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Rheumatologists Underestimate the Patients Ability to Work

Researchers at University of south Florida has found that Rheumatologists substantially overestimate the physical disability of patients with rheumatoid arthritis which may lead to inaccurate evaluations of the patients ability to work and need for lifestyle modifications.

The rheumatologists consistently rated their rheumatoid arthritis patients degree of difficulty in performing activities of daily living, such as walking, dressing and eating, higher than the patients themselves. This was particularly true for patients in advanced stages of the disease.

We flunked, said co-first author John D. Carter, MD, assistant professor of medicine in the USF Division of Rheumatology. The very physicians deemed to be experts in rheumatoid arthritis failed to make the grade when it came to determining their patients functional status.

This discrepancy is important to correct because patients can rely on these assessments for their livelihood or other necessities to perform activities of daily living.

Rheumatologists are frequently asked to complete functional disability reports by employers, disability attorneys, insurance companies and government agencies weighing a persons eligibility for disability payments, employment, or assistive devices such as wheelchairs, walkers, braces and splints.

Using the Stanford Health Assessment Questionnaire-Disability Index (HAQ-DI), rheumatologists evaluated 223 patients during their regularly scheduled visits to the USF Rheumatology Clinics and James A. Haley Veterans Hospital.

The effectiveness of the HAQ-DI, based on patient self-reporting of their disability status, has been validated in clinical studies. The questionnaire covers eight activities of daily living: dressing, arising, eating, hygiene, walking, reach, grip and outside activity.

Both physician and patient completed the HAQ-DI independently immediately following the visit and the
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