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Rachelle Buchbinder

Publications and source records attributed to Rachelle Buchbinder.

At least 37 records · Page 2Linked to original sources
PubMed2004

A linguistic framework for assessing the quality of written patient information: its use in assessing methotrexate information for rheumatoid arthritis.

Patient information leaflets are an important adjunct to verbal exchange between doctor and patient. Their value is dependent upon whether they contain useful information from the viewpoint of the patient and are easily understood. We developed a framework based upon linguistic theory for assessing the quality of written patient information and applied it to a set of leaflets about methotrexate treatment. Items included the overall structure of the text, the technicality of the vocabulary used, the number of content words per clause ('lexical density'), and the clarity of the role relationship between author and reader. The leaflets consisted of up to nine identifiable sections (range 3-8): background information about the drug, summary of its use, dosage instructions, outline of benefits and side-effects, monitoring information, constraints on patient behavior, storage instructions, and clinical contact availability. Most leaflets contained a high number of content words per clause and the identity of the author was clear in only three (17%). Linguistic analysis provides highly relevant information about written patient information. Together with critical assessment of factual and visual aspects, consideration of key linguistic features should improve the quality of informational texts for our patients.

Antirheumatic Agents↗
PubMed2004

Validity and internal consistency of a whiplash-specific disability measure.

STUDY DESIGN: Cross-sectional study of patients with whiplash-associated disorders investigating the internal consistency, factor structure, response rates, and presence of floor and ceiling effects of the Whiplash Disability Questionnaire (WDQ). OBJECTIVES: The aim of this study was to confirm the appropriateness of the proposed WDQ items. SUMMARY OF BACKGROUND DATA: Whiplash injuries are a common cause of pain and disability after motor vehicle accidents. Neck disability questionnaires are often used in whiplash studies to assess neck pain but lack content validity for patients with whiplash-associated disorders. The newly developed WDQ measures functional limitations associated with whiplash injury and was designed after interviews with 83 patients with whiplash in a previous study. METHODS: Researchers sought expert opinion on items of the WDQ, and items were then tested on a clinical whiplash population. Data were inspected to determine floor and ceiling effects, response rates, factor structure, and internal consistency. Packages of questionnaires were distributed to 55 clinicians, whose patients with whiplash completed and returned 101 questionnaires to researchers. RESULTS: No substantial floor or ceiling effects were identified on inspection of data. The overall floor effect was 12%, and the overall ceiling effect was 4%. Principal component analysis identified one broad factor that accounted for 65% of the variance in responses. Internal consistency was high; Cronbach's alpha = 0.96. CONCLUSIONS: Results of the study supported the retention of the 13 proposed items in a whiplash-specific disability questionnaire. Dependent on the results of further psychometric testing, the WDQ is likely to be an appropriate outcome measure for patients with whiplash.

Adult↗
PubMed2004

Reproducibility and responsiveness of the Whiplash Disability Questionnaire.

This study continued the validation of a Whiplash Specific Disability Questionnaire (WDQ) that was developed from the Neck Disability Index (NDI) using self-reported disabilities in a group of participants experiencing whiplash-associated disorders [J Manipulative Physiol Ther 14 (1991) 409]. Previous research has established the content, construct and face validity and internal consistency of the WDQ. The aim of this study was to establish the short-term and medium-term test-retest reliability and responsiveness of the WDQ. Participants (n = 63) receiving physiotherapy treatment for WAD were recruited from 30 private physiotherapy practices in Melbourne, Australia. Each participant completed three WDQ questionnaires over a 1-month period, the first two separated by 24 h. The third questionnaire contained an additional item that asked respondents to rate their perceived change in condition over the month. Reproducibility was determined using an intra-class correlation co-efficient. Responsiveness was assessed via correlation with participant perceived change, the effect size, standardised response mean (SRM) and the responsiveness statistic. Results demonstrated excellent short-term test-retest reliability (ICC 0.96). Reproducibility over 1 month was excellent (ICC 0.93). Correlation between change in WDQ score over 1 month and participant perceived change was r(s) = 0.64, the effect size was 0.03, the SRM was 0.08 and the responsiveness statistics were 0.90 (participants who improved) and -1.60 (participants who deteriorated). The minimal detectable change of the WDQ was established at 15 points. These results demonstrate that the WDQ has excellent short- and medium-term reproducibility and responsiveness in a population seeking treatment for WAD.

