Dorcas E Beaton

Institute for Work and Health, Toronto, Ontario, Canada

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Publications (200)597.08 Total impact

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    ABSTRACT: To investigate the predictive ability of the Upper-Limb Work Instability Scale (UL-WIS) for transitioning out of work among injured workers with chronic work-related upper-extremity disorders (WRUEDs) DESIGN: Secondary analysis of a 12-month cohort study with data collection at baseline, and 3, 6, and 12-month follow-up. Survey questionnaires were used to collect data on an array of socio-demographic, health-related, and work-related variables SETTING: Upper-Extremity Specialty clinics operated by the Workplace Safety & Insurance Board of Ontario PARTICIPANTS: Injured workers with WRUEDs who were working at time of initial clinic attendance (n=356) INTERVENTIONS: Not applicable. Transitioning out of work. Multivariable logistic regression that considered nine potential confounders revealed baseline UL-WIS (range: 0-17) to be a statistically significant predictor of a subsequent transition out of work (adjusted odds ratio=1.18 [95%CI: 1.07, 1.31], p=0.001). An assessment of predictive values across the UL-WIS score range identified cut-scores of <6 (negative predictive value=0.81 [95%CI, 0.62, 0.94]) and >15 (positive predictive value=0.80, [95%CI: 0.52, 0.96]), differentiating the scale into three bands representing low, moderate, and high risk of exiting work. The UL-WIS was shown to be an independent predictor of poor work sustainability among injured workers with chronic WRUEDs; however, when applied a standalone tool in clinical settings, some limits to its predictive accuracy should also be recognized. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
    Archives of physical medicine and rehabilitation 05/2015; DOI:10.1016/j.apmr.2015.04.022 · 2.44 Impact Factor
  • Revue d Épidémiologie et de Santé Publique 05/2015; 63:S60. DOI:10.1016/j.respe.2015.03.052 · 0.66 Impact Factor
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    ABSTRACT: To examine work absenteeism, job disruptions and perceived productivity loss and factors associated with each outcome in young adults living with systemic lupus erythematosus (SLE) and juvenile arthritis (JA). One hundred and forty three young adults, ages 18 to 30 years, with SLE (54.5%) and JA (45.5%) completed an online survey of work experiences. Demographic, health (e.g., fatigue, disease activity), psychosocial (e.g., independence, social support) and work context (e.g., career satisfaction, job control, self-disclosure) information were collected. Participants were asked about absenteeism, job disruptions and perceived productivity loss in the last six months. Log-Poisson regression analyses examined factors associated with work outcomes. A majority of participants were employed (59%) and reported a well-managed health condition. Employed respondents were satisfied with their career progress and indicated moderate job control. Over forty percent of participants reported absenteeism, job disruptions and productivity loss. Greater job control and self-disclosure, and less social support were related to a higher likelihood of absenteeism; more disease activity was related to a greater likelihood of reporting job disruptions; lower fatigue and higher job control was associated with a reduced likelihood of a productivity loss. Young adult respondents with rheumatic disease experienced challenges with employment including absenteeism, job disruptions and productivity loss. While related to greater absenteeism, job control could play a role in a young person's ability to manage their health condition and sustain productive employment. Greater attention should also be paid to understanding health factors, and social support in early work experiences. This article is protected by copyright. All rights reserved. © 2015 American College of Rheumatology.
    04/2015; DOI:10.1002/acr.22601
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    ABSTRACT: Patient-reported outcome measures are increasingly used evaluating clinical care. Many measures used to assess operative hindfoot interventions vary in content, and some have not been psychometrically validated in this population. The purpose of this study was to compare measurement properties of 6 lower-extremity patient-reported outcome measures, and to evaluate their reliability and validity in light of patients' preferences. Cross-sectional survey of 42 preoperative and 100 postoperative patients completed 6 lower-extremity outcome measures on 2 occasions: Foot Function Index (FFI), Ankle Osteoarthritis Scale (AOS), patient-reported items of the American Orthopaedic Foot and Ankle Society Questionnaire (AOFAS), Lower Extremity Functional Scale (LEFS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Musculoskeletal Function Assessment (SMFA), as well as measures of preference, and symptoms. Internal consistency was good to excellent for all scales and subscales (α = .84-.97; ICC [2,1] = .81-.96). Correlations between scales ranged from .50 (WOMACStiffness and FFIActivity Limitations) to .92 (LEFS and SMFAOverall, WOMACPain and AOSOverall, FFIOverall and AOFASOverall). Higher correlations occurred within instruments (r = .97 AOSPain and AOSOverall) and between similar subscales from different instruments (r = .91 WOMACPain and AOSPain). Construct validity showed moderate to high correlations to global ratings of Pain, Stiffness, and difficulty performing Daily Activities. The highest correlations (r > .75) occurred between Pain and AOSOverall (r = .84), stiffness and WOMACStiffness (r = .81), and Daily Activities and AOSDisability (r = .87). Patients rated instruments by preference. FFI, WOMAC, LEFS, and SMFA rated favorably for length. FFI, WOMAC, LEFS, and AOFAS rated high for understandability. FFI was rated by postoperative patients as most likely to capture change due to surgery. SMFA rated the best overall. Direct comparison of instruments revealed similarity between scales in construct validity and reliability. Patient preferences supported the use of these scales. Foot-specific instruments offered no clear advantage over lower-extremity instruments. Level II, prospective comparative study. © The Author(s) 2015.
