Eric C Sayre

Arthritis Research Centre of Canada, Ричмонд, British Columbia, Canada

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Publications (106)384.31 Total impact

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    ABSTRACT: Background: Osteoarthritis (OA) is the most common joint disease and a major cause of disability. Incidence and prevalence of OA are expected to increase due to population aging and increased levels of obesity. Objective: The purpose of this study was to project the effect of hypothetical interventions that change the distribution of body mass index (BMI) on OA burden in Canada. Methods: We used a microsimulation computer model of OA called POHEM-OA. The model used demographic predictions for Canada and population data from an administrative database in British Columbia and national Canadian surveys. Results: Under the base-case scenario, between 2010 and 2030 OA prevalence is expected to increase from 11.5% to 15.6% in men and 16.3% to 21.1% in women. In scenarios assuming, on average, a 0.3, 0.5 or 1-unit drop in BMI/year, OA prevalence in 2030 would reach 14.9%, 14.6% and 14.2% in men and 20.3%, 19.7%, and 18.5%, in women, respectively. Under these scenarios, the proportion of new cases prevented would be 9.5%, 13.2% and 16.7%, respectively, in men, and 9.1%, 15.2% and 25.0% in women. Targeting only those aged 50 years or older for weight reduction would achieve about 70% of the impact of a full population strategy. Targeting only the obese (BMI>30) would likely result in a larger benefit for men than women. Conclusions: Due to the aging of the population, OA will remain a major and growing health issue in Canada over the next two decades, regardless of the course of the obesity epidemic. This article is protected by copyright. All rights reserved.
    No preview · Article · Nov 2015
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    ABSTRACT: Purpose: To assess risk and time trends of newly recorded myocardial infarction and stroke in cases with systemic sclerosis. Methods: We conducted a matched incident cohort study (1996-2010) among patients satisfying at least one of the following: a) diagnosis of systemic sclerosis on at least two visits within a two-year period by a non- rheumatologist physician; or b) diagnosis of systemic sclerosis on at least one visit by a rheumatologist or from hospitalization; as well as receiving no prior systemic sclerosis diagnosis between 1990 and 1995. Ten controls were matched by birth year, sex and calendar year of exposure from the general population for each case. Incident myocardial infarction, stroke, and myocardial infarction or stroke was recorded from hospital or death certificates. We estimated incidence rate ratios (IRRs) and hazard ratios (HRs) after adjusting for confounders. Results: Among 1,239 individuals with systemic sclerosis and no history of myocardial infarction (83% female, 56 years old) the incidence rate for myocardial infarction was 13.0/1,000 person-years versus 4.1/1,000 person-years in the comparison cohort. The incidence rate for stroke was 8.0/1,000 person-years versus 3.7/1,000 among controls. The adjusted HRs were 3.49 (95% CI; 2.52-4.83) and 2.35 (95% CI; 1.59-3.48) for myocardial infarction and stroke respectively. For myocardial infarction and stroke the risk was highest within the first year following diagnosis (HRs= 8.95 (95% CI, 5.43-14.74) and 5.25 (95% CI, 2.90-9.53), respectively). Conclusion: This large general population-based study indicates an increased risk of myocardial infarction and stroke in patients with systemic sclerosis, especially within the first year of diagnosis.
    No preview · Article · Nov 2015 · The American journal of medicine
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    ABSTRACT: Objective: Limited data are available on the risk of cardiovascular disease in DM and PM. The purpose of this study was to estimate the risk of incident myocardial infarction (MI) and ischaemic stroke in adults with incident PM/DM at the general population level. Methods: We assembled a retrospective cohort of all adults with incident PM/DM in British Columbia, and we matched up to 10 adults randomly selected from the general population. We estimated the incidence rates (IRs) per 1000 person-years for MI and stroke. We calculated hazard ratios (HRs), adjusting for potential confounders. Results: Among 774 new cases of inflammatory myopathies, 424 had PM (59% female, mean age 60 years) and 350 had DM (65% female, mean age 56 years). IRs for MI and stroke in PM were 22.52 and 10.15 events per 1000 person-years, respectively, vs 5.50 and 5.58 events in the comparison cohort, respectively. Fully adjusted HRs (95% CI) were 3.89 (95% CI: 2.28, 6.65) for MI and 1.76 (95% CI: 0.91, 3.40) for stroke. The age-, sex- and entry time-matched HRs for MI and stroke were highest in the first year after PM diagnosis (6.51, [95% CI: 3.15, 13.47] and 3.48 [95% CI: 1.26, 9.62], respectively). Similar trends were seen for DM. Conclusion: Our study demonstrates that PM and DM are both associated with an increased risk of MI but not ischaemic stroke. Our findings support increased vigilance in cardiovascular prevention, surveillance and risk modification in adults with PM and DM.
    No preview · Article · Sep 2015 · Rheumatology (Oxford, England)
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    ABSTRACT: To determine the risk of newly recorded myocardial infarction (MI) and stroke among incident GCA cases compared with controls from the general population. We also evaluated time trends during follow-up. We conducted a matched cohort study (1996-2010) of all patients with incident GCA from the province of British Columbia, Canada. We estimated incidence rates of MI and stroke according to GCA disease duration. We calculated hazard ratios (HRs), adjusting for potential confounders. Among 809 individuals with GCA (mean age 75.9 years, 75.8% female), 83 developed MI and 60 developed stroke, with corresponding incidence rates of 38.1 and 26.4/1000 person-years, respectively. Compared with non-GCA cases, the age-, sex- and entry time-matched HRs were 2.75 (95% CI 2.16, 3.50) for MI and 2.21 (95% CI 1.68, 2.91) for stroke. When other covariates were adjusted for, the corresponding HRs were 1.77 (95% CI 1.29, 2.43) and 2.04 (95% CI 1.43, 2.93). The age-, sex- and entry time-matched HRs for MI and stroke were highest during the first year after GCA diagnosis [4.76 (95% CI 3.29, 6.88) and 3.20 (95% CI 2.11, 4.87), respectively]. These findings provide general population-based evidence that GCA patients are at a substantially increased risk of cardiovascular disease. Increased monitoring for this potentially fatal outcome and its modifiable risk factors is warranted for GCA patients. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    No preview · Article · Aug 2015 · Rheumatology (Oxford, England)
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    ABSTRACT: Objective To determine the association of body mass index (BMI) with incidence and progression of knee effusion on magnetic resonance imaging (MRI) and physical examination (PE) in a longitudinal cohort with knee pain.MethodsA population-based cohort was assessed at baseline and 3 years (N=163). BMI was categorized: normal (<25), overweight (25–29.9), obese (≥30). Knee effusion was graded 0-3 (absent/mild/moderate/severe) on MRI and 0-1 (absent/present) on PE. Progression of MRI effusion (MRIeff) was an increase of ≥1 grade in those with grade 1 or 2 at baseline. Incident MRIeff and PE effusion (PEeff) are any effusion at follow-up (>0) in those with grade 0 at baseline. A second type of incident MRIeff was effusion grade ≥2 at follow-up in those with grade <2 at baseline. Exponential regression analysis was used, adjusted for age, sex and radiographic severity.ResultsIncident MRIeff≥1, incident MRIeff≥2, incident PEeff, and progression of MRIeff were seen in 14/73 (19%), 18/140 (13%), 26/127 (20%) and 18/86 (21%), respectively. There was a borderline statistical association of obesity with progression of MRIeff (HR 3.3, 95%CI 1.0-11.2) and with incident MRIeff≥2 (HR 3.4, 95%CI 1.0-11.5). BMI was not associated with incident MRIeff≥1 (HR [95%CI] overweight: 1.1 [0.3-3.6]; obese 1.0 [0.2-5.0]). Overweight was associated with incident PEeff (HR 4.5, 95%CI 1.4-14.2), while obesity was not statistically significant (HR 3.1, 95%CI 0.9-11.1).Conclusion Obesity was a risk factor for incident and progressive knee effusion in this population-based cohort. These findings highlight an important link between obesity and inflammation in knee OA. This article is protected by copyright. All rights reserved.
    No preview · Article · Aug 2015

