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James F. Fries

Bio: James F. Fries is an academic researcher from Stanford University. The author has contributed to research in topics: Rheumatoid arthritis & Arthritis. The author has an hindex of 100, co-authored 369 publications receiving 83589 citations. Previous affiliations of James F. Fries include University of Saskatchewan & National Institutes of Health.


Papers
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Journal ArticleDOI
01 Jan 1987
TL;DR: It is concluded that while straightforward repackaging onto CD‐ROM of single online databases may not be attractive, ‘value‐added’ products such as Datext, which collate information from several sources and provide facilities for manipulation of the retrieved data, will be greatly valued in particular library situations.
Abstract: The Feldberg (business studies) Library at Dartmouth College has, since January 1986, been subscribing to Datext, a CD‐ROM database containing bibliographic, textual, and numeric information on over 10,000 American public companies. The data is derived from six commercial online databases and held on four optical discs, new versions of which arrive monthly. The ‘ondisc’ database is searched using software supplied by Datext, Inc. and running on an IBM PC. Searching is menu‐based and designed with end‐users in mind. Datext menus, screen displays, and facilities for further processing of retrieved data (e.g. on spreadsheets) are described and illustrated. CD‐ROM ondisc searching is compared with traditional online searching, and the currency of information on Datext is discussed. It is concluded that while straightforward repackaging onto CD‐ROM of single online databases may not be attractive, ‘value‐added’ products such as Datext, which collate information from several sources and provide facilities for manipulation of the retrieved data, will be greatly valued in particular library situations.

4 citations

Journal ArticleDOI
TL;DR: Observations suggest substantial improvement in senior health status over the past quarter century in selected populations, and they contrast with equivocal changes that have been noted with traditional serial survey techniques.
Abstract: Differences in health status between subjects, their parents, and their children were analyzed in 2206 subjects who had attended the University of Pennsylvania during the 1939 to 1940 school year. Subjects compared their overall health status at the average age of 70 with that of their same-sex parent at the same age and with that of their same-sex child at the approximate average age of 45, providing reasons for reported differences. Thus, health status in family members of the same sex at the same age in 1988 was compared with that in approximately 1963. Subject health was strikingly improved compared with that of their parents a generation earlier, with 58% reporting their health to be better or much better, and only 9% reporting it to be worse or much worse (P less than .001). The major reasons for the difference were decreased prevalence of chronic conditions and healthier life-styles. The same results were observed in a community-based population of 317 subjects and, even more strikingly, in a group...

3 citations

Journal ArticleDOI
TL;DR: The perspectives elaborated below involve drawing valid conclusions from soft data, and the group was involved in the study of each of these issues (Table 1) and their implications challenge the conventional wisdom.
Abstract: The term “perspectives” suggests thoughtful opinions accumulated over some period of time and from a great height. “Perspectives” are linked opinions. There will always be omissions by accident and embellishments from distant memories. The perspective is always better from 35,000 feet and is best painted with a broad brush. The “conventional wisdom” is another useful term, one which reminds us that today’s wisdom will be tomorrow’s ignorance and that “truth” in science and medicine often has an expiration date. “Thinking outside the box” means thinking beyond the conventional wisdom. Challenging the conventional wisdom can be quite challenging. When I entered rheumatology, the conventional wisdom held that rheumatoid arthritis (RA) was best treated according to a pyramid strategy designed to “first, do no harm,” with rest and aspirin at the pyramid base. Unfortunately, the pyramid mandated that the most effective treatments would reach few patients and that research into more effective treatments reserved for the top was discouraged. This period ended with “inversion of the pyramid,” and thus began the flowering of rheumatology. Another conventional wisdom of the time held that activity aggravated inflammation and that complete bed rest should be the basic treatment for RA. Of the available treatments, nonsteroidal antiinflammatory drugs (NSAIDs) were preferred because they were safer, until it became known that they often caused gastrointestinal (GI) problems, heart attacks, strokes, and deaths in large numbers— many more than were caused by disease-modifying antirheumatic drugs (DMARDs). Exercise, as conventionally viewed, was bad for arthritis because it put stress on the joints. Now, it is good for the joints and essential for health. Where did all this mistaken conventional “wisdom” come from? What were people thinking? How were these opinions identified as false and diverting? Are replacements for the mistaken conventional wisdom still around? How can we recognize them? Such heretical musings have occupied much of my professional life and have shaped my perspectives. The perspectives elaborated below involve drawing valid conclusions from soft data, and our group was involved in the study of each of these issues (Table 1). In one, a patient with a uniformly and rapidly fatal syndrome was treated based on pathophysiologic reasoning (1,2). The patient recovered and lived normally for the next 2 decades, as do most with this syndrome who came after him. No animal models and only an “n of 1” trial. Just connecting the dots. A second perspective argues for patient-reported outcomes to standardize outcome metrics and to set more relevant outcome targets, measuring morbidity outcomes to emphasize the longitudinal assessment of chronic illness (3). A third perspective emphasizes surveillance of the harms that drugs sometimes do and is presented against the perspective that the Food and Drug Administration (FDA) and industry have long since ensured the public safety (4). The fourth perspective focuses on the need for longitudinal data on human morbidity as well as mortality (5). The final perspective argues that the way to postpone human aging is to reduce behavioral health risks and that this postponement is best begun decades before the observable clinical events (6,7). Overall, these perspectives challenge the conventional wisdom.

