestige, journal impact factors, and citation rates of trials and to examine whether journal impact factors mediated the relationships between study quality and author prestige on citation rates. STUDY DESIGN AND SETTING:We used bibliometric data fr...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Tanner-Smith EE,Polanin JR

    更新日期:2016-07-01 00:00:00

  • Trends in fatal coronary heart disease among people aged 25-74 years in Oita City, Japan, from 1987-1998.

    abstract::Serum cholesterol has been increasing in recent years in Japan. There is concern that risk of coronary heart disease (CHD) may be increasing too, but there is little information on validated fatal CHD trends in the Japanese population. We identified 1,056 deaths from heart disease and other deaths possibly hiding CHD ...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Saito I,Ozawa H,Aono H,Ikebe T,Yamashita T,Makino Y

    更新日期:2002-05-01 00:00:00

  • Zinc supplementation reduced cost and duration of acute diarrhea in children.

    abstract:OBJECTIVE:To determine whether zinc with oral rehydration solution (ORS) is more cost effective than ORS alone in the treatment of acute diarrhea. STUDY DESIGN AND SETTING:Cost-effectiveness analysis among patients consulting the emergency room of a government institution. METHOD:Cost of treatment and outcome of part...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,随机对照试验


    authors: Gregorio GV,Dans LF,Cordero CP,Panelo CA

    更新日期:2007-06-01 00:00:00

  • Analysis of menstrual diary data across the reproductive life span applicability of the bipartite model approach and the importance of within-woman variance.

    abstract::The nature of variability in menstrual function has not been adequately described or quantified across the reproductive life span. This article evaluates the applicability of the bipartite model approach to the analysis of menstrual data and the relative importance of within-woman variability across the reproductive l...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Harlow SD,Lin X,Ho MJ

    更新日期:2000-07-01 00:00:00

  • Meta-analysis identifies Back Pain Questionnaire reliability influenced more by instrument than study design or population.

    abstract:OBJECTIVE:To assess if predefined variables in study design, instrument type, and patient characteristics account for variance in reported retest reliability for the Oswestry Disability Index (ODI) and Roland-Morris Questionnaire (RMQ). A second aim was a more precise estimate of instrument reliability. STUDY DESIGN A...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,meta分析,评审


    authors: Geere JH,Geere JA,Hunter PR

    更新日期:2013-03-01 00:00:00

  • An observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded randomized clinical trial recruitment.

    abstract:OBJECTIVES:To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment. STUDY DESIGN AND SETTING:Qualitative analysis of 73 audio recordings of recruitment consultations from fiv...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,多中心研究


    authors: Jepson M,Elliott D,Conefrey C,Wade J,Rooshenas L,Wilson C,Beard D,Blazeby JM,Birtle A,Halliday A,Stein R,Donovan JL,CSAW study group.,Chemorad study group.,POUT study group.,ACST-2 study group.,OPTIMA prelim study group.

    更新日期:2018-07-01 00:00:00

  • In network meta-analysis, most of the information comes from indirect evidence: empirical study.

    abstract:OBJECTIVES:Network meta-analysis (NMA) may produce more precise estimates of treatment effects than pairwise meta-analysis. We examined the relative contribution of network paths of different lengths to estimates of treatment effects. STUDY DESIGN AND SETTING:We analyzed 213 published NMAs. We categorized network shap...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Papakonstantinou T,Nikolakopoulou A,Egger M,Salanti G

    更新日期:2020-08-01 00:00:00

  • Time-dependent variability in repeated measurements of cholesterol levels: clinical implications for risk misclassification and intervention monitoring.

    abstract::Intraindividual variability (IIV) in total cholesterol levels based on measurements taken 1 week apart is compared with an estimate based on measurements taken 2 years apart. Single-subject 95% confidence intervals around the mean of two repeated measurements were Xi +/- 21 and +/- 28 mg/dl, respectively, and Xi +/- 3...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Roeback JR,Cook JR,Guess HA,Heyse JF

    更新日期:1993-10-01 00:00:00