Adolescent↗
PubMed2004

Is the Human Activity Profile a useful measure in people with knee osteoarthritis?

This study evaluated the usefulness of the Human Activity Profile (HAP) in people with knee osteoarthritis (OA). People with OA (N = 226) completed the HAP and a battery of pain and physical function measures. Healthy elderly controls (N = 33) also completed the HAP, and 20 OA participants underwent repeat testing 2 to 7 days later. Test-retest reliability was excellent (intraclass correlation coefficients 0.96 and 0.95). The HAP was sensitive enough to detect differences in physical activity between people with (N = 33) and without OA (N = 33) (p < 0.01). When OA individuals were classified as impaired, moderately active, or active based on HAP score, differences in pain and physical function were detected (p < 0.05). Correlations between HAP and commonly used pain and physical function measures were weak to moderate (r = 0.18-0.63, all p < 0.01), indicating that the HAP measures additional information not gained by other assessment tools. The HAP is a reliable measure, and it is sensitive enough to discriminate between people with and without knee OA, and within an OA cohort. The HAP appears to have greater applicability in osteoarthritic women than men.

Aged↗
PubMed2004

Longitudinal study comparing sonographic and MRI assessments of acute and healing hamstring injuries.

OBJECTIVE: We compared sonography and MRI for assessing hamstring injuries in professional football players (Australian football) 3 days, 2 weeks, and 6 weeks after an injury and identified imaging characteristics at baseline that may be useful in predicting the time needed for return to competition. MATERIALS AND METHODS: Sixty men who are professional football players presented with suspected acute hamstring strain underwent sonography and MRI within 3 days of injury; those who were injured returned 2 and 6 weeks later for follow-up MRI and sonography. Two radiologists interpreted either the MR images or the sonograms and were blinded to the results of the other technique. The following six parameters were measured at each assessment: the muscle injured, the site of injury within the muscle, the longitudinal injury length (expressed in millimeters), the cross-sectional injured area (expressed as a percentage), and the presence of interand intramuscular hematoma. RESULTS: At baseline, MRI identified abnormalities in 42 (70.0%) of 60 patients, whereas sonography found abnormalities in 45 (75%) of 60. At 2 weeks, 29 (59.2%) of 49 scans showed abnormalities on MRI and 25 (51.0%) of 49 showed abnormalities on sonograms. Of those players who were injured at baseline, 15 (35.7%) of 42 and 10 (22.2%) of 45 still showed abnormal results on scans at 6 weeks on MRI and sonography, respectively. However, all but one player had returned to competition. The biceps femoris was the most commonly injured muscle and the musculotendinous junction was the most common site of injury. Injuries appeared significantly larger on MRI than on sonography at all time points. Our analysis showed that at baseline, the longitudinal length of hamstring tear on MRI had the highest statistical correlation with recovery (r = 0.58, p < 0.0001) and was the best radiologic predictor for return to competition. CONCLUSION: Sonography is as useful as MRI in depicting acute hamstring injuries and because of lower costs may be the preferred imaging technique. However, MRI is more sensitive for follow-up imaging of healing injuries. The longitudinal length of the strain as measured on MRI is a strong predictor for the amount of time needed until an athlete can return to competition.

Adult↗
PubMed2004

A comparison of magnetic resonance imaging, sonography, and radiography of the hand in patients with early rheumatoid arthritis.

