Anna T. R. Legedza

The placebo effect in irritable bowel syndrome trials: a meta-analysis1

Abstract  Background:  Despite the apparent high placebo response rate in randomized placebo‐controlled trials (RCT) of patients with irritable bowel syndrome (IBS), little is known about the variability and predictors of this response.

Interpreter services, language concordance, and health care quality. Experiences of Asian Americans with limited English proficiency.

AbstractBACKGROUND: Patients with limited English proficiency (LEP) have more difficulty communicating with health care providers and are less satisfied with their care than others. Both interpreter- and language-concordant clinicians may help overcome these problems but few studies have compared these approaches. OBJECTIVE: To compare self-reported communication and visit ratings for LEP Asian immigrants whose visits involve either a clinic interpreter or a clinician speaking their native language. DESIGN: Cross-sectional survey—response rate 74%. PATIENTS: Two thousand seven hundred and fifteen LEP Chinese and Vietnamese immigrant adults who received care at 11 community-based health centers across the U.S. MEASUREMENTS: Five self-reported communication measures and overall rating of care. RESULTS: Patients who used interpreters were more likely than language-concordant patients to report having questions about their care (30.1% vs 20.9%, P<.001) or about mental health (25.3% vs 18.2%, P=.005) they wanted to ask but did not. They did not differ significantly in their response to 3 other communication measures or their likelihood of rating the health care received as “excellent” or “very good” (51.7% vs 50.9%, P=.8). Patients who rated their interpreters highly (“excellent” or “very good”) were more likely to rate the health care they received highly (adjusted odds ratio 4.8, 95% confidence interval, 2.3 to 10.1). CONCLUSIONS: Assessments of communication and health care quality for outpatient visits are similar for LEP Asian immigrants who use interpreters and those whose clinicians speak their language. However, interpreter use may compromise certain aspects of communication. The perceived quality of the interpreter is strongly associated with patients’ assessments of quality of care overall.

Health care expenditures associated with overweight and obesity among US adults: importance of age and race.

OBJECTIVES We estimated health care expenditures associated with overweight and obesity and examined the influence of age, race, and gender. METHODS Using 1998 Medical Expenditure Panel Survey data, we employed 2-stage modeling to estimate annual health care expenditures associated with high body mass index (BMI) and examine interactions between demographic factors and BMI. RESULTS Overall, the mean per capita annual health care expenditure (converted to December 2003 dollars) was

Asian Americans’ Reports of Their Health Care Experiences

3338 before adjustment. While the adjusted expenditure was

Joint Replacement Surgery in Elderly Patients With Severe Osteoarthritis of the Hip or Knee: Decision Making, Postoperative Recovery, and Clinical Outcomes

2127 (90% confidence interval [CI]=

Perceived Benefit of Complementary and Alternative Medicine (CAM) for Back Pain: A National Survey

1927,

Addition of Choice of Complementary Therapies to Usual Care for Acute Low Back Pain: A Randomized Controlled Trial

2362) for a typical normal-weight White woman aged 35 to 44 years, expenditures were

An overview of practical approaches for handling missing data in clinical trials.

2358 (90% CI=

Association between language and risk factor levels among Hispanic adults with hypertension, hypercholesterolemia, or diabetes

2128,

Japanese-Style Acupuncture for Endometriosis-Related Pelvic Pain in Adolescents and Young Women: Results of a Randomized Sham-Controlled Trial

2604) for women with BMIs of 25 to 29.9 kg/m(2),