Prediction of Long-Term Mortality in Patients with Rheumatoid Arthritis according to Simple Questionnaire and Joint Count Measures

Pincus, Theodore; Brooks, Raye H.; Callahan, Leigh F.

doi:10.7326/0003-4819-120-1-199401010-00005

Cited by 266 publications

(159 citation statements)

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“…Our findings are consistent with prior observations that various markers of RA disease activity and severity are associated with either all-cause or cardiovascular mortality. Joint swelling, even in the absence of a diagnosis of RA, has been shown to be a predictor of death (9,52,66). Similarly, rheumatoid nodules (9,17,18,20), erosions (17,20), RA vasculitis (67,68), and higher ESR levels (9,51) were all reported to be significantly associated with mortality.…”

Section: Discussionmentioning

confidence: 98%

Cardiovascular death in rheumatoid arthritis: A population‐based study

Kremers¹,

Nicola²,

Crowson³

et al. 2005

Arthritis & Rheumatism

847

532

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Objective. To determine whether systemic inflammation confers any additional risk for cardiovascular death among patients with rheumatoid arthritis (RA), after adjusting for traditional cardiovascular risk factors and comorbidities.Methods. Using the population-based data resources of the Rochester Epidemiology Project, we assembled an incidence cohort of all Rochester, Minnesota residents ages >18 years who first fulfilled the American College of Rheumatology 1987 criteria for RA between January 1, 1955 and January 1, 1995. All subjects were followed up longitudinally through their complete (inpatient, outpatient) medical records, beginning at age 18 years and continuing until death, migration, or January 1, 2001. Detailed information on the occurrence of various cardiovascular risk factors (personal history of coronary heart disease [CHD], congestive heart failure, smoking, hypertension, dyslipidemia, body mass index [BMI], diabetes mellitus, menopausal status) as well as indicators of systemic inflammation and RA disease severity (rheumatoid factor [RF] seropositivity, erythrocyte sedimentation rate [ESR], joint swelling, radiographic changes, RA nodules, RA complications, RA treatments, disease duration) and comorbidities were collected on all subjects. Causes of death were ascertained from death certificates and medical records. Cox regression models were used to estimate the independent predictors of cardiovascular death.Results. This inception cohort comprised a total of 603 RA patients whose mean age was 58 years, of whom 73% were women. During a mean followup of 15 years, 354 patients died and cardiovascular disease was the primary cause of death in 176 patients. Personal history of CHD, smoking, hypertension, low BMI, and diabetes mellitus, as well as comorbidities, including peripheral vascular disease, cerebrovascular disease, chronic pulmonary disease, dementia, ulcers, malignancies, renal disease, liver disease, and history of alcoholism, were all significant risk factors for cardiovascular death (P < 0.01 for each

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Section: Discussionmentioning

confidence: 98%

Cardiovascular death in rheumatoid arthritis: A population‐based study

Kremers¹,

Nicola²,

Crowson³

et al. 2005

Arthritis & Rheumatism

847

532

View full text Add to dashboard Cite

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“…In a series of patients with much more longstanding RA (35), 80% had at least 1 significant comorbid condition, including hypertension in 36%, allergies in 22%, stomach ulcer in 21%, chronic bronchitis in 13%, diabetes in 5%, and so forth. The relative odds ratios for the presence of these conditions in RA patients were generally 3-5-fold higher than in the general population without arthritis.…”

Section: (Cardiovascular) Comorbidity In Ramentioning

confidence: 99%

Making an impact on mortality in rheumatoid arthritis: Targeting cardiovascular comorbidity

Boers¹,

Dijkmans²,

Gabriel³

et al. 2004

Arthritis & Rheumatism

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101

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“…The MDHAQ offers outcomes measures for patients with rheumatoid arthritis (6,7), which can serve to guide rheumatologic treatment decisions (8 -11). Moreover, the prognostic value of these PRO data has been compared to the importance of systolic or diastolic blood pressure, cholesterol, and smoking as risk factors for premature cardiovascular death (12).…”

Section: Introductionmentioning

confidence: 99%

Touchscreen questionnaire patient data collection in rheumatology practice: Development of a highly successful system using process redesign

Newman¹,

Lerch²,

Stewart³

2012

Arthritis Care & Research

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Objective. While questionnaires have been developed to capture patient-reported outcomes (PROs) in rheumatology practice, these instruments are not widely used. We developed a touchscreen interface designed to provide reliable and efficient data collection. Using the touchscreen to obtain PROs, we compared 2 different workflow models implemented separately in 2 rheumatology clinics. Methods. The Plan-Do-Study-Act methodology was used in 2 cycles of workflow redesign. Cycle 1 relied on off-the-shelf questionnaire builder software, and cycle 2 relied on a custom programmed software solution. Results. During cycle 1, clinic 1 (private practice model, resource replete, simple flow) demonstrated a high completion rate at the start, averaging between 74% and 92% for the first 12 weeks. Clinic 2 (academic model, resource deficient, complex flow) did not achieve a consistent completion rate above 60%. The revised cycle 2 implementation protocol incorporated a 15-minute "nurse visit," an instant messaging system, and a streamlined authentication process, all of which contributed to substantial improvement in touchscreen questionnaire completion rates of ϳ80% that were sustained without the need for any additional clinic staff support. Conclusion. Process redesign techniques and touchscreen technology were used to develop a highly successful, efficient, and effective process for the routine collection of PROs in a busy, complex, and resource-depleted academic practice and in typical private practice. The successful implementation required both a touchscreen questionnaire, human behavioral redesign, and other technical solutions.

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Prediction of Long-Term Mortality in Patients with Rheumatoid Arthritis according to Simple Questionnaire and Joint Count Measures

Cited by 266 publications

References 0 publications

Cardiovascular death in rheumatoid arthritis: A population‐based study

Cardiovascular death in rheumatoid arthritis: A population‐based study

Making an impact on mortality in rheumatoid arthritis: Targeting cardiovascular comorbidity

Touchscreen questionnaire patient data collection in rheumatology practice: Development of a highly successful system using process redesign

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