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Biomedical subjects

J Wasson

Publications and source records attributed to J Wasson.

44 records · Page 3Linked to original sources
PubMed1987

Chief complaint fatigue: a longitudinal study from the patient's perspective.

Fatigue is one of the 10 most common reasons for visiting a physician. Yet little is known about its course or impact, from the patient's perspective, on quality of life or utilization of medical care. The Dartmouth COOP Project, a primary care research network, conducted a one-year prospective study comparing chief complaint fatigue (CCF) patients with two age/sex matched comparison groups (N = 243). Results show that almost 67% of the CCF patients improved over one year; however, they had much higher utilization rates and substantial limitations in physical and emotional function. Fatigue was associated with physical symptoms and interference with many aspects of daily life. We conclude that fatigue has a powerful, adverse effect on quality of life. We hope the findings may help physicians to better understand and treat patients who seek care for fatigue.

Fatigue↗
PubMed1983

Functional health status levels of primary care patients.

A cross-sectional study was conducted on functional status of adults visiting primary care practices. Limitations in physical and mental function were assessed independently in 28 practices by patients (N = 1,227) and physicians (N = 47) using a simple global index of disability. Results indicated 12% of patients rated their physical limitations as major and 8% rated major emotional limitations during the past month. Comparable assessments by physicians were 5% and 4%, respectively. Differences between patients and physicians were statistically significant and are demonstrated to be clinically relevant. Patients' functional limitations were associated with increased utilization of ambulatory care, older age, lower level of education, unemployment, and a primary diagnosis of a chronic condition. We conclude that functional status can be routinely recorded in medical practice to help describe severity, predict utilization, and improve the physician-patient relationship.

Activities of Daily Living↗
PubMed1980

The clinical value of the upper gastrointestinal tract roentgenogram series.

We studied the role of the upper gastrointestinal tract roentgenogram series (UGI) in the care of 483 ambulatory patients with varied abdominal complaints. The test was significantly abnormal about 20% of the time, rarely led to changes in therapy, and was ordered inappropriately 30% of the time (according to criteria devised by experts). Regardless of their test results, most patients' symptoms improved in the several months after the test. We created a simple rule, based on the patient's history, that would have led to a decrease in the number of inappropriately ordered tests without significantly compromising care. This decision rule may help to improve the utilization of the UGI by identifying patients who are unlikely to benefit from the test.

Digestive System↗
PubMedDate not supplied

Transverse sinus thrombosis: an unusual cause of headache.

A 24-year-old woman presented with headache of 6 days' duration, described as throbbing pain in the right periorbital region radiating to her right ear and neck. The pain was unresponsive to oral analgesics. She had no speech or hearing difficulties, no previous history of migraines, and no family history of neurologic disease. Her medications included oral contraceptives for 8 months' duration. This report describes the salient features of dural sinus thrombosis and recent advances in diagnostic and therapeutic procedures. The relationship between oral contraceptives and protein S levels is also discussed. Cerebral dural sinus thrombosis should be considered in the differential of new onset of headaches, seizures, or focal neurological deficits.

Adult↗