    Foot & Ankle International 02/2015; DOI:10.1177/1071100714566624 · 1.63 Impact Factor
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    ABSTRACT: Prior to the Outcome Measures in Rheumatology (OMERACT) 12 meeting in Budapest, Hungary, a workshop was held bringing together individuals from a number of international outcome measure organizations to assess how best to further develop consensus on how pain is conceptualized and measured in trials of musculoskeletal conditions, and how the trials should be reported in systematic reviews.
    The Journal of Rheumatology 02/2015; DOI:10.3899/jrheum.141430 · 3.17 Impact Factor
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    ABSTRACT: Prior to the Outcome Measures in Rheumatology (OMERACT) 12 meeting in Budapest, Hungary, a workshop was held bringing together individuals from a number of international outcome measure organizations to assess how best to further develop consensus on how pain is conceptualized and measured in trials of musculoskeletal conditions, and how the trials should be reported in systematic reviews. (J Rheumatol First Release Feb 1 2015; doi:10.3899/jrheum.141430) Key Indexing Terms: PAIN MEASUREMENT CHRONIC PAIN OUTCOMES RESEARCH SYSTEMATIC REVIEW Prior to the Outcome Measures in Rheumatology (OMERACT) 12 meeting in Budapest, Hungary, in May 2014, a workshop of 42 individuals was held to assess how best to move toward developing consensus on how pain is conceptualized and measured in trials of musculoskeletal (MSK) conditions, and how the trials should be reported in systematic reviews. The workshop included clinicians, patients, and researchers from 9 countries in the Americas, Australasia, and Europe, from 7 organizations representing the Cochrane Collaboration (6 Cochrane subgroups/entities), COMET (Core Outcome Measures in Effec tiveness Trials), COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments), GRADE (Grading of Recommendations Assessment, Development, and Evalu -ation), IMMPACT/ACTTION (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials/Anal -gesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks), OMERACT, and VAPAIN (Validation and Application of a core set of patient-relevant outcome domains to assess the effec-tiveness of multimodal pain therapy). David Tovey, editor-in-chief of The Cochrane Library, noted that Cochrane Systematic Reviews aim to provide trustworthy and interpretable estimates of what works in health and healthcare. Identifying the proper research question using a formulation based on the P (Population), I (Intervention), C (Comparator), and O (Outcomes) frame -work is a critical first step. The aim of a review focused on treatment is to determine whether, for a given comparison and outcome, there is any effect/difference, the direction of any effect, and the degree of certainty that the calculated
    The Journal of Rheumatology 02/2015; 42. DOI:10.3899/jrheum.141430) · 3.17 Impact Factor
  • Health 01/2015; 07(05):514-520. DOI:10.4236/health.2015.75061 · 0.51 Impact Factor
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    7th International Symposium: Safety & Health in Agricultural & Rural Populations: Global Perspectives (SHARP), Saskatoon, SK, Canada; 10/2014
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    ABSTRACT: Objective. To examine perceived independence, overprotection, and support, and their association with the employment participation of young adults with rheumatic disease. Methods. One hundred and forty-three young adults, ages 18 to 30 years, with systemic lupus erythematosus (54.5%) and juvenile arthritis (45.5%) completed a 30-min online questionnaire of their work and education experiences. Information collected was demographic, health (e.g., pain, fatigue, disease activity), work context (e.g., career satisfaction, helpfulness of job accommodation/benefits, and workplace activity limitations), and psychosocial (e.g., independence, social support, and overprotection). Log-Poisson regression analysis examined factors associated with employment status. Results. Over half of respondents were employed (59%) and 26% were enrolled in school. Respondents reported moderate to high perceptions of independence and social support. However, 27% reported that "quite a bit" to "a great deal" of overprotection characterized their relationships with those closest to them. At the bivariate level, employed participants and those indicating greater perceived independence reported greater social support and less overprotection. Multivariable analysis revealed that being employed was associated with older age, more job accommodations/benefits perceived as being helpful, and greater perceived independence. Conclusion. This is one of the first studies examining the employment of young adults with rheumatic diseases. Findings highlight the importance of psychosocial perceptions such as independence and overprotection, in addition to support related to working. Additional research is needed to better understand the role of those close to young adults with rheumatic diseases in supporting independence and encouraging employment.
