Biomedical subjects

H H Kuper

Publications and source records attributed to H H Kuper.

4 recordsLinked to original sources

PubMed1999

Socio-economic consequences of rheumatoid arthritis in the first years of the disease.

OBJECTIVE: Few data have been presented to document the impact of rheumatoid arthritis (RA) on socio-economic well-being. In this study, exact figures on socio-economic consequences were assessed. METHODS: The socio-economic consequences were studied in an inception cohort (186 early RA patients, mean disease duration 3 yr) by measuring the change in work capability, income, rest during the daytime, leisure time activity, transport mobility, housing and social support occurring in the first years of the disease. RESULTS: For 89% of the patients, RA had an impact on one of the socio-economic items; for 58%, at least three of these items were affected simultaneously. Work disability appeared to be 4-15 times higher than in the general population. After 3 yr, 42% of the patients were registered as work disabled. Nearly a quarter of the patients experienced income reduction. Over 40% of the patients claimed extra rest during the daytime. Leisure activity changed towards activities with a lower joint load. There was a decline in transport mobility for 52% of the patients. Social support increased strongly. CONCLUSIONS: Socio-economic change already presents in the first years of RA and appears to be influenced by age, gender, marital status and work disability. Furthermore, physical limitation appeared to be predictive for work-related income reduction, reduced transport mobility and development of social dependency.

Activities of Daily Living↗

PubMed1997

Radiographic damage in large joints in early rheumatoid arthritis: relationship with radiographic damage in hands and feet, disease activity, and physical disability.

An assessment of the onset of radiographic damage in the large joints (hip, knees, shoulders, elbows, ankles and tarsus) in patients with early rheumatoid arthritis, and the relationship of the progression of large joint damage with joint damage in hands and feet, with physical disability, and with cumulative disease activity, was performed in a prospective 6 yr follow-up study. Large joint damage appeared to be an early phenomenon with 20% of the patients having some damage in at least one large joint within 1 yr, and 50% of the patients within 6 yr after disease onset. Radiographic damage in large joints was significantly related to the damage in hands and feet, the physical disability index, and the cumulative disease activity. The initial disease activity at study entry was the only prognostic factor that reached significance.

Adolescent↗

PubMed1995

Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis.

OBJECTIVE: The development and validation of Modified Disease Activity Scores (DAS) that include different 28-joint counts. METHODS: These scores were developed by canonical discriminant analyses and validated for criterion, correlational, and construct validity. The influence of disease duration on the composition of the DAS was also investigated. RESULTS: No influence of disease duration was found. The Modified DAS that included 28-joint counts were able to discriminate between high and low disease activity (as indicated by clinical decisions of rheumatologists). CONCLUSION: The Modified DAS are as valid as disease activity scores that include more comprehensive joint counts.

Adult↗

PubMed1993

Validity and reliability of joint indices. A longitudinal study in patients with recent onset rheumatoid arthritis.

This prospective longitudinal study evaluates the validity and reliability of joint indices (JIs) used to measure disease activity in patients with RA. From seven traditional JIs (Ritchie Articular Index (RAI), Modified RAI, Thompson score, 28 JI, 36 JI, total tender and total swollen joints) 37 'new' JIs were computed by considering three different characteristics of joint inflammation, tenderness, swelling and the combination of tenderness and swelling, and by grading for tenderness and/or weighting for surface area of the joints. Several aspects of validity were investigated, the construct (correlation with radiographic damage), correlational (correlation with ESR, general health) and criterion validity (correlation with a Health Assessment Questionnaire, discrimination between high and low disease activity). It was found that the validity and reliability of traditional JIs do not differ substantially. Graded JIs are almost always more valid than ungraded JIs. Weighted JIs are almost always less valid and reliable than unweighted JIs. Therefore no JI proved to be superior for measuring the disease activity under consideration. Taking simplicity into account the 28 JI, not graded and not weighted, was preferable.

Aged↗