OBJECTIVE: As therapy for rheumatoid arthritis (RA) becomes more effective, more sensitive imaging methods are required to assess disease activity and joint damage. We compared magnetic resonance imaging (MRI), sonography, and radiography for assessment of disease activity for the detection of bony erosions. METHODS: Forty-six patients with newly diagnosed RA (onset within 2 years) received clinical and laboratory assessment followed by radiographs, sonography, and MRI of the right hand at baseline and at 6 months according to a standardized protocol. We determined the presence of edema, synovitis, effusions, tendon fluid, tendon thickening, and size in the same way by MRI and sonography. The intra- and interreader reliability of MRI and radiographs and predictors of MRI erosions at 6 month followup were also examined. RESULTS: At baseline, 39 (85%), 14 (30%), and 17 (37%) patients had erosions identified on MRI, sonography, and radiography, respectively. Over time, the percentage of patients with erosions increased to 91% for MRI, 41% for sonography, and 48% for radiography. The absolute number of erosions increased from 177 to 239 erosions for MRI, from 30 to 43 for sonography, and from 38 to 73 for radiographs. The intra- and interreader reliability for the assessment of erosions and synovitis on MRI was acceptable (intrareader ICC of 0.60 and 0.90; interreader ICC of 0.77 and 0.89, respectively). CONCLUSION: MRI appears to be the most sensitive modality for erosive disease compared with sonography and radiography. Sonography detected more joint and tendon sheath effusions than MRI in this study and therefore may have a role in the assessment of disease activity.

Adult↗
PubMed2004

Tennis elbow.

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Acupuncture↗
PubMed2003

Tennis elbow.

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Acupuncture Therapy↗
PubMed2003

Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplash-associated disorders.

The Neck Disability Index (NDI) and Northwick Park Neck Pain Questionnaire (NPQ) were developed to measure self-perceived disability from neck pain, including that which may arise from whiplash injury. However, there is little data specifically concerning their validity for whiplash-associated disorders (WAD). The aim of this study was to assess the validity of the NDI and NPQ as measures of outcome in WAD by comparing them to a patient preference questionnaire, the problem elicitation technique (PET), which identifies problems that are of most importance to the individual patient. A cross-sectional study of 71 patients with varying severity and duration of WAD were recruited from a private physiotherapy practice. All patients completed a standardized self-administered questionnaire that included demographic and clinical details as well as self-perceived pain and severity of symptoms, NDI and NPQ. A trained interviewer administered the PET. Construct validity of the disability measures was examined by determining their correlation with each other and with pain and severity of symptoms by calculating Pearson's correlation coefficients. Content validity of the NDI and NPQ was assessed by comparing the items of both questionnaires to the problems identified by the PET. Participants' mean age was 40.1 years (SD=14.3) and 59 were women (83.1%). Most patients were in WAD category I (n=23, 32.1%), or II (n=42, 59.2%). Mean NDI, NPQ, and PET scores were 40.7 (SD=17.0), 38.7 (SD=15.8), and 160.2 (SD=92.0, range 6.0-509.5), respectively. Correlations between the NDI and PET, NPQ and PET, and NDI and NPQ were r=0.57, 0.56 and 0.88, respectively. The PET identified an average of 7.7 problems per patient (SD=4.2, range 1-17 problems). Problems most commonly identified were work for wages (52.1%), fatigued during the day (50.7%), participation in sports (47.9%), depression (43.7%), drive a car (43.7%), socialize with friends (33.8%), sleep through the night (31.0%), frustration (31.0%), and anger (28.2%). Only three of these problems are included in the NDI (work, driving, and sleeping) and only four are included in the NPQ (work, driving, sleeping, and social activities). While both the NDI and NPQ include some problems that are common in patients with WAD, frequently identified problems, such as emotional and social items are absent. In contrast to the PET, neither instrument captures the full spectrum of disabilities judged to be important by the patient.

Adult↗
PubMed2003

Relationship of knee joint proprioception to pain and disability in individuals with knee osteoarthritis.

Proprioception plays an integral role in neuromotor control of the knee joint and deficits in knee joint proprioception are well documented in individuals with knee osteoarthritis (OA). However, the functional relevance of these deficits is not clear. This cross-sectional study evaluated the relationship between knee joint proprioception and pain and disability in a large cohort of individuals with knee OA. Two hundred and twenty participants (145 F, 75 M) with symptomatic knee OA were recruited from the community. Five non-weight bearing active tests with ipsilateral limb matching responses were performed at 20 degrees and 40 degrees flexion to measure knee joint position sense. Pain and disability were assessed by self-reported questionnaires and objective measures of balance and gait. Results showed little association between knee joint position sense variables and measures of pain and disability (r values <0.24, most p>0.05). When comparing participants with the worst and best joint position sense, no significant differences in pain and disability could be found (p>0.05). While our study design does not allow causality to be established, these results suggest that deficits in joint position sense may be due to factors other than pain and that deficits are not large enough to impact upon disability.

