At A Glance
Monthly highlights of ICES research findings for stakeholders
Access to specialists improves treatment for arthritis patients
Shipton D, Glazier R, Guan J, Badley E. Effects of use of specialty services on disease-modifying antirheumatic drug use in
rheumatoid arthritis in an insured elderly population. Medical Care. 2004; 42 (9): 907-913.
Disease-modifying antirheumatic drugs (DMARDs) can significantly slow the progress
rheumatoid arthritis (RA). The extent to which Canadian RA patients are referred to s
prescribed DMARDs is not known.
Tracked individuals aged 65 years and older with RA in Ontario from 1997 to 2001 to ex
proportion seeing general practitioners and specialist physicians, and the number being
Of the 13,698 people in the study group, those who saw a specialist were nearly twice
receive DMARDs. There was considerable variation by county in both the proportion o
visiting specialists (39 to 82 per 100 RA population), and receiving DMARDs (36% to
Implications Lack of access to specialists is associated with suboptimal treatment for RA patients.
improve access to specialists could include improving FP/GPs’ knowledge and behav
referral for RA patients, and reducing geographic disparities in the provision of specia
Colonoscopy does not detect all colon cancers
Bressler B, Paszat L, Vinden C, Li C, He J, Rabeneck L. Colonoscopic miss rates for right-sided colon cancer: a population-based a
Gastroenterology. 2004; 127 (2): 452-456.
The marked increase in the use of colonoscopy to detect colorectal cancer (CRC), as w
the proportion of right-sided colon cancers, make it vital to document the accuracy of th
Identified all Ontario adults with a new diagnosis of right-sided CRC admitted to hosp
resection of the colon between 1997 and 2001. Patients who had a colonoscopy withi
diagnosis were divided into two groups: detected cancers (those who had a colonosc
months of diagnosis), and missed cancers (those who had a colonoscopy six months