{"title":"基于患者MDHAQ和医生报告的标准定量科学数据,为类风湿关节炎患者进行循证医疗访问。","authors":"Theodore Pincus, Isabel Castrejón","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>An evidence-based visit is described based on quantitative, standard scientific data on two simple forms for a patient and a physician. The focus is rheumatoid arthritis (RA), but the principles may be applied to most rheumatic and chronic diseases. A quantitative patient history is recorded on a selfreport multidimensional health assessment questionnaire (MDHAQ), which includes scales for physical function, pain, patient global estimate, psychological distress, change in status, exercise status, morning stiffness, fatigue, and a template to score RAPID3 (routine assessment of patient index data 3). RAPID3, an index of only patient self-report measures, distinguishes active from control treatments in clinical trials at similar levels to a disease activity score (DAS28) and clinical disease activity index (CDAI) but is calculated in 5 seconds, compared to almost 2 minutes for DAS28 or CDAI. The MDHAQ also includes traditional \"medical\" matters-a self-report joint count, review of systems, recent medical history, medications, demographic data, and consents for future monitoring by mail and sharing data with research colleagues; these queries enhance acceptance by patients and save time for doctors. Patient questionnaire physical function scores-not radiographs or laboratory tests-are the most significant prognostic markers for long-term work disability and premature death in RA. The physician completes a \"doctor evaluation\" (DOCEVAL) form, which includes four visual analog scales for overall status, inflammation, damage, and \"neither\" (usually fibromyalgia), reflecting quantitatively the expertise of a rheumatologist to classify the etiology of pain and distress into one of these three broad categories in formulating a treatment plan. Quantitative data from patients and doctors on an evidence-based visit can advance rheumatology clinical care and clinical science.</p>","PeriodicalId":72485,"journal":{"name":"Bulletin of the NYU hospital for joint diseases","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"An evidence-based medical visit for patients with rheumatoid arthritis based on standard, quantitative scientific data from a patient MDHAQ and physician report.\",\"authors\":\"Theodore Pincus, Isabel Castrejón\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>An evidence-based visit is described based on quantitative, standard scientific data on two simple forms for a patient and a physician. The focus is rheumatoid arthritis (RA), but the principles may be applied to most rheumatic and chronic diseases. A quantitative patient history is recorded on a selfreport multidimensional health assessment questionnaire (MDHAQ), which includes scales for physical function, pain, patient global estimate, psychological distress, change in status, exercise status, morning stiffness, fatigue, and a template to score RAPID3 (routine assessment of patient index data 3). RAPID3, an index of only patient self-report measures, distinguishes active from control treatments in clinical trials at similar levels to a disease activity score (DAS28) and clinical disease activity index (CDAI) but is calculated in 5 seconds, compared to almost 2 minutes for DAS28 or CDAI. The MDHAQ also includes traditional \\\"medical\\\" matters-a self-report joint count, review of systems, recent medical history, medications, demographic data, and consents for future monitoring by mail and sharing data with research colleagues; these queries enhance acceptance by patients and save time for doctors. Patient questionnaire physical function scores-not radiographs or laboratory tests-are the most significant prognostic markers for long-term work disability and premature death in RA. The physician completes a \\\"doctor evaluation\\\" (DOCEVAL) form, which includes four visual analog scales for overall status, inflammation, damage, and \\\"neither\\\" (usually fibromyalgia), reflecting quantitatively the expertise of a rheumatologist to classify the etiology of pain and distress into one of these three broad categories in formulating a treatment plan. Quantitative data from patients and doctors on an evidence-based visit can advance rheumatology clinical care and clinical science.</p>\",\"PeriodicalId\":72485,\"journal\":{\"name\":\"Bulletin of the NYU hospital for joint diseases\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2012-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bulletin of the NYU hospital for joint diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bulletin of the NYU hospital for joint diseases","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
An evidence-based medical visit for patients with rheumatoid arthritis based on standard, quantitative scientific data from a patient MDHAQ and physician report.
An evidence-based visit is described based on quantitative, standard scientific data on two simple forms for a patient and a physician. The focus is rheumatoid arthritis (RA), but the principles may be applied to most rheumatic and chronic diseases. A quantitative patient history is recorded on a selfreport multidimensional health assessment questionnaire (MDHAQ), which includes scales for physical function, pain, patient global estimate, psychological distress, change in status, exercise status, morning stiffness, fatigue, and a template to score RAPID3 (routine assessment of patient index data 3). RAPID3, an index of only patient self-report measures, distinguishes active from control treatments in clinical trials at similar levels to a disease activity score (DAS28) and clinical disease activity index (CDAI) but is calculated in 5 seconds, compared to almost 2 minutes for DAS28 or CDAI. The MDHAQ also includes traditional "medical" matters-a self-report joint count, review of systems, recent medical history, medications, demographic data, and consents for future monitoring by mail and sharing data with research colleagues; these queries enhance acceptance by patients and save time for doctors. Patient questionnaire physical function scores-not radiographs or laboratory tests-are the most significant prognostic markers for long-term work disability and premature death in RA. The physician completes a "doctor evaluation" (DOCEVAL) form, which includes four visual analog scales for overall status, inflammation, damage, and "neither" (usually fibromyalgia), reflecting quantitatively the expertise of a rheumatologist to classify the etiology of pain and distress into one of these three broad categories in formulating a treatment plan. Quantitative data from patients and doctors on an evidence-based visit can advance rheumatology clinical care and clinical science.