    The Journal of Rheumatology 10/2014; 41(12). DOI:10.3899/jrheum.140419 · 3.17 Impact Factor
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    ABSTRACT: Workforce health is capturing increased attention as a critical driver of the economy. An important demographic trend that will affect worker health and work disability is aging of the workforce. While the number of aging workers wanting or needing to return to work or stay at work after injury or chronic disease is increasing, knowledge on their specific needs and circumstances has not been summarized in a systematic way. The increasing aging working population will necessitate an understanding of efforts to prevent work disability among aging workers. Therefore, we have undertaken a review to synthesize the evidence on the effectiveness of interventions aimed at preventing poor outcome in aging workers and synthesize the literature on what determines risk of poor outcome in aging workers.
    3rd WDPI Conference: Implementing Work Disability Prevention Knowledge, Hyatt Regency Hotel, Toronto Canada; 10/2014
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    ABSTRACT: Background Improved appreciation of recovery profiles of sensory and motor function as well as complex motor functions (prehension) after cervical spinal cord injury (SCI) will be essential to inform clinical studies to consider primary and secondary outcome measures for interventions and the optimization of dosing and timing of therapies in acute and chronic SCI. Objectives (1) To define the sensory, motor, and prehension recovery profiles of the upper limb and hand in acute cervical SCI and (2) to confirm the impact of AIS severity and conversion on upper limb sensorimotor recovery. Methods An observational longitudinal cohort study consisting of serial testing of 53 patients with acute cervical SCI was conducted. International Standards of Neurological Classification of Spinal Cord Injury, Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP), Capabilities of Upper Extremity (CUE-Q) Questionnaire, and Spinal Cord Independence Measure III (SCIM-III) were administered at 0-10 days, 1, 3, 6, and 12 months. Analysis Change over time was plotted using mean and standard deviation of the total and subgroups of the sample. Results Individuals with traumatic tetraplegia show distinct patterns of recovery. Factors that distinguish homogeneous subgroups of the sample are: severity of injury (level of injury, completeness) at baseline and conversion from a complete to an incomplete injury. Conclusions In cervical SCI, clinical recovery can be assessed using standardized measures that distinguish levels of activity and impairment. Specific recovery profiles of the upper limb over the 1-year timecourse provide new insights and opportunity for combined analysis of recovery profiles for different clinical assessment tools of upper limb function which are meaningful to inform the design of study protocols.
    The journal of spinal cord medicine 09/2014; 37(5):503-510. DOI:10.1179/2045772314Y.0000000252 · 1.88 Impact Factor
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    ABSTRACT: We examined patients' experiences regarding bone mineral density (BMD) testing and bone health treatment after being screened through Ontario's Fracture Clinic Screening Program. Provider-level barriers to testing and treatment appeared to be as significant as patient-level barriers and potentially had more of an impact on treatment than on testing.
    Osteoporosis International 08/2014; 25(11). DOI:10.1007/s00198-014-2804-4 · 4.17 Impact Factor
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    ABSTRACT: Background Lack of standardization of outcome measures limits the usefulness of clinical trial evidence to inform health care decisions. This can be addressed by agreeing on a minimum core set of outcome measures per health condition, containing measures relevant to patients and decision makers. Since 1992, the Outcome Measures in Rheumatology (OMERACT) consensus initiative has successfully developed core sets for many rheumatologic conditions, actively involving patients since 2002. Its expanding scope required an explicit formulation of its underlying conceptual framework and process. Methods Literature searches and iterative consensus process (surveys and group meetings) of stakeholders including patients, health professionals, and methodologists within and outside rheumatology. Results To comprehensively sample patient-centered and intervention-specific outcomes, a framework emerged that comprises three core “Areas,” namely Death, Life Impact, and Pathophysiological Manifestations; and one strongly recommended Resource Use. Through literature review and consensus process, core set development for any specific health condition starts by identifying at least one core “Domain” within each of the Areas to formulate the “Core Domain Set.” Next, at least one applicable measurement instrument for each core Domain is identified to formulate a “Core Outcome Measurement Set.” Each instrument must prove to be truthful (valid), discriminative, and feasible. In 2012, 96% of the voting participants (n = 125) at the OMERACT 11 consensus conference endorsed this model and process. Conclusion The OMERACT Filter 2.0 explicitly describes a comprehensive conceptual framework and a recommended process to develop core outcome measurement sets for rheumatology likely to be useful as a template in other areas of health care.
