This paper presents the main findings of a 1994 survey of UK industry practices in the evaluation and realisation of IS/IT benefits ('benefits management'). The survey addresses the issues which affect the ability of organizations to realise the full benefits of IS/IT investments, i.e. not only the pre-investment appraisal and post-investment evaluation processes, but also how organizations do or do not ensure that benefits claimed are actively managed through to realisation. To do this a new benefits management process model was used to structure a questionnaire to elicit details of how effective organizations are in addressing benefits management throughout the investment lifecycle. Sixty organizations responded to the survey, thus providing a wealth of data for analysis. This paper presents some of the key results of that analysis. From the survey, it is clear that many organizations believe that current methods are far from satisfactory in ensuring that the benefits are properly identified and realised. Very few have a comprehensive process for managing the delivery of benefits from IS/IT. This paper offers new insight into the reasons for the current unsatisfactory situation and points the way to how the situation could be significantly improved.

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Objective. To determine whether sulfasalazine (SSZ) at a dosage of 2,000 mg/day is effective for the treatment of active psoriatic arthritis (PsA) resistant to nonsteroidal antiinflammatory drug therapy.Methods. Two hundred twenty-one patients with PsA were recruited from 15 clinics, randomized (doubleblind) to SSZ or placebo treatment, and followed up for 36 weeks. Treatment response was based on joint p a i d Address reprint request requests to Daniel 0. Clegg, MD, Division of Rheumatology, 4B200-SOM, 50 North Medical Drive, Salt Lake City, UT 84132.Submitted for publication March 19,1996; accepted in revised form July 19, 1996. tenderness and swelling scores and physician and patient global assessments.Resubs. Longitudinal analysis revealed a trend favoring SSZ treatment (P = 0.13). At the end of treatment, response rates were 57.8% for SSZ compared with 44.6% for placebo (P = 0.05). The Westergren erythrocyte sedimentation rate declined more in the PsA patients taking SSZ than in those taking placebo (P < 0.0001). Adverse reactions were fewer than expected and were mainly due to nonspecific gastrointestinal complaints, including dyspepsia, nausea, vomiting, and diarrhea.Conclusion. SSZ at a dosage of 2,000 mg/day is well tolerated and may be more effective than placebo in the treatment of patients with PsA.

One hundred eighty-nine patients with rheumatoid arthritis were entered into a prospective, controlled, double-blind multicenter trial comparing placebo amd methotrexate (MTX).721 bles measured, including joint paidtenderness and swelling counts, rheumatoid nodules, and patient and physician assessment of disease activity. MTX treatment demonstrated statistically significant improvement over placebo in patients with anemia, elevated erythrocyte sedimentation rate, and rheumatoid factor. However, nearly one-third of the patients receiving MTX were withdrawn for adverse drug reactions, of which elevated levels of liver enzymes was the most common. Pancytopenia occurred in 2 patients taking MTX. All adverse drug effects resolved without sequelae. MTX appears to be effective in the treatment of active rheumatoid arthritis but requires close monitoring for toxicity.

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Thirty-seven patients with psoriatic arthritis were entered into a 12-week prospective, controlled, double-blind multicenter trial comparing placebo and oral pulse methotrexate therapy. Methotrexate was given in a dose of 2.5-5.0 mg every 12 hours in 3 consecutive doses per week. A stable background medication program with nonsteroidal antiinflammatory drugs was allowed. Methotrexate was superior to placebo only in physician assessment of arthritis activity and in improvement of the amount of skin surface area with --

Depression is common in rheumatoid arthritis (RA) populations and has been hypothesized to result from patients' belief that they cannot control their disease or its impact. In a sample of 106 patients with RA, we found that scores on a measure of helplessness mediated the relationship between severe, disabling RA and depression. Further, this association was independent of the previously demonstrated correlation between cognitive distortion and depression in RA patients. Thus, both helplessness and cognitive distortion may be important factors in the development and treatment of depression among RA patients.