Cohort Studies↗
PubMed2003

Effectiveness of physiotherapy for lateral epicondylitis: a systematic review.

AIM: To evaluate the available evidence of the effectiveness of physiotherapy for lateral epicondylitis of the elbow. METHOD: Randomised controlled trials (RCTs) identified by a highly sensitive search strategy in six databases in combination with reference checking. Two independent reviewers selected RCTs that included a physiotherapy intervention, patients with lateral epicondylitis, and at least one clinically relevant outcome measure. No language restrictions were made. Methodological quality was independently assessed by two blinded reviewers. A best evidence synthesis, including a quantitative and qualitative analysis, was conducted, weighting the studies with respect to their internal validity, statistical significance, clinical relevance, and statistical power. RESULTS: 23 RCTs were included in the review, evaluating the effects of lasertherapy, ultrasound treatment, electrotherapy, and exercises and mobilisation techniques. Fourteen studies satisfied at least 50% of the internal validity criteria. Except for ultrasound, pooling of data from RCTs was not possible because of insufficient data, or clinical or statistical heterogeneity. The pooled estimate of the treatment effects of two studies on ultrasound compared to placebo ultrasound, showed statistically significant and clinically relevant differences in favour of ultrasound. There is insufficient evidence either to demonstrate benefit or lack of effect of lasertherapy, electrotherapy, exercises and mobilisation techniques for lateral epicondylitis. CONCLUSIONS: Despite the large number of studies, there is still insufficient evidence for most physiotherapy interventions for lateral epicondylitis due to contradicting results, insufficient power, and the low number of studies per intervention. Only for ultrasound, weak evidence for efficacy was found. More better designed, conducted and reported RCTs are needed.

Australia↗
PubMed2002

Ultrasound-guided extracorporeal shock wave therapy for plantar fasciitis: a randomized controlled trial.

CONTEXT: Extracorporeal shock wave therapy (ESWT) is increasingly used for plantar fasciitis, but limited evidence supports its use. OBJECTIVE: To determine whether ultrasound-guided ESWT reduces pain and improves function in patients with plantar fasciitis. DESIGN: Double-blind, randomized, placebo-controlled trial conducted between April 1999 and June 2001. SETTING: Participants were recruited from the community-based referring physicians (primary care physicians, rheumatologists, orthopedic surgeons, and sports physicians) of a radiology group in Melbourne, Australia. PARTICIPANTS: We screened 178 patients and enrolled 166; 160 completed the 15-week protocol. Entry criteria included age at least 18 years with plantar fasciitis, defined as heel pain maximal over the plantar aspect of the foot of at least 6 weeks' duration, and an ultrasound-confirmed lesion, defined as thickening of the origin of the plantar fascia of at least 4 mm, hypoechogenicity, and alterations in the normal fibrillary pattern. INTERVENTIONS: Patients were randomly assigned to receive either ultrasound-guided ESWT given weekly for 3 weeks to a total dose of at least 1000 mJ/mm(2) (n = 81), or identical placebo to a total dose of 6.0 mJ/mm(2) (n = 85). MAIN OUTCOME MEASURES: Overall, morning, and activity pain, measured on a visual analog scale; Maryland Foot Score; walking ability; Short-Form-36 Health Survey (SF-36) score; and Problem Elicitation Technique score, measured at 6 and 12 weeks after treatment completion. RESULTS: At 6 and 12 weeks, there were significant improvements in overall pain in both the active group and placebo group (mean [SD] improvement, 18.1 [30.6] and 19.8 [33.7] at 6 weeks [P =.74 for between-group difference], and 26.3 [34.8] and 25.7 [34.9] at 12 weeks [P =.99], respectively). Similar improvements in both groups were also observed for morning and activity pain, walking ability, Maryland Foot Score, Problem Elicitation Technique, and SF-36. There were no statistically significant differences in the degree of improvement between treatment groups for any measured outcomes. CONCLUSION: We found no evidence to support a beneficial effect on pain, function, and quality of life of ultrasound-guided ESWT over placebo in patients with ultrasound-proven plantar fasciitis 6 and 12 weeks following treatment.

