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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.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

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. . . . [Full Text PDF of this Article]

Author Affiliations
for the Evidence-Based Medicine Working Group

From the Departments of Clinical Epidemiology and Biostatistics (Drs Guyatt and Cook and Ms Juniper) and Medicine (Drs Guyatt, Heyland, Jaeschke, and Cook), McMaster University, Hamilton, Ontario, and the Institute for Clinical Evaluative Sciences and the Clinical Epidemiology Unit, Sunnybrook Health Science Centre, University of Toronto, Toronto, Ontario (Dr Naylor).

Footnotes
The original list of members (with affiliations) appears in the first article of this series (JAMA. 1993;270: 2093-2095). A list of new members appears in the 10th article of the series (JAMA. 1996;275:1435-1439). The following members contributed to this article: Paul Glasziou, MB, PhD; Virginia Moyer, MD, MPH; and Peter Tugwell, MD, MSc.

Reprints: Gordon H. Guyatt, MD, MSc, McMaster University Health Sciences Centre, 1200 Main St W, Room 2C12, Hamilton, Ontario, Canada L8N 3Z5.

Users' Guides to the Medical Literature section editor: Drummond Rennie, MD, Deputy Editor (West), JAMA.

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