Measurement of patient outcome in arthritis

Authors

  • Dr. James F. Fries MD,

    Corresponding author
    1. Stanford Arthritis Center, and the Department of Medicine, Stanford University School of Medicine, Stanford, California
    • Department of Medicine (S102B), Stanford University, School of Medicine, Stanford, CA 94305
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  • Patricia Spitz RN,

    1. Stanford Arthritis Center, and the Department of Medicine, Stanford University School of Medicine, Stanford, California
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  • R. Guy Kraines,

    1. Stanford Arthritis Center, and the Department of Medicine, Stanford University School of Medicine, Stanford, California
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  • Halsted R. Holman MD

    1. Stanford Arthritis Center, and the Department of Medicine, Stanford University School of Medicine, Stanford, California
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Abstract

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 acheived 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.

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