Featured Research

from universities, journals, and other organizations

Rheumatologists Overestimate Physical Disability Of Rheumatoid Arthritis Patients, Study Finds

Date:
July 3, 2007
Source:
University of South Florida Health
Summary:
Rheumatologists substantially overestimate the physical disability of patients with rheumatoid arthritis, which may lead to inaccurate evaluations of patients' ability to work and need for lifestyle modifications, a new study found.

Rheumatologists substantially overestimate the physical disability of patients with rheumatoid arthritis – which may lead to inaccurate evaluations of the patient’s ability to work and need for lifestyle modifications, a new study found.

Researchers at the University of South Florida College of Medicine and James A. Haley Veterans’ Hospital found a clear physician-patient difference in assessment of the patients’ functional disability. The rheumatologists consistently rated their rheumatoid arthritis patients’ degree of difficulty in performing activities of daily living, such as walking, dressing and eating, higher than the patients themselves. This was particularly true for patients in advanced stages of the disease. The findings appear in the May 2007 issue of the Journal of Rheumatology.

“We flunked,” said co-first author John D. Carter, MD, assistant professor of medicine in the USF Division of Rheumatology. “The very physicians deemed to be experts in rheumatoid arthritis failed to make the grade when it came to determining their patients’ functional status.

“This discrepancy is important to correct because patients can rely on these assessments for their livelihood or other necessities to perform activities of daily living.”

Rheumatologists are frequently asked to complete functional disability reports by employers, disability attorneys, insurance companies and government agencies weighing a person’s eligibility for disability payments, employment, or assistive devices such as wheelchairs, walkers, braces and splints.

Using the Stanford Health Assessment Questionnaire-Disability Index (HAQ-DI), rheumatologists evaluated 223 patients during their regularly scheduled visits to the USF Rheumatology Clinics and James A. Haley Veterans’ Hospital. The effectiveness of the HAQ-DI, based on patient self-reporting of their disability status, has been validated in clinical studies. The questionnaire covers eight activities of daily living: dressing, arising, eating, hygiene, walking, reach, grip and outside activity.

Both physician and patient completed the HAQ-DI independently immediately following the visit and their respective scores were not shared.

The rheumatologists overestimated the degree of functional disability in 154, or 69 percent, of the 223 the patients. However, they were significantly more accurate at determining the degree of physical limitations in patients with less severe disease.

The reasons for the overestimation are unclear, but may include empathy and suggest that even patients with advanced rheumatoid arthritis adapt their activities to the progression of the chronic disease, Dr. Carter said. “We tend to associate visible joint deformities with incapacitated function, but patients may actually be more capable than we think.”

Rheumatologists typically determine functional disability based on the patient’s examination and medical history, but these impressions during routine care are inadequate, Dr. Carter said. The study points to the need for a formal, standardized evaluation, such as the HAQ-DI. “It needs to be reimbursable and include input from physical and occupational therapists who could add valuable insight to the process of evaluating disability,” he added.

Rheumatoid arthritis affects about 2.1 million Americans, or 1 percent of the population. Over the last decade new drugs have revolutionized the treatment of this debilitating inflammatory disease, but nearly all patients with rheumatoid arthritis eventually develop some degree of work or daily lifestyle disability, often severe.

Other authors of the study were Abdul B. Lohdi, MD (co-first author); Sonia R. Nagda; Louis Ricca, MD; Colleen Ward, DO; Erica Traina; Zachary J. Thompson; Yangxin Huang, PhD; Joanne Valeriano, MD; and Frank B. Vasey, MD.


Story Source:

The above story is based on materials provided by University of South Florida Health. Note: Materials may be edited for content and length.


Cite This Page:

University of South Florida Health. "Rheumatologists Overestimate Physical Disability Of Rheumatoid Arthritis Patients, Study Finds." ScienceDaily. ScienceDaily, 3 July 2007. <www.sciencedaily.com/releases/2007/06/070628161740.htm>.
University of South Florida Health. (2007, July 3). Rheumatologists Overestimate Physical Disability Of Rheumatoid Arthritis Patients, Study Finds. ScienceDaily. Retrieved September 30, 2014 from www.sciencedaily.com/releases/2007/06/070628161740.htm
University of South Florida Health. "Rheumatologists Overestimate Physical Disability Of Rheumatoid Arthritis Patients, Study Finds." ScienceDaily. www.sciencedaily.com/releases/2007/06/070628161740.htm (accessed September 30, 2014).

Share This



More Health & Medicine News

Tuesday, September 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How 'Yes Means Yes' Defines Sexual Assault

How 'Yes Means Yes' Defines Sexual Assault

Newsy (Sep. 29, 2014) Aimed at reducing sexual assaults on college campuses, California has adopted a new law changing the standard of consent for sexual activity. Video provided by Newsy
Powered by NewsLook.com
Scientists May Have Found An Early Sign Of Pancreatic Cancer

Scientists May Have Found An Early Sign Of Pancreatic Cancer

Newsy (Sep. 29, 2014) Researchers looked at 1,500 blood samples and determined people who developed pancreatic cancer had more branched chain amino acids. Video provided by Newsy
Powered by NewsLook.com
Colo. Doctors See Cluster of Enterovirus Cases

Colo. Doctors See Cluster of Enterovirus Cases

AP (Sep. 29, 2014) Doctors at the Children's Hospital of Colorado say they have treated over 4,000 children with serious respiratory illnesses since August. Nine of the patients have shown distinct neurological symptoms, including limb weakness. (Sept. 29) Video provided by AP
Powered by NewsLook.com
Dr.'s Unsure of Cause of Fast-Spreading Virus

Dr.'s Unsure of Cause of Fast-Spreading Virus

AP (Sep. 29, 2014) Doctors at the Children's Hospital of Colorado say they have treated over 4,000 children with serious respiratory illnesses since August. Nine of the patients have shown distinct neurological symptoms, including limb weakness. (Sept. 29) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins