National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Alcohol Use (1)
- Arthritis (3)
- Back Health and Pain (1)
- Behavioral Health (1)
- Cancer (11)
- Cancer: Breast Cancer (4)
- Cancer: Colorectal Cancer (1)
- Cancer: Lung Cancer (1)
- Cancer: Prostate Cancer (1)
- Cardiovascular Conditions (2)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Comparative Effectiveness (7)
- Diagnostic Safety and Quality (1)
- Digestive Disease and Health (1)
- Disparities (3)
- Elderly (3)
- Evidence-Based Practice (2)
- Genetics (1)
- Healthcare Costs (2)
- Healthcare Delivery (3)
- Health Information Technology (HIT) (2)
- Heart Disease and Health (2)
- Kidney Disease and Health (1)
- Medication (2)
- Outcomes (3)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (4)
- Patient Safety (3)
- Prevention (1)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (2)
- Racial and Ethnic Minorities (2)
- Risk (2)
- Shared Decision Making (1)
- Substance Abuse (1)
- Surgery (5)
- (-) Treatments (26)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedCochran G, Field C, DiClemente C
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
The purpose of this study was to identify differential improvement in alcohol use among injured patients following brief intervention. Increases in both clinical trials for days abstinent were reported by classes characterized by multiple risks and minimal risks. Decreases in volume consumed for both studies were also reported by classes characterized by multiple risks and minimal risks.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, DiClemente C .
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
Behav Med 2016;42(1):29-38. doi: 10.1080/08964289.2014.951305.
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Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Treatments
Giordano SH, Niu J, Chavez-MacGregor M
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
The objective of the current study was to generate cost estimates for guideline-concordant adjuvant chemotherapy regimens from payers' and patients' perspectives in a large, insured US population. It concluded that the costs of breast cancer chemotherapy vary widely across regimens, and patients bear a substantial out-of-pocket burden.
AHRQ-funded; HS020263.
Citation: Giordano SH, Niu J, Chavez-MacGregor M .
Estimating regimen-specific costs of chemotherapy for breast cancer: observational cohort study.
Cancer 2016 Nov 15; 122(2):3447-3455. doi: 10.1002/cncr.30274.
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Keywords: Cancer, Cancer: Breast Cancer, Treatments, Healthcare Costs
Raman G, Adam GP, Halladay CW
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
This study compared benefits and harms of percutaneous transluminal renal angioplasty with stent placement (PTRAS) versus medical therapy alone in adults with atherosclerotic renal artery stenosis (ARAS). The strength of evidence regarding the relative benefits and harms of PTRAS versus medical therapy alone for patients with ARAS is low.
AHRQ-funded; 290201500002.
Citation: Raman G, Adam GP, Halladay CW .
Comparative effectiveness of management strategies for renal artery stenosis: an updated systematic review.
Ann Intern Med 2016 Nov;165(9):635-49. doi: 10.7326/m16-1053.
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Keywords: Kidney Disease and Health, Treatments, Comparative Effectiveness, Evidence-Based Practice
Devine EB, Alfonso-Cristancho R, Yanez ND
Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes.
This study compared the effectiveness of a medical (walking program, smoking cessation counseling, and medications) vs revascularization (endovascular or surgical) intervention for intermittent claudication (IC) in the community, focusing on outcomes of greatest importance to patients. Among patients with IC, those in the revascularization cohort had significantly improved function (Walking Impairment Questionnaire), better health-related quality of life , and fewer symptoms at 12 months compared with those in the medical cohort.
AHRQ-funded; HS020025.
Citation: Devine EB, Alfonso-Cristancho R, Yanez ND .
Effectiveness of a medical vs revascularization intervention for intermittent leg claudication based on patient-reported outcomes.
JAMA Surg 2016 Oct 19;151(10):e162024. doi: 10.1001/jamasurg.2016.2024.
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Keywords: Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research, Quality of Life, Treatments
Piccini JP, Fauchier L
Rhythm control in atrial fibrillation.
Many patients with atrial fibrillation have substantial symptoms despite ventricular rate control and require restoration of sinus rhythm to improve their quality of life. In patients who continue to have recurrent atrial fibrillation despite medical therapy, catheter ablation has been shown to substantially reduce recurrent atrial fibrillation, decrease symptoms, and improve quality of life.
AHRQ-funded; HS021092.
Citation: Piccini JP, Fauchier L .
Rhythm control in atrial fibrillation.
Lancet 2016 Aug 20;388(10046):829-40. doi: 10.1016/s0140-6736(16)31277-6.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Treatments
Fitzgerald GK, Fritz JM, Childs JD
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
The purposes of this paper are to determine if (1) treatment effects differ between participants receiving manual therapy (MT) with exercise compared to subjects who don't, and if (2) treatment effects are better sustained when participants receive booster sessions compared to those who don't over a one year period in subjects with knee osteoarthritis. The researchers found that MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year. Also, secondary outcomes suggest MT may have some short term benefit, and booster sessions may improve responder status and knee pain at 1 year.
AHRQ-funded; HS019624.
Citation: Fitzgerald GK, Fritz JM, Childs JD .
Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial.
Osteoarthritis Cartilage 2016 Aug;24(8):1340-9. doi: 10.1016/j.joca.2016.03.001.
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Keywords: Arthritis, Comparative Effectiveness, Patient-Centered Outcomes Research, Treatments
McLean LP, Cross RK
Pharmacodynamic assessment of vedolizumab for the treatment of ulcerative colitis.
This review discusses the chemistry, pharmacologic properties, clinical efficacy, and safety of vedolizumab in ulcerative colitis. It concluded that vedolizumab is a promising new agent for the treatment of ulcerative colitis. Its mechanism of action differs from tumor necrosis factor (TNF)-alpha inhibitors and immune suppressants, allowing it to be used in cases of TNF-alpha inhibitor failure or non-response, or as a first-line biologic drug.
AHRQ-funded; HS018975.
Citation: McLean LP, Cross RK .
Pharmacodynamic assessment of vedolizumab for the treatment of ulcerative colitis.
Expert Opin Drug Metab Toxicol 2016 Jul;12(7):833-42. doi: 10.1080/17425255.2016.1181171.
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Keywords: Comparative Effectiveness, Digestive Disease and Health, Medication, Treatments
Liu S, Mazur T, Li H
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
The aim of this paper was to demonstrate the feasibility and creditability of computing and verifying 3D fluencies to assure IMRT and VMAT treatment deliveries, by correlating the passing rates of the 3D fluence-based QA (P(alpha)) to the passing rates of 2D dose measurement based QA (P(Dm)). It concluded that the demonstrated correlations improve the creditability of using 3D fluence-based QA for assuring treatment deliveries for IMRT/VMAT plans.
AHRQ-funded; HS022888.
Citation: Liu S, Mazur T, Li H .
SU-F-T-275: A correlation study on 3D fluence-based QA and 2D dose measurement-based QA.
Med Phys 2016 Jun;43(6 Part 17):3525-26. doi: 10.1118/1.4956415.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Liu S, Wu Y, Chang X
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
A novel computer software system, namely APDV (Automatic Pre-Delivery Verification), was developed for verifying patient treatment plan parameters right prior to treatment deliveries in order to automatically detect and prevent catastrophic errors. This study implemented APDV as a stand-alone program to ensure required real time performance. It concluded that APDV could be useful in detecting and preventing catastrophic errors immediately before treatment deliveries.
AHRQ-funded; HS022888.
Citation: Liu S, Wu Y, Chang X .
TU-FG-201-03: Automatic pre-delivery verification using statistical analysis of consistencies in treatment plan parameters by the treatment site and modality.
Med Phys 2016 Jun;43(6 Part 35):3753. doi: 10.1118/1.4957526.
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Keywords: Cancer, Healthcare Delivery, Treatments, Patient Safety, Health Information Technology (HIT)
Ellis CT, Samuel CA, Stitzenberg KB
National trends in nonoperative management of rectal adenocarcinoma.
The researchers examined the use of non-operative management (NOM) for rectal cancer over time and the patient- and facility-level factors associated with its use. They found evidence of increasing NOM use, with this increase occurring more frequently in black and uninsured/Medicaid patients, raising concern that increased NOM use may actually represent increasing disparities in rectal cancer care rather than innovation. They recommended further studies to assess survival differences by treatment strategy.
AHRQ-funded; HS000032.
Citation: Ellis CT, Samuel CA, Stitzenberg KB .
National trends in nonoperative management of rectal adenocarcinoma.
J Clin Oncol 2016 May 10;34(14):1644-51. doi: 10.1200/jco.2015.64.2066.
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Keywords: Cancer, Cancer: Colorectal Cancer, Disparities, Patient-Centered Healthcare, Treatments
Yang D, Wooten HO, Green O
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
The researchers developed a method for verification of treatment delivery after each treatment fraction in order to detect and correct errors, and they developed a comprehensive daily report. The end result has been integrated into a commercial version of the treatment delivery system, and it has been in clinical use for over one year.
AHRQ-funded; HS022888.
Citation: Yang D, Wooten HO, Green O .
A software tool to automatically assure and report daily treatment deliveries by a Cobalt-60 radiation therapy device.
J Appl Clin Med Phys 2016 May 8;17(3):6001.
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Keywords: Treatments, Cancer, Quality of Care, Patient Safety
Healy MA, Yin H, Wong SL
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
The researchers compared effects of resection with other therapies on long-term outcomes across U.S. hospitals. They examined claims in the Surveillance, Epidemiology, and End Results (SEER) Medicare dataset for patients with esophageal and pancreatic cancers and found that a significant association exists between long-term survival and rates of cancer-directed surgery across hospitals, without variation in rates of other therapies.
AHRQ-funded; HS020937.
Citation: Healy MA, Yin H, Wong SL .
Multimodal cancer care in poor prognosis cancers: resection drives long-term outcomes.
J Surg Oncol 2016 May;113(6):599-604. doi: 10.1002/jso.24217.
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Keywords: Cancer, Outcomes, Surgery, Treatments, Disparities
Barnett AS, Bahnson TD, Piccini JP
Recent advances in lesion formation for catheter ablation of atrial fibrillation.
This review summarized several recent advancements in catheter technology for atrial fibrillation (AF ablation) aimed at improving lesion formation It concluded that despite advances during the past decade, recurrence of AF after ablation is common. Recent technological innovations are likely to increase the safety, efficiency, and durability of lesion formation.
AHRQ-funded; HS021092.
Citation: Barnett AS, Bahnson TD, Piccini JP .
Recent advances in lesion formation for catheter ablation of atrial fibrillation.
Circ Arrhythm Electrophysiol 2016 May;9(5). doi: 10.1161/circep.115.003299.
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Keywords: Heart Disease and Health, Cardiovascular Conditions, Treatments
Farbman KS, Michelson KA
Anaphylaxis in children.
Anaphylaxis is a serious allergic reaction that can be life threatening. The authors reviewed the most recent evidence regarding the diagnosis, treatment, monitoring, and prevention of anaphylaxis in children. It concluded that epinephrine remains the mainstay of anaphylaxis treatment, and adjuvant medications should not be used in its place.
AHRQ-funded; HS000063.
Citation: Farbman KS, Michelson KA .
Anaphylaxis in children.
Curr Opin Pediatr 2016 Mar 8;28(3):294-7. doi: 10.1097/mop.0000000000000340..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Prevention, Treatments
Fritz JM, Rundell SD, Dougherty P
Deconstructing chronic low back pain in the older adult-step by step evidence and expert-based recommendations for evaluation and treatment. Part vi: Lumbar spinal stenosis.
This article is the sixth in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. It focuses on the evaluation and management of lumbar spinal stenosis (LSS), the most common condition for which older adults undergo spinal surgery. It concluded that lumbar spinal stenosis exists not uncommonly in older adults with CLBP and management often can be accomplished without surgery.
AHRQ-funded; HS022982.
Citation: Fritz JM, Rundell SD, Dougherty P .
Deconstructing chronic low back pain in the older adult-step by step evidence and expert-based recommendations for evaluation and treatment. Part vi: Lumbar spinal stenosis.
Pain Med 2016 Mar;17(3):501-10. doi: 10.1093/pm/pnw011..
Keywords: Back Health and Pain, Elderly, Chronic Conditions, Treatments, Surgery
Scott FI, Mamtani R, Brensinger CM
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
The study objective was to determine the relative hazard of a second nonmelanoma skin cancer (NMSC) in patients with rheumatoid arthritis and inflammatory bowel disease who use methotrexate, anti-tumor necrosis factor (anti-TNF) therapy, or thiopurines after an initial NMSC. It concluded that methotrexate use is associated with an increased risk of a second NMSC.
AHRQ-funded; HS018517.
Citation: Scott FI, Mamtani R, Brensinger CM .
Risk of nonmelanoma skin cancer associated with the use of immunosuppressant and biologic agents in patients with a history of autoimmune disease and nonmelanoma skin cancer.
JAMA Dermatol 2016 Feb;152(2):164-72. doi: 10.1001/jamadermatol.2015.3029.
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Keywords: Cancer, Arthritis, Risk, Comparative Effectiveness, Treatments
Mohanty S, Rajaram R, Bilimoria KY
Assessment of non-surgical versus surgical therapy for localized hepatocellular carcinoma.
Hypothesizing that non-surgical techniques have expanded to localized disease, the researchers examined treatment patterns, factors associated with surgical therapy, and the impact of modality on survival for patients with hepatocellular carcinoma (HCC). They concluded that non-surgical therapy has become as common as surgery in the treatment of non-cirrhotic, localized HCC.
AHRQ-funded; HS000078.
Citation: Mohanty S, Rajaram R, Bilimoria KY .
Assessment of non-surgical versus surgical therapy for localized hepatocellular carcinoma.
J Surg Oncol 2016 Feb;113(2):175-80. doi: 10.1002/jso.24113.
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Keywords: Cancer, Surgery, Treatments
Farias AJ, Du XL
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
The aim of this study was to determine whether there are racial/ethnic differences in initiation and timing of adjuvant endocrine therapy (AET) after Medicare Part D drug coverage. After controlling for all variables, only Asian women were found to have a greater odds of initiation of overall AET compared to non-Hispanic white women. Hispanic Mexicans and non-Hispanic black patients had a significantly lower odds of tamoxifen initiation.
AHRQ-funded; HS018956.
Citation: Farias AJ, Du XL .
Ethnic differences in initiation and timing of adjuvant endocrine therapy among older women with hormone receptor-positive breast cancer enrolled in Medicare Part D.
Med Oncol 2016 Feb;33(2):19. doi: 10.1007/s12032-016-0732-1.
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Keywords: Cancer: Breast Cancer, Treatments, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Rajaram R, Paruch JL, Mohanty S
Patterns and predictors of chemotherapy use for resected non-small cell lung cancer.
The researchers sought to evaluate chemotherapy use in resected stage IB to IIIA non-small cell lung cancer (NSCLC) over time and to identify predictors of perioperative chemotherapy administration. They found that the use of chemotherapy has significantly increased in patients with resected stage IB to IIIA NSCLC.
AHRQ-funded; HS000078.
Citation: Rajaram R, Paruch JL, Mohanty S .
Patterns and predictors of chemotherapy use for resected non-small cell lung cancer.
Ann Thorac Surg 2016 Feb;101(2):533-40. doi: 10.1016/j.athoracsur.2015.08.077..
Keywords: Treatments, Cancer: Lung Cancer, Surgery, Outcomes, Quality Improvement
Shen C, Tina Shih YC
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
The authors studied the impact of the fast diffusion of robotic surgical systems on the overall treatment pattern of localized prostate cancer. They found that the density of robotic systems at state-level had a significantly positive impact on the rate of surgery and a significantly negative impact on the rate of radiation therapy. They concluded that part of the increase in the rate of surgery was driven by substitution across treatment types with a large proportion originating from the younger population.
AHRQ-funded; HS018535; HS020263.
Citation: Shen C, Tina Shih YC .
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
Soc Sci Med 2016 Feb;151:110-20. doi: 10.1016/j.socscimed.2016.01.016.
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Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Healthcare Costs, Treatments
Roberts MC, Weinberger M, Dusetzina SB
Racial variation in the uptake of oncotype DX testing for early-stage breast cancer.
Oncotype DX (ODX) has the potential to improve quality of care; however, if not equally accessible across racial groups, disparities in cancer care quality may persist or worsen. The researchers examined racial disparities in ODX testing uptake. They did not find racial disparities in ODX testing for node-negative patients for whom ODX testing is guideline recommended and widely covered by insurers.
HS019468; HS022189
Citation: Roberts MC, Weinberger M, Dusetzina SB .
Racial variation in the uptake of oncotype DX testing for early-stage breast cancer.
J Clin Oncol 2016 Jan 10;34(2):130-8. doi: 10.1200/jco.2015.63.2489..
Keywords: Cancer: Breast Cancer, Healthcare Delivery, Treatments, Disparities, Racial and Ethnic Minorities
Gartlehner G, Dobrescu A, Evans TS
Average effect estimates remain similar as evidence evolves from single trials to high-quality bodies of evidence: a meta-epidemiologic study.
The objective of this study was to use a diverse sample of medical interventions to assess empirically whether first trials rendered substantially different treatment effect estimates than reliable, high-quality bodies of evidence. It concluded that results of first trials often change, but the magnitude of change, on average, is small. Exceptions are first trials that present large treatment effects, which often dissipate as new evidence accrues.
AHRQ-funded; 290201200008I.
Citation: Gartlehner G, Dobrescu A, Evans TS .
Average effect estimates remain similar as evidence evolves from single trials to high-quality bodies of evidence: a meta-epidemiologic study.
J Clin Epidemiol 2016 Jan;69:16-22. doi: 10.1016/j.jclinepi.2015.02.013..
Keywords: Evidence-Based Practice, Comparative Effectiveness, Treatments
Poonawalla IB, Piller LB, Lairson DR
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
The researchers sought to determine the effectiveness of erythropoietin-stimulating agent (ESA) and granulocyte colony-stimulating factor (CSF) in reducing blood transfusion needs and neutropenia incidence in community-dwelling elderly ovarian cancer patients. They found that erythropoietin-stimulating agents were effective in reducing blood transfusion need. Granulocyte colony-stimulating factors were effective in lowering neutropenia incidence and also were associated with improved survival in elderly ovarian cancer patients.
AHRQ-funded; HS018956.
Citation: Poonawalla IB, Piller LB, Lairson DR .
Impact of hematopoietic growth factors on blood transfusion needs, incidence of neutropenia, and overall survival among elderly advanced ovarian cancer patients treated with chemotherapy.
Int J Gynecol Cancer 2016 Jan;26(1):95-103. doi: 10.1097/igc.0000000000000564.
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Keywords: Cancer, Treatments, Comparative Effectiveness, Elderly, Patient-Centered Outcomes Research
Roberts MC, Bryson A, Weinberger M
Oncologists' barriers and facilitators for oncotype DX use: qualitative study.
The purpose of this paper was to understand better the U.S. oncologists' oncotype DX (ODX) uptake and how they use ODX during adjuvant chemotherapy decision making. This study identified multi-level factors that influence ODX uptake, including organizational factors, interpersonal factors, and intrapersonal factors.
AHRQ-funded; HS022189.
Citation: Roberts MC, Bryson A, Weinberger M .
Oncologists' barriers and facilitators for oncotype DX use: qualitative study.
Int J Technol Assess Health Care 2016 Jan;32(5):355-61. doi: 10.1017/s026646231600060x.
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Keywords: Cancer: Breast Cancer, Treatments, Shared Decision Making, Genetics, Medication
Goodman SM, Johnson B, Zhang M
Patients with rheumatoid arthritis have similar excellent outcomes after total knee replacement compared with patients with osteoarthritis.
The purpose of this study is to assess pain, function, and quality of life 2 years after total knee replacement (TKR) in contemporary patients with rheumatoid arthritis (RA) compared with patients with osteoarthritis (OA). It concluded that patients with RA undergoing primary TKR have excellent 2-year outcomes, comparable with OA, in spite of worse preoperative pain and function.
AHRQ-funded; HS016075.
Citation: Goodman SM, Johnson B, Zhang M .
Patients with rheumatoid arthritis have similar excellent outcomes after total knee replacement compared with patients with osteoarthritis.
J Rheumatol 2016 Jan;43(1):46-53. doi: 10.3899/jrheum.150525..
Keywords: Quality of Life, Treatments, Risk, Arthritis