TY - JOUR
T1 - Prediction of permanent work disability in a follow-up study of early rheumatoid arthritis: Results of a tree structured analysis using RECPAM
AU - Mau, W.
AU - Bornmann, M.
AU - Weber, H.
AU - Weidemann, H. F.
AU - Hecker, H.
AU - Raspe, H. H.
N1 - Funding Information:
The authors would like to thank Miss M. Heina and Miss K. Bernitt for creating the data base and performing the analyses, Miss K. Radke for her valuable secretarial help and for organizing the re-examination, and Mrs Ann C. Papageorgiou for the English corrections of the manuscript. They are grateful for the helpful discussions with Prof. Dr H. Zeidler. The study has been supported by a grant from the German Ministry of Research and Technology (07068223).
PY - 1996
Y1 - 1996
N2 - The objectives of this study are: (a) to determine the occurrence of permanent work disability (PWD) in early rheumatoid arthritis (RA); (b) to identify prognostic groups of patients; (c) to assess the employment rates for these groups over time. Seventy-three gainfully employed consecutive out-patients with early RA(≤5 ARA 1958 criteria, disease duration ≤12 months) at time one (T1) were re-examined at time two (T2) after a mean follow-up of 6 yr (S.D. ± 2 yr). Potential risk factors, identified at T1, for PWD at T2 were entered in a tree structured survival analysis using RECPAM (RECursive Partition and AMalgamation). Cumulative 3 yr employment rates (3-yrER ± S.E.M.) were computed from the resulting Kaplan-Meier curves. At T2, PWD occurred in 27 of the 73 patients (37%). The fastest decline in the employment rate was found within the first 3 yr of the disease onset, with a 3-yrER reduced to 73 ± 5%. The group with the poorest prognosis (n = 14; 3-yrER 14 ± 9%) was defined by age ≤50 yr with either ESR ≤60 mm/h or the combination of modified functional class (1-7) ≤4 with a disease duration ≤7 months. An intermediate group (n = 38; 3-yrER 79 ± 6%) was defined by (a) age ≤50 yr and low or moderate disease activity, (b) age < 50 yr and more strenuous job-related physical requirements, (c) age < 50 yr and less strenuous work, but joint count ≤ 15. No case of PWD occurred in 21 individuals aged < 50 yr with a joint count < 15 and less physically demanding jobs. PWD occurs early in a substantial number of patients with RA. RECPAM defines risk profiles that can readily be applied in actual clinical situations and allow an estimation of the risk of PWD at different time paints using the resulting Kaplan-Meier curves.
AB - The objectives of this study are: (a) to determine the occurrence of permanent work disability (PWD) in early rheumatoid arthritis (RA); (b) to identify prognostic groups of patients; (c) to assess the employment rates for these groups over time. Seventy-three gainfully employed consecutive out-patients with early RA(≤5 ARA 1958 criteria, disease duration ≤12 months) at time one (T1) were re-examined at time two (T2) after a mean follow-up of 6 yr (S.D. ± 2 yr). Potential risk factors, identified at T1, for PWD at T2 were entered in a tree structured survival analysis using RECPAM (RECursive Partition and AMalgamation). Cumulative 3 yr employment rates (3-yrER ± S.E.M.) were computed from the resulting Kaplan-Meier curves. At T2, PWD occurred in 27 of the 73 patients (37%). The fastest decline in the employment rate was found within the first 3 yr of the disease onset, with a 3-yrER reduced to 73 ± 5%. The group with the poorest prognosis (n = 14; 3-yrER 14 ± 9%) was defined by age ≤50 yr with either ESR ≤60 mm/h or the combination of modified functional class (1-7) ≤4 with a disease duration ≤7 months. An intermediate group (n = 38; 3-yrER 79 ± 6%) was defined by (a) age ≤50 yr and low or moderate disease activity, (b) age < 50 yr and more strenuous job-related physical requirements, (c) age < 50 yr and less strenuous work, but joint count ≤ 15. No case of PWD occurred in 21 individuals aged < 50 yr with a joint count < 15 and less physically demanding jobs. PWD occurs early in a substantial number of patients with RA. RECPAM defines risk profiles that can readily be applied in actual clinical situations and allow an estimation of the risk of PWD at different time paints using the resulting Kaplan-Meier curves.
UR - http://www.scopus.com/inward/record.url?scp=0029933644&partnerID=8YFLogxK
U2 - 10.1093/rheumatology/35.7.652
DO - 10.1093/rheumatology/35.7.652
M3 - Journal articles
C2 - 8670599
AN - SCOPUS:0029933644
SN - 0263-7103
VL - 35
SP - 652
EP - 659
JO - British Journal of Rheumatology
JF - British Journal of Rheumatology
IS - 7
ER -