[Backache in East and West Germany].

On the basis of data of the East German Health Survey (1991/92) and regional studies from West Germany (Bad Säckingen 1990, Lübeck 1991/92, Bad Säkingen 1993/94) results on the prevalence of back pain, other rheumatic complaints and general health problems are compared. East German respondents report on back pain and all other rheumatic complaints definitely less often than West German respondents but suffer equally from general health complaints. Apart from the differences in the prevalence of rheumatic complaints there are remarkable structural analogies between East Germany and the West German cities.

[Patient "satisfaction" in medical rehabilitation--a useful outcome indicator?].

Within the context of a five-part quality assurance programme for rehabilitation hospitals issued by the German Association of Statutory Pension Scheme Underwriters (Verband Deutscher Rentenversicherungsträger) we developed a multisectional questionnaire to assess patient satisfaction with rehabilitation measures. This questionnaire records the patients' perceptions and ratings of rehabilitation structures and processes as well as the results of then. The article describes basic positions, chances and risks of assessing this measure of satisfaction as well as the development of our questionnaire.

Prediction of permanent work disability in a follow-up study of early rheumatoid arthritis: results of a tree structured analysis using RECPAM.

The objectives of this study are: (a) to determine the occurrence of permanent work disability (PWD) in early rheumatoid arthritis (RA); (b) to identify prognostic groups of patients; (c) to assess the employment rates for these groups over time. Seventy-three gainfully employed consecutive out-patients with early RA (> or = 5 ARA 1958 criteria, disease duration < or = 12 months) at time one (T1) were re-examined at time two (T2) after a mean follow-up of 6 yr (S.D.

[Measuring functional capacity in backache patients in rehabilitation: a comparison of standardized questionnaires].

In recent years, subjective assessment of functional ability by patients has become an important diagnostic instrument in rehabilitation medicine. We compared three self-administered standardized questionnaires for measuring functional capacity in patients with back pain (the back pain-specific version of the Hannover Functional Ability Questionnaire, the Roland & Morris Scale, and the Measurement of Patient Outcome Scales) with respect to feasibility, reliability, and validity. The sample comprised 119 patients treated for back pain in a rehabilitation clinic in North Germany.

[A leukemia cluster in the Pinneberg district. Results of an incidence study by the epidemiologic task force of the Schleswig-Holstein Medical Association].

After regional media had reported in early 1995 of multiple leukaemia cases in a small community in the state of Schleswig-Holstein, an "Epidemiological Task Force" was asked to review the existing evidence for a possible cluster. The Task Force is a small group appointed in 1994 by the regional Medical Association and the state's ministry of social affairs. It includes five professionals from the fields of environmental toxicology and hygiene, Public Health, epidemiology and cancer pathology.

[Hannover Functional Questionnaire in ambulatory diagnosis of functional disability caused by backache].

This paper describes conceptual and clinimetric aspects as well as fields of application of the Hannover Functional Ability Questionnaire for measuring back pain-related disability (FFbH-R). The FFbH-R belongs to a series of short self-administered questionnaires for the assessment of functional limitations in activities of daily living among patients with musculoskeletal disorders. In addition to the FFbH-R, a specific version is available for patients with polyarticular diseases (the FFbH-P), as well as a combined version of both questionnaires.

Fibromyalgia.

The article details the history, concept, definition and assessment of the still enigmatic condition of 'fibrositis' or, as it has more recently been called, 'fibromyalgia'. The concept and diagnosis became popular, especially in North America, in the 1970s, after the seminal publications of Hugh Smythe (1972) and Smythe and Moldofsky (1977). It is noticeable that there does not appear to be an early case report as there is for instance for gout, rheumatoid arthritis or certain vasculitides.

Back pain.

Classification of back pain is a difficult task. Traditional schemes have focused on the small percentage of cases which have specific causes. Structural anomalies observed on X-ray examination explain only a small proportion of back pain cases, and the emphasis placed on these in the traditional schemes is, as Anderson put it, the tail wagging the dog (Anderson, 1977).

[Basic principles of community, continuous and cooperative management of patients with chronic rheumatic diseases in Germany].

The lecture presents foundations and results of the work of a commission of the German Rheumatological Association. Based on epidemiological data on the occurrence of selected rheumatic disorders, reference figures for both, in- and outpatient services are developed. There is need of at least one full-time rheumatologist for every 150,000 residents.

