Measurement of patient outcome in arthritis.

A structure for representation of patient outcome is presented, together with a method for outcome measurement and validation of the technique in rheumatoid arthritis. The paradigm represents outcome by five separate dimensions: death, discomfort, disability, drug (therapeutic) toxicity, and dollar cost. Each dimension represents an outcome directly related to patient welfare. Quantitation of these outcome dimensions may be performed at interview or by patient questionnaire. With standardized, validated questions, similar scores are achieved by both methods. The questionnaire technique is preferred since it is inexpensive and does not require interobserver validation. These techniques appear extremely useful for evaluation of long term outcome of patients with rheumatic diseases.

[1]  O. Steinbrocker,et al.  Therapeutic criteria in rheumatoid arthritis. , 1949, Journal of the American Medical Association.

[2]  E. Lowman Rehabilitation of the rheumatoid cripple; a five year study. , 1958, Arthritis and rheumatism.

[3]  S. Katz,et al.  STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. , 1963, JAMA.

[4]  Mahoney Fi,et al.  FUNCTIONAL EVALUATION: THE BARTHEL INDEX. , 1965 .

[5]  A. Donabedian,et al.  Promoting Quality through Evaluating the Process of Patient Care , 1968 .

[6]  Jacob Cohen,et al.  Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit. , 1968 .

[7]  J. W. Williamson Evaluating quality of patient care. A strategy relating outcome and process assessment. , 1971, JAMA.

[8]  W. Buchanan,et al.  Evaluation of a functional index in rheumatoid arthritis. , 1973, Scandinavian journal of rheumatology.

[9]  R H Brook,et al.  Quality-of-care assessment: choosing a method for peer review. , 1973, The New England journal of medicine.

[10]  J F Fries,et al.  A standard database for rheumatic diseases. , 1974, Arthritis and rheumatism.

[11]  S. Greenfield,et al.  Quality of Medical Care Assessment Using Outcome Measures: Eight Disease-Specific Applications , 1976 .

[12]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[13]  D. Amiel,et al.  Polyarticular disability: a functional assessment. , 1977, Archives of physical medicine and rehabilitation.

[14]  D. L. Curtis,et al.  The costs of rheumatoid arthritis. A patient-oriented study of chronic disease costs. , 1978, Arthritis and rheumatism.