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Biomedical subjects

E Allander

Publications and source records attributed to E Allander.

At least 55 records · Page 3Linked to original sources
PubMed1985

Rheumatic pain in a Philippine village. A WHO-ILAR COPCORD Study.

In initiating a community oriented programme for the control of rheumatic disease (COPCORD), 1685 people of all ages from a rural area in the Philippines were questioned by primary health care workers (PHW) for limb and spinal rheumatic pain and disability. The total complaint rate was 15.3% for men and 18.5% for women. For those 15 years and older the age adjusted rheumatic pain rates for pain present at the time of survey were 28.4% for the Philippines and 22.6% for Lawrence's UK population. The most common rheumatic pain sites in this community were knee, lumbar spine, neck and the trapezius muscle. The disability rate was 4.5% for those 15 years and older. One quarter of those with pain had received medical attention and the remainder, herbal treatment, massage, various faith and/or self-treatment methods.

Adolescent↗
PubMed1985

Problems in the classification of cause of death diagnoses affecting the reliability of mortality statistics for rheumatoid arthritis.

The uniformity of physicians' diagnostic language on death certificates involving rheumatoid arthritis (RA), and its influence on the medical classification and on the mortality statistics was investigated. The point of departure was a disagreement between physicians' reporting of RA on death certificates and the Swedish National Central Bureau of Statistics' (NCBS) registration of this condition, to the effect that the NCBS registered a threefold mortality increase for women and a twofold increase for men attributed to RA between 1971 and 1975, whereas the physicians had reported practically no change at all for women and a slight decrease for men between the years. It is investigated in the present study to what extent this increased NCBS registration of RA as the underlying cause of death could be explained by physicians' diagnoses for underlying non-RA conditions being disregarded in favour of RA due to classification problems with the former diagnoses. All Swedish RA death certificates for the years 1971 and 1975 were studied. A total of 1224 such death certificates were identified. Physicians' diagnostic language was found to be strongly individualistic. Out of the total of 1666 diagnostic expressions 1229 (74%) had been used only once. The corresponding proportions were 76% in 1971 and 73% in 1975. Thus, there was practically no change in the linguistic individualization between these years. The 1666 expressions could be coded by 287 ICD 8 codes. One hundred and thirty-nine different expressions had been used for rheumatoid arthritis (ICD 8 code 712.3). One hundred and fifty-six (13%) of the death certificates contained diagnostic expressions encumbered with one or more of four major kinds of classification problems: (1) Expression(s) without ICD 8 code (24 certificates); (2) Expression(s) with several codes, uncertainty about which to select (45 certificates); (3) Expression(s) with several codes, one is preferable according to the ICD (39 certificates); and (4) Expression(s) which can be coded both by one specific code and by several codes (60 certificates). In one third (35%) of these cases the expression used referred to an underlying cause of death. The alternative interpretations of all these expressions differed in most cases on a three-digit level and in some cases on chapter level in the classification. Clarification of ambiguous expressions were solicited by the NCBS in only one case in 1971 and one in 1975. The NCBS' increased registration RA as the underlying cause of death between 1971 and 1975 could not be explained by problems of classification.

Arthritis, Rheumatoid↗
PubMed1985

Utilization of hospital care among persons with rheumatoid arthritis compared with controls. A 13-year follow-up of an epidemiological survey.

The use of hospital care was assessed in a 13-year follow-up of 293 persons with rheumatoid arthritis (RA) and a healthy contrast group of 456 persons. The groups were identified in an epidemiological survey of RA made in Stockholm in 1965-67. Data on deaths, migration and use of in-patient care during the follow-up were obtained by a linkage with the Stockholm County Medical Information System. Follow-up shows that the persons in the RA group were admitted to hospital more than twice as often as the controls and had three times as many hospital days. However, only 15% of the individuals in the RA group were ever admitted with a diagnosis of rheumatoid arthritis and only 1% of the RA group's total number of hospital days were spent at specialist rheumatology departments. The amount of psychiatric care was also low. The use of hospital care in the RA group was closely correlated to the severity of the disease prior to follow-up, as measured by Steinbrocker functional grading, number of criteria for RA fulfilled and perceived severity of joint symptoms.

Adult↗
PubMed1985

Mortality in rheumatoid arthritis, particularly as regards drug use.

239 persons with rheumatoid arthritis (RA), previously investigated in an epidemiological survey of RA in Stockholm, were monitored for 13 years with the aim of eliciting the cause(s) of the high mortality among persons with RA. All hospitalizations were identified through the in-patient register of Stockholm County. A study based on medical record information was performed on a group of 157 persons who had been hospitalized during the follow-up. Dead and surviving persons were compared with regard to characteristics at the start of the follow-up, drug use, and diseases other than RA during the follow-up. Male sex and high Steinbrocker functional grading were the factors most closely associated with an increased death risk. Neither drug use generally, nor use of any particular type of drug, contributory cause, the disease RA in itself--and particularly its severe forms--is the main cause of the high mortality among RA sufferers.

Adult↗
PubMed1984

Rheumatic disorders in a health survey: how valid and reliable are the reports?

