Variation among rheumatologists in the use of prednisone and second-line agents for the treatment of rheumatoid arthritis.
OBJECTIVE
To test for and estimate variation among rheumatologists in their prescribing of prednisone and second-line agents for the treatment of rheumatoid arthritis (RA), after taking into account the characteristics of their patients.


METHODS
Multiple logistic regression incorporating random effects for rheumatologists, with adjustment for patient characteristics.


RESULTS
Values for the likelihood-ratio statistic provided strong evidence of such variation. Random-effect variance estimates showed that the variation is of great magnitude.


CONCLUSIONS
Even after patient characteristics have been taken into account, the data show that the rheumatologist may strongly influence the use of prednisone and second-line agents by a patient.
Criswell
L A
LA
University of California, San Francisco.
Redfearn
W J
WJ
D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D011897:Random Allocation; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
D000893:Anti-Inflammatory Agents; D011241:Prednisone