    Journal of clinical epidemiology 07/2014; 67(7). DOI:10.1016/j.jclinepi.2013.11.013 · 5.48 Impact Factor
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    ABSTRACT: To examine messages perceived by members of an osteoporosis (OP) patient group from various healthcare providers regarding bone health. We conducted a phenomenological (qualitative) study in members of an OP patient group who resided in Canada, had sustained a fragility fracture at 50+ years old, and were not taking antiresorptive medication at the time of that fracture. Participants were interviewed for approximately 1 h by telephone and responded to questions about visits to healthcare providers for their bone health and what was discussed during those visits. We analyzed the data guided by Giorgi's methodology. We interviewed 28 members (2 males, 26 females; 78 % response rate), aged 51-89 years old. Most participants perceived that their specialist was more interested than their primary care physician in bone health and took the time to discuss issues with them. Participants perceived very few messages from the fracture clinic and other providers. We found many instances where perceived messages within and across various healthcare providers were inconsistent, suggesting there is a need to raise awareness of bone health management guidelines to providers who treat fracture patients.
    Rheumatology International 06/2014; 35(1). DOI:10.1007/s00296-014-3079-y · 1.63 Impact Factor
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    ABSTRACT: Objective. The objective of this study was to examine the extent of workplace activity limitations among persons with lupus and to identify factors associated with activity limitations among those employed. Methods. We conducted a cross-sectional study using a mailed survey and clinical data of persons with lupus who attended a large lupus outpatient clinic. Data were collected on demographics, health, work factors and psychosocial measures. The workplace activity limitations scale (WALS) was used to measure difficulty related to different activities at work. Multivariable analysis examined the association of health, work context, psychosocial and demographic variables with workplace activity limitations. Results. We received 362 responses from 604 (60%) mailed surveys. Among those not employed, 52% reported not working because of lupus. A range of physical and mental tasks were reported as difficult. Each of the physical, cognitive and energy work activities was cited as difficult by more than one-third of participants. Among employed participants, 40% had medium to high WALS difficulty scores. In the multivariable analysis, factors significantly associated with workplace activity limitations were older age, greater disease activity, fatigue, poorer health status measured by the 36-item Short Form Health Survey, lower job control, greater job strain and working more than 40 h/week. Conclusion. People with lupus experience limitations and difficulty at work. Determinants of workplace activity limitations are mainly those related to workplace and health factors.
    Rheumatology (Oxford, England) 06/2014; 53(11). DOI:10.1093/rheumatology/keu242 · 4.44 Impact Factor
  • Joanna E M Sale, Dorcas Beaton, Earl Bogoch
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    ABSTRACT: This article is an overview of the status of postfracture secondary prevention programs. The concept of fracture risk, the inclusion of fracture risk in clinical practice guidelines for osteoporosis, and how fracture risk has contributed to the development of postfracture secondary prevention programs are described. The scope of postfracture secondary prevention programs, the gaps in care that persist despite these initiatives, and the potential reasons for these gaps are also described. Recommendations for future research in the area of postfracture secondary prevention are provided.
    05/2014; 30(2):317-332. DOI:10.1016/j.cger.2014.01.009
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    ABSTRACT: The Outcome Measures in Rheumatology (OMERACT) Filter provides guidelines for the development and validation of outcome measures for use in clinical research. The "Truth" section of the OMERACT Filter requires that criteria be met to demonstrate that the outcome instrument meets the criteria for content, face, and construct validity. Discussion groups critically reviewed a variety of ways in which case studies of current OMERACT Working Groups complied with the Truth component of the Filter and what issues remained to be resolved. The case studies showed that there is broad agreement on criteria for meeting the Truth criteria through demonstration of content, face, and construct validity; however, several issues were identified that the Filter Working Group will need to address. These issues will require resolution to reach consensus on how Truth will be assessed for the proposed Filter 2.0 framework, for instruments to be endorsed by OMERACT.