Double-Blind Method↗
PubMed2002

Adhesive capsulitis: role of MR imaging in differential diagnosis.

The purpose of this study was to describe and characterize the MR imaging findings in a group of patients who underwent surgery for adhesive capsulitis. Twenty-four MR imaging studies in 24 consecutive patients with clinical evidence of adhesive capsulitis were performed prior to arthroscopic capsulotomy. There were 17 women and 7 men with a mean age of 53.5 years. Images were scrutinised for changes in the synovium particularly in the rotator interval, around the biceps anchor and axillary pouch. Intravenous gadolinium was given routinely. We also examined a control group of 22 patients who underwent the same MR imaging protocol after referral for rotator cuff pathology. Soft tissue density showing variable enhancement after gadolinium administration was visible in the rotator interval in 22 of 24 studies on MR imaging. Seventeen patients showed soft tissue density partially encasing the biceps anchor. Ten patients showed thickening and gadolinium enhancement of the axillary pouch. Three patients from the study cohort had partial tears of the supraspinatus tendon. All the patients subsequently had surgery which confirmed fibrovascular scar tissue in the rotator interval, around the biceps anchor and a variable degree of synovial inflammation of the glenohumeral capsule. Two patients from a control group with suspected rotator cuff pathology showed abnormal intensity in the rotator interval on MR imaging. Magnetic resonance imaging can identify changes in the shoulder joint that correspond to abnormalities seen at surgery. This may be useful for discriminating adhesive capsulitis from other causes of shoulder pain.

Adult↗
PubMed2002

Malignancy in patients with inflammatory myopathy.

The most recent evidence from population-based cohort studies confirms the association between malignancy and dermatomyositis and polymyositis. These studies show an even stronger association between polymyositis and malignancy than previous studies, suggesting less misclassification. This is particularly true of one study that used pathologic criteria to distinguish between myositis subtypes. Recent data also confirm that the association for dermatomyositis and polymyositis is not purely caused by diagnostic suspicion or surveillance bias. More data are still required to determine individual cancer risks, although it appears that ovarian and lung cancer are associated with dermatomyositis while lung cancer and non-Hodgkin's lymphoma are associated with polymyositis. An association between malignant disease and inclusion body myositis has also been verified for the first time. Of interest, too, is the increasing number of reports documenting cases in which the clinical course of the myositis mirrors that of the cancer, supporting the notion that in some instances, myositis is a paraneoplastic disorder.

Case-Control Studies↗
PubMed2002

Corticosteroid injections for lateral epicondylitis: a systematic review.

Patients with lateral epicondylitis (tennis elbow) are frequently treated with corticosteroid injections, in order to relieve pain and diminish disability. The objective of this review was to evaluate the effectiveness of corticosteroid injections for lateral epicondylitis. Randomised controlled trials (RCTs) were identified by a highly sensitive search strategy in six databases in combination with reference tracking. Two independent reviewers selected and assessed the methodological quality of RCTs that included patients with lateral epicondylitis treated with corticosteroid injection(s), and reported at least one clinically relevant outcome measure. Standardised mean differences were computed for continuous data and relative risks (RR) for dichotomous data. A best-evidence synthesis was conducted, weighting the studies with respect to their internal validity, statistical significance, clinical relevance, and statistical power. Thirteen studies consisting of 15 comparisons were included in the review, evaluating the effects of corticosteroid injections compared to placebo injection (n=2), injection with local anaesthetic (n=5), another conservative treatment (n=5), or another corticosteroid injection (n=3). Almost all studies had poor internal validity scores. For short-term outcomes ( or=6 months), no statistically significant or clinically relevant results in favour of corticosteroid injections were found. Although the available evidence shows superior short-term effects of corticosteroid injections for lateral epicondylitis, it is not possible to draw firm conclusions on the effectiveness of injections, due to the lack of high quality studies. No beneficial effects were found for intermediate or long-term follow-up. More, better designed, conducted and reported RCTs with intermediate and long-term follow-up are needed.

Adrenal Cortex Hormones↗