The validity and reliability of interview reports on rheumatic disorders in a Swedish nationwide health survey were studied. Two samples, including altogether 157 individuals, who had reported rheumatic disorders, were medically examined 6 to 24 months after the original interview. The reproducibility of the original interview was studied by the means of two re-interviews. The proportional distribution of rheumatic disorders according to diagnostic group was similar to that in the original interview, in the two re-interviews and at the medical examination. In a subject-to-subject comparison the overall agreement between the medical examination and the lay re-interview was 84% (kappa 0.35) regarding presence of rheumatic disorders, and 57% (kappa 0.41) regarding matching of rheumatic diagnostic groups. In the original interview and the lay re-interview the same individual rheumatic disorder was reported by 38% of the subjects; 58% agreed regarding rheumatic diagnostic groups. The interview reports on rheumatic disorders in the health survey can therefore be considered to have acceptable validity and reliability only with regard to the proportional distribution of groups of rheumatic disorders, based on aggregated data.

Adolescent↗
PubMed1984

Do oral contraceptives reduce the incidence of rheumatoid arthritis? A pilot study using the Stockholm County medical information system.

The Stockholm County medical information system was used to select cases for a pilot study on the association between oral contraceptive (OC) use and the incidence of rheumatoid arthritis (RA). A selection procedure is described by which we obtained 76 cases of RA. These were compared in a case-control study with 152 healthy controls with regard to OC use prior to the onset of RA. For all women who had used OCs for more than one year the relative risk of RA was 0.70 (0.40, 1.24). The relative risk decreased with advancing age at onset of RA, being 0.40 (0.10, 1.65) for women with age at onset over 40. Although the material is small, and there are some inconsistencies in the results, our findings are compatible with the hypothesis that the use of OCs is associated with a reduced incidence of RA.

Adolescent↗
PubMed1983

Rheumatoid arthritis in a medical information system: how valid is the diagnosis?

In order to validate the Stockholm County Medical Information System with regard to rheumatoid arthritis (RA) we have studied the medical records of 276 cases coded as RA in the medical information system. We searched information on the criteria for RA from (1961) and New York (1966). 18% of the medical records lacked information to the extent that an assessment of the number of criteria fulfilled was not possible. 9% fulfilled only one New York criterion and 7% fewer than three Rome criteria. 47% fulfilled four New York criteria and 35% at least seven Rome criteria. The most complete information on criteria was found in medical records from departments of rheumatology and these had also the highest degree of criteria fulfillment. A comparison is also presented between this sample of cases and a sample of RA persons selected from the general population with regard to fulfillment of criteria.

Adolescent↗
PubMed1983

Observations on rheumatic disease in Polynesia and the Philippines.

Two different types of study of rheumatic disease in the southwest Pacific are outlined. The Philippines study of a rural developing population is primarily oriented to intervention rather than causation, but before intervention can be effectively planned, information on the frequency and causes of rheumatic complaints is necessary. The Tokelauan investigation is a comprehensive prospective study of the total population with full medical examination of each subject allowing hypotheses to be tested concerning genetic and environmental variables.

Adolescent↗
PubMed1983

Symptoms: hard facts on soft data.

Symptoms form an essential part of the description of rheumatic diseases. The process of collecting information on symptoms--pain, stiffness, and discomfort--is subtle and influenced by observer and examine through various linguistic, cultural, and situational circumstances. Symptom descriptions are lay-dependent, but should be placed within a scientific framework.

Data Collection↗
PubMed1983

Registry data: how to harvest the seed of others.

Registries hold data collected by others than the investigator. Detailed knowledge of coverage and coding procedures enables the epidemiologist to extract essential information from registries. Rules and regulations vary from country to country and can be restrictive (U.S.) or liberal (Sweden). Registries form sampling frames for case-control and other studies of rheumatic diseases. The epidemiological potential of registries is underutilized.

Epidemiologic Methods↗
PubMed1981

Developments in epidemiological studies on rheumatoid arthritis.

The present state of epidemiological knowledge concerning rheumatoid arthritis is summarized. The potential for further epidemiological approaches to rheumatoid arthritis is indicated and priorities listed for the future directions of such studies.

Arthritis, Rheumatoid↗
PubMed1981

Increased mortality among persons with rheumatoid arthritis, but where RA does not appear on death certificate. Eleven-year follow-up of an epidemiological study.

We have performed an 11-year follow-up study on mortality in rheumatoid arthritis (RA). The population was selected by random sampling and consisted of 293 persons with RA fulfilling two sets of relevant criteria and a contrast group of 453 healthy persons. The mortality in the RA group was found elevated, when compared with both the contrast group and the general Stockholm population. The mortality was correlated with the severity of the disease, as defined by the numbers of criteria for RA fulfilled, the Steinbrocker functional grading, and serological titres. The differences in the distribution of causes of death between RA and contrast groups were not large enough to warrant special consideration. Only 9 out of 84 death certificates in the RA group mentioned rheumatic disease, and 4 of these had RA as underlying cause of death.

Adult↗
PubMed1981

Regional distribution of rheumatic complaints in Sweden.

Regional differences regarding prevalence of rheumatic complaints were found in a nation-wide interview survey of the adult Swedish population. A higher prevalence was found in regions of low population density, the highest being in the North. Osteo-arthritis was more prevalent in Northern Sweden, particularly among men, while back disorders were more common in all regions of low population density. Physically strenuous working conditions were found more frequently in all regions of low population density. Among other possible factors contributing to the regional differences in rheumatic complaints, genetic differences in HLA B27 within the Swedish population and the occurrence of cryophilic arthritogenic microbial flora, are discussed.

Adolescent↗