M Patrick

Publications (2)12.42 Total impact

• Source

  Available from: Jan L Hoving

  Article: How reliably do rheumatologists measure shoulder movement?

  J L Hoving, R Buchbinder, S Green, A Forbes, N Bellamy, C Brand, R Buchanan, S Hall, M Patrick, P Ryan, A Stockman
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  ABSTRACT: To assess the intrarater and interrater reliability among rheumatologists of a standardised protocol for measurement of shoulder movements using a gravity inclinometer. After instruction, six rheumatologists independently assessed eight movements of the shoulder, including total and glenohumeral flexion, total and glenohumeral abduction, external rotation in neutral and in abduction, internal rotation in abduction and hand behind back, in random order in six patients with shoulder pain and stiffness according to a 6x6 Latin square design using a standardised protocol. These assessments were then repeated. Analysis of variance was used to partition total variability into components of variance in order to calculate intraclass correlation coefficients (ICCs). The intrarater and interrater reliability of different shoulder movements varied widely. The movement of hand behind back and total shoulder flexion yielded the highest ICC scores for both intrarater reliability (0.91 and 0.83, respectively) and interrater reliability (0.80 and 0.72, respectively). Low ICC scores were found for the movements of glenohumeral abduction, external rotation in abduction, and internal rotation in abduction (intrarater ICCs 0.35, 0.43, and 0.32, respectively), and external rotation in neutral, external rotation in abduction, and internal rotation in abduction (interrater ICCs 0.29, 0.11, and 0.06, respectively). The measurement of shoulder movements using a standardised protocol by rheumatologists produced variable intrarater and interrater reliability. Reasonable reliability was obtained only for the movement of hand behind back and total shoulder flexion.
  Annals of the Rheumatic Diseases 08/2002; 61(7):612-6. · 8.73 Impact Factor
• Article: Incidence of inflammatory myopathies in Victoria, Australia, and evidence of spatial clustering.

  M Patrick, R Buchbinder, D Jolley, X Dennett, R Buchanan
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  ABSTRACT: To determine the incidence of idiopathic inflammatory myopathies (IIM) in Victoria, Australia, and look for evidence of space-time or spatial clustering. Cases of IIM diagnosed between 1989 and 1991 were identified by muscle biopsy and hospital discharge diagnosis review. Diagnosis was verified by medical record review and included if Bohan and Peter criteria for definite or probable disease were met. The pair-wise Euclidean distances between cases' residences were computed using grid references, and temporal distances were calculated between biopsy dates. The Mantel test for space-time clustering was computed. Each patient was also characterized by statistical local area (SLA) according to place of residence. For each SLA, the expected annual incidence of IIM was calculated, based upon its population distribution, and these were compared to the observed annual incidence. Confidence intervals for the true rate ratio (RR) for each SLA were calculated assuming a Poisson distribution, and the level of heterogeneity in the data was examined by calculation of a chi-squared for homogeneity. Ninety-four cases met inclusion criteria for an annual incidence of 7.4 (95% CI 6.0-9.0) per million person-years. No space-time clustering was found (z = -0.434, p = 0.665), but there was evidence of spatial clustering. A total of 67 observed cases were distributed among 58 urban SLA. Four SLA had a greater than expected incidence of myositis (95% Poisson based CI excluded 1), accounting for 20 of the observed cases. The incidence of IIM in Australia is higher than most previous population based estimates. The finding of spatial clustering supports the hypothesis that environmental factors may be important in the pathogenesis of these diseases.
  The Journal of Rheumatology 06/1999; 26(5):1094-100. · 3.69 Impact Factor