3 citations

Journal Article
TL;DR: The relation between a specific infective event (shigellosis), a specific disease entity (Reiter's syndrome), and a specific histocompatibility antigen (HL-A B27) is documented by follow-up study of an epidemic of post-Shigella Reiter's Syndrome.
Abstract: The relation between a specific infective event (shigellosis), a specific disease entity (Reiter's syndrome), and a specific histocompatibility antigen (HL-A B27) is documented by follow-u...

3 citations

Journal ArticleDOI
TL;DR: An analysis of the putative association between bovine collagen implants and subsequent dermatomyositis and polymyositis raises substantial issues about establishing causality, especially in the absence of biologic plausibility.

3 citations


Cited by
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Journal ArticleDOI
TL;DR: The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non-RA).
Abstract: The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non-RA). The new criteria are as follows: 1) morning stiffness in and around joints lasting at least 1 hour before maximal improvement; 2) soft tissue swelling (arthritis) of 3 or more joint areas observed by a physician; 3) swelling (arthritis) of the proximal interphalangeal, metacarpophalangeal, or wrist joints; 4) symmetric swelling (arthritis); 5) rheumatoid nodules; 6) the presence of rheumatoid factor; and 7) radiographic erosions and/or periarticular osteopenia in hand and/or wrist joints. Criteria 1 through 4 must have been present for at least 6 weeks. Rheumatoid arthritis is defined by the presence of 4 or more criteria, and no further qualifications (classic, definite, or probable) or list of exclusions are required. In addition, a "classification tree" schema is presented which performs equally as well as the traditional (4 of 7) format. The new criteria demonstrated 91-94% sensitivity and 89% specificity for RA when compared with non-RA rheumatic disease control subjects.

19,409 citations

Journal ArticleDOI
TL;DR: The 1971 preliminary criteria for the classification of systemic lupus erythematosus (SLE) were revised and updated to incorporate new immunologic knowledge and improve disease classification and showed gains in sensitivity and specificity.
Abstract: The 1971 preliminary criteria for the classification of systemic lupus erythematosus (SLE) were revised and updated to incorporate new immunologic knowledge and improve disease classification. The 1982 revised criteria include fluorescence antinuclear antibody and antibody to native DNA and Sm antigen. Some criteria involving the same organ systems were aggregated into single criteria. Raynaud's phenomenon and alopecia were not included in the 1982 revised criteria because of low sensitivity and specificity. The new criteria were 96% sensitive and 96% specific when tested with SLE and control patient data gathered from 18 participating clinics. When compared with the 1971 criteria, the 1982 revised criteria showed gains in sensitivity and specificity.

14,272 citations

Journal Article
TL;DR: In the early 1990s, the National Kidney Foundation (K/DOQI) developed a set of clinical practice guidelines to define chronic kidney disease and to classify stages in the progression of kidney disease.

10,265 citations

Journal ArticleDOI
TL;DR: In 1992, Piette and colleagues suggested that the ACR revised criteria be reevaluated in light of the above discoveries, and the presence and clinical associations or antiphospholipid antibodies in patients with SLE was suggested.
Abstract: In 1982, the Diagnostic and Therapeutic Criteria Committee of the American College of Rheumatology (ACR)published revised criteria for the classification of systemiclupus erythematosus (SLE) (1). During the ensuing decade several investigators, including Drs. Graham Hughes and Donato Alarcon-Segovia, among others, have described the presence and clinical associations or antiphospholipid antibodies in patients with SLE, as well as the occurrence of theprimary antiphospholipid syndrome (2-5). In 1992, Piette and colleagues suggested that the ACR revised criteria be reevaluated in light of the above discoveries (6).

9,999 citations

Journal ArticleDOI
TL;DR: Criteria for the classification of fibromyalgia are widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites, and no exclusions are made for the presence of concomitant radiographic or laboratory abnormalities.
Abstract: To develop criteria for the classification of fibromyalgia, we studied 558 consecutive patients: 293 patients with fibromyalgia and 265 control patients. Interviews and examinations were performed by trained, blinded assessors. Control patients for the group with primary fibromyalgia were matched for age and sex, and limited to patients with disorders that could be confused with primary fibromyalgia. Control patients for the group with secondary-concomitant fibromyalgia were matched for age, sex, and concomitant rheumatic disorders. Widespread pain (axial plus upper and lower segment plus left- and right-sided pain) was found in 97.6% of all patients with fibromyalgia and in 69.1% of all control patients. The combination of widespread pain and mild or greater tenderness in greater than or equal to 11 of 18 tender point sites yielded a sensitivity of 88.4% and a specificity of 81.1%. Primary fibromyalgia patients and secondary-concomitant fibromyalgia patients did not differ statistically in any major study variable, and the criteria performed equally well in patients with and those without concomitant rheumatic conditions. The newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites. No exclusions are made for the presence of concomitant radiographic or laboratory abnormalities. At the diagnostic or classification level, the distinction between primary fibromyalgia and secondary-concomitant fibromyalgia (as defined in the text) is abandoned.

9,289 citations