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Users' Guides to the Medical Literature XII. How to Use Articles About Health-Related Quality of Life

Gordon H. Guyatt, MD, MSc; C. David Naylor, MD, MSc, DPhil; Elizabeth Juniper, MCSP, MSc; Daren K. Heyland, MD; Roman Jaeschke, MD, MSc; Deborah J. Cook, MD, MSc
JAMA. 1997;277(15):1232-1237. doi:10.1001/jama.1997.03540390062037.
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CLINICAL SCENARIO  You are a physician following a 35-year-old man who has had active Crohn disease for 8 years. The symptoms were severe enough to require resectional surgery 4 years ago, and despite treatment with sulfasalazine and metronidazole, the patient has had active disease requiring oral steroids for the last 2 years. Repeated attempts to decrease the prednisone have failed, and the patient has required doses of greater than 15 mg per day to control symptoms. You are impressed by both the methods and results of a recent article1 documenting that such patients benefit from oral methotrexate and suggest to the patient that he consider this medication. When you explain some of the risks of methotrexate, particularly potential liver toxicity, the patient is hesitant. How much better, he asks, am I likely to feel while taking this medication?

INTRODUCTION  There are 3 reasons we offer treatment to our patients.


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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