A database for back (axial skeletal) pain.

Back pain cannot be considered a mere symptom that has as its only function reference to relevant hidden disease. Back pain must be acknowledged as a disorder that requires description and assessment as carefully as any of the well-established clinical entities. This article outlines a clinically useful, descriptive "morphology" or nosography of the various axial skeletal pains stated, and proposes methods for their classification and evaluation.

Survey response rates: national and regional differences in a European multicentre study of vertebral osteoporosis.

Study Objective: This analysis aimed to compare the response rates of those invited to attend for screening in a multicentre, multinational study within Europe.

Design: This was a population survey.

Setting: Thirty four centres in 16 European countries.

Fibromyalgia and disability. Report of the Moss International Working Group on medico-legal aspects of chronic widespread musculoskeletal pain complaints and fibromyalgia.

The present article is the result of a working group conference held in Moss, Norway, in June 1993, financed by the Royal Norwegian Ministry of Health and Social Affairs. Its purpose was to review and focus upon problems and needs related to the medico-legal aspects of fibromyalgia and chronic widespread musculoskeletal complaints: thus to define directions for future work on issues which have generally not been addressed within the medical community. Our report describes specific problems in this area in regard to definition, evaluation and recommendation, and in currently available work and disability statistics.

Disorders characterised by pain: a methodological review of population surveys.

OBJECTIVE--To review a series of conceptual and methodological problems encountered in surveys primarily devoted to pain disorders. CRITERIA FOR INCLUSION AND EXCLUSION OF ARTICLES--Published reports were systematically collected by electronic database searches (Medline), citations in existing publications, and through personal contacts. Relevant articles from clinical and epidemiological research on pain were included and special attention was given to epidemiological research on back pain.

[Guidelines for social medicine assessment and evaluation of primary fibromyalgia].

Primary fibromyalgia belongs to the spectrum of rheumatic soft tissue disorders. It is characterized by wide-spread chronic pain and a low pain threshold. The etiology of the disorders is still unknown.

[Grading of backache].

Back pain is occurring in a broad spectrum of severity; therefore, a grading procedure which is derived from a sound conceptual basis and can be easily applied is of crucial importance in clinical research and in epidemiologic studies. Following a grading procedure which has been developed in epidemiologic studies in the U.S.

[The current backache epidemic].

All available data presented show that we are confronted with a back-pain (BP) epidemic; it affects numerous industrialized countries. More severe forms of BP make up one fifth of the prevalence. The greater part of BP seems to be mild, especially among persons aged 25 to 54.

Reproducibility of a questionnaire on risk factors for osteoporosis in a multicentre prevalence survey: the European Vertebral Osteoporosis Study.

Background: The European Vertebral Osteoporosis Study Group (EVOS) developed a questionnaire, back translated into 14 different European languages, for use in a multinational epidemiological study of vertebral osteoporosis. We investigated the reproducibility of this questionnaire in four of the participating study centres.

Methods: In all 151 men and women, aged 50-85 years, from Lubeck (Germany), Malmo (Sweden), Warsaw (Poland) and Oviedo (Northern Spain), were retested with the questionnaire on two occasions using a different observer within a 28-day period.

[Work capacity--a central category of practical social medicine].

Gainful employment-related performance capacity is a central but rarely considered category of practical social medicine. Its evaluation belongs to the workday routine of social physicians. Special difficulties arise if chronic pain disorders are to be evaluated, especially in chronic "nonspecific" cases, i.

[Current musculoskeletal symptoms in peri and postmenopausal women: results of a multicenter population epidemiological study. The EVOS Study Group].

Within the European vertebral osteoporosis study four stratified systematic samples of German residents aged 50-79 in Lübeck, Heidelberg, Jena and East Berlin have been drawn. Overall 4628 subjects were included, of whom 4385 were contactable and 3106 (71%) responded to the postal questionnaire enquiring about rheumatic complaints "today". 2348 (54%) followed an invitation to a medical examination in which a specific gynaecological history was taken.

[Measuring work capacity in rheumatic diseases: functional disability, pain, pain-related cognitions and affects].

Rheumatic diseases, particularly those affecting the back, cervical spine, and the joints, are widespread in the general population. The general costs, especially those associated with social medical services, show constant increases. Time and effectiveness lost from work due to back problems in the FRG accounted for most of the days off the job because of disability, time spent in the hospital or at a health spa facility.