    The Journal of Rheumatology 04/2014; 41(5). DOI:10.3899/jrheum.131310 · 3.17 Impact Factor
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    ABSTRACT: To examine if age differences in the consequences of work injury are exacerbated when occupational physical demands are higher. A secondary analysis of workers' compensation claims in British Columbia (N = 373,672). Regression models examined the relationship between age and health care expenditures, days of wage replacement and the occurrence of long-term-disability following a work-related injury in occupations with lower and higher physical demands. Models were adjusted for individual and injury related covariates. Older age and higher occupational physical demands were associated with worse work-injury outcomes. The relationship between age and each outcome was not exacerbated when occupational physical demands were higher compared to when they were lower. Counter to our hypotheses age differences in health care expenditures were smaller among women in more demanding occupations. In this study, we found no evidence that the relationship between age and the consequences of work injury is exacerbated when physical occupational demands are high. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 04/2014; 57(4). DOI:10.1002/ajim.22303 · 1.59 Impact Factor
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    ABSTRACT: The "Discrimination" part of the OMERACT Filter asks whether a measure discriminates between situations that are of interest. "Feasibility" in the OMERACT Filter encompasses the practical considerations of using an instrument, including its ease of use, time to complete, monetary costs, and interpretability of the question(s) included in the instrument. Both the Discrimination and Reliability parts of the filter have been helpful but were agreed on primarily by consensus of OMERACT participants rather than through explicit evidence-based guidelines. In Filter 2.0 we wanted to improve this definition and provide specific guidance and advice to participants.
    The Journal of Rheumatology 04/2014; 41(5). DOI:10.3899/jrheum.131311 · 3.17 Impact Factor
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    ABSTRACT: The Outcome Measures in Rheumatology (OMERACT) Filter provides guidelines for the development and validation of outcome measures for use in clinical research. The "Truth" section of the OMERACT Filter presupposes an explicit framework for identifying the relevant core outcomes that are universal to all studies of the effects of intervention effects. There is no published outline for instrument choice or development that is aimed at measuring outcome, was derived from broad consensus over its underlying philosophy, or includes a structured and documented critique. Therefore, a new proposal for defining core areas of measurement ("Filter 2.0 Core Areas of Measurement") was presented at OMERACT 11 to explore areas of consensus and to consider whether already endorsed core outcome sets fit into this newly proposed framework. Discussion groups critically reviewed the extent to which case studies of current OMERACT Working Groups complied with or negated the proposed framework, whether these observations had a more general application, and what issues remained to be resolved. Although there was broad acceptance of the framework in general, several important areas of construction, presentation, and clarity of the framework were questioned. The discussion groups and subsequent feedback highlighted 20 such issues. These issues will require resolution to reach consensus on accepting the proposed Filter 2.0 framework of Core Areas as the basis for the selection of Core Outcome Domains and hence appropriate Core Outcome Sets for clinical trials.
    The Journal of Rheumatology 03/2014; 41(5). DOI:10.3899/jrheum.131309 · 3.17 Impact Factor

Publication Stats

11k Citations
597.08 Total Impact Points

Institutions

  • 1996–2015
    • Institute for Work and Health
      Toronto, Ontario, Canada
  • 1993–2015
    • University of Toronto
      • • Department of Occupational Science and Occupational Therapy
      • • Department of Physical Therapy
      • • Institute of Health Policy, Management and Evaluation
      • • Department of Anesthesia
      • • Department of Rehabilitation Science
      • • Department of Surgery
      Toronto, Ontario, Canada
  • 2009–2014
    • Christus St. Michaels' Hospital
      텍사캐나, Arkansas, United States
    • SickKids
      • Division of Gastroenterology, Hepatology and Nutrition
      Toronto, Ontario, Canada
  • 2013
    • University of Ottawa
      • Institute of Population Health
      Ottawa, Ontario, Canada
  • 1995–2013
    • St. Michael's Hospital
      • Department of Surgery
      Toronto, Ontario, Canada
  • 1993–2012
    • Saint Michael's Medical Center
      Newark, New Jersey, United States
  • 2010
    • Peterborough Regional Health Centre
      Питерборо, Ontario, Canada
  • 2007
    • Laval University
      • Département de Phytologie
      Québec, Quebec, Canada
  • 2002
    • Health Canada
      Ottawa, Ontario, Canada