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Showing papers by "James F. Fries published in 1995"


Journal ArticleDOI
TL;DR: Despite causing disability, pain, and, in many, the need for long-term medication, patients with adult Still's disease are resilient and the disease did not interfere with educational attainment, occupational prestige, social functioning and support, time lost from work, or family income.

51 citations


Journal ArticleDOI
01 Jan 1995-AIDS
TL;DR: Adjustment for covariates in a 2-equation econometric model reduced the difference in employment rates between the AIDS patients and the other two groups, suggesting that characteristics other than AIDS status account, in part, for their low employment rates.
Abstract: Objective : To study differences in employment and work hours among three groups of HIV-infected and non-infected individuals. Methods : Data on 1263 patients seen in five different sites in California were drawn from the AIDS Time-Oriented Health Outcome Study. Three groups of patients were examined : AIDS patients, HIV-positives without diagnosed AIDS, and HIV-negatives. The HIV-negative patients were used as a comparison group in comparing hours worked by all patients, whether they worked or not ; the probability of working, regardless of the number of hours ; and work hours only for those patients who worked. Results : Adjustment for covariates in a 2-equation econometric model reduced the difference in employment rates between the AIDS patients and the other two groups, suggesting that characteristics other than AIDS status account, in part, for their low employment rates. After adjustment, we did not find any statistically significant differences in employment probabilities or work hours between the HIV-positive patients without diagnosed AIDS and the comparison group. However, AIDS patients reported approximately 14 work hours fewer (P<0.0001) and lower probabilities of employment (P< 0.0001) than the HIV-negative comparison group among all patients with and without jobs. Moreover, among those with jobs, patients with AIDS reported approximately 3 work hours fewer per week (P=0.0385). No statistically significant differences in work hours were found between HIV-positives without diagnosed AIDS and comparison patients. Conclusion : AIDS patients were less likely to be employed than either of the other groups, but crude, unadjusted unemployment rates exaggerate the effect of AIDS. For those employed, AIDS patients work only 3 h less per week than either of the other groups.

21 citations


Journal Article
TL;DR: Although there is little data, the small number of response categories in the dimensions covered, plus the lack of comprehensiveness, make it likely that responsiveness will be low and valid conclusions and health policy regarding musculoskeletal diseases cannot be based on generic measures of health status.
Abstract: Rheumatologists and other interested professionals at the OMERACT II conference formed small groups to discuss whether it was sensible to use a generic health status instrument in musculoskeletal disease trials. These instruments promise the possibility of comparison of health status between disease states. However, data is lacking on validity of the current generation of instruments to support their use. Participants had little personal experience with these instruments. After inspection, many voiced strong concerns over comprehensiveness and responsiveness. Many dimensions of health relevant for patients with this group of diseases were felt to be underrepresented. The dimension of adverse effects was universally absent, although this is more a problem of state of the art in trial methodology than a problem of these measures. Although there is little data, the small number of response categories in the dimensions covered, plus the lack of comprehensiveness, make it likely that responsiveness will be low. Further research, especially the adoption of one or more generic measures alongside specific measures, both in trials and in observational studies, is necessary to validate and improve the current generic measures. Until that time, valid conclusions and health policy regarding musculoskeletal diseases cannot be based on generic measures of health status.

19 citations


Journal ArticleDOI
TL;DR: It is found that patients with AIDS reported 29-32 and HIV-positive patients reported 9-13 more potential and actual workdays lost out of the previous 90 than the comparison patients, other variables being equal.
Abstract: How many more potential and actual workdays are lost by HIV patients than persons without HIV? To answer this question, we assessed differences in the number of workdays among a panel of AIDS patients, patients who were HIV positive but did not yet have AIDS, and comparison patients The patients included persons who were employed and unemployed Information on 1,346 patients was gathered from January 1, 1990, to December 31, 1992, as part of the ongoing ATHOS (AIDS Time-Oriented Health Outcome Study) study Data were collected every 3 months on AIDS and HIV-positive patients and every 6-12 months on the comparison patients At the end of the study (December 31, 1992), 856 people were still enrolled A total of 5,507 panel data points covering 3 years were available Data were analyzed with a linear regression model We found that patients with AIDS reported 29-32 and HIV-positive patients reported 9-13 more potential and actual workdays lost out of the previous 90 than the comparison patients, other variables being equal All p values were < 0005, and most were < 00001 We conclude that (a) while the AIDS patients showed substantially more workdays lost than the comparison group, the HIV-positive group showed only a modest number of more days lost than the comparison group and (b) that previous estimates exaggerated indirect morbidity costs

15 citations


Journal Article
TL;DR: The development of the Arthritis, Rheumatism and Aging Medical Information System (ARAMIS) Toxicity Index and the issues arising in construction of such an index are described and early results in comparing toxicities of antirheumatic drugs are reviewed.
Abstract: Side effects of medications make up an important part of adverse outcomes experienced by patients with rheumatic diseases. Quantitative measures to assess toxicity, however, have not been available, and this lack has limited estimates of the magnitude of effects and of differences in side effects among different drugs. This paper describes the development of the Arthritis, Rheumatism and Aging Medical Information System (ARAMIS) Toxicity Index and the issues arising in construction of such an index, and reviews early results in comparing toxicities of antirheumatic drugs. Findings have had major value in revising therapeutic strategies for rheumatic diseases, particularly rheumatoid arthritis, and have set the stage for development of toxicity-therapeutic ratios for different drugs

14 citations