  • No preview · Conference Paper · Jul 2015

  • No preview · Conference Paper · Jul 2015

  • No preview · Conference Paper · Jul 2015
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    ABSTRACT: Background Femoroacetabular impingement (FAI) and physical activity involving hip flexion have been suggested as key risk factors for hip pain among young and middle-aged individuals [1] but population studies have been lacking. Objectives To determine if physical activity involving hip flexion is a risk factor for persistent or recurrent hip pain in young and middle-aged persons with and without FAI. Methods A population sample of persons aged 20-49 with (cases) and without (controls) hip pain in Metro Vancouver, Canada, was selected through random digit dialing. Hip pain was defined as pain in the groin or upper thigh in the past 12 months that lasted 6 weeks or longer or occurred on 3 or more occasions. Subjects completed a lifetime physical activity questionnaire including domestic, occupational and sports/recreational activities. Flexion scores were calculated from reported total hours of activities involving hip flexion>70 degrees (e.g., squatting, kneeling, skiing, rowing, but excluding sitting). Data on peak hip flexion for various activities were derived from the literature. Standardized X-rays of the pelvis/hips with AP and Dunn views were obtained. FAI was defined as one or more of the following: lateral centre edge angle (LCE) >40°, alpha angle >55° and positive cross-over sign. We analyzed the relationship between flexion scores and hip pain among persons with and without FAI using logistic regression. In secondary analyses we a) used hip (rather than person) as the unit of analysis; b) considered only activities prior to the onset of pain. Odds ratios (OR) are reported for a one standard deviation difference in flexion scores. Results Data were obtained for 500 subjects, 269 cases and 231 controls. Mean age was 43 years in both groups, 34% of the cases and 39% of the controls were male. Prevalence of radiographic FAI was 49% in the cases and 43% in the controls. Mean (SD, range) flexion scores were 78 (126, 0-1074) in the cases and 60 (112, 0-782) in the controls for work/domestic activities, and 25 (37, 0-198) and 24 (48, 0-306) for sports activities, respectively. After adjusting for age and sex, a higher flexion score for work/domestic activities was associated with hip pain in subjects with FAI (OR=1.54, 1.01-2.35) but not in those without FAI (OR=1.10, 0.89-1.36). For sports/recreational activities, flexion score was not significantly associated with pain in either group (OR=0.90, 0.71-1.14 and OR=1.25, 0.93-1.68 for those with and without FAI, respectively). The hip-based analysis and the analysis limited to activities prior to the onset of pain showed similar results. Conclusions A one SD increase in the frequency of domestic and work-related activities involving hip flexion is associated with a 50% increase in the risk of persistent or recurrent hip pain in young and middle-aged persons with radiographic FAI. This finding may help understand the causes of hip osteoarthritis. References Acknowledgements The study was supported by a grant from the Canadian Institutes of Health Research. Disclosure of Interest None declared
    No preview · Article · Jun 2015 · Annals of the Rheumatic Diseases
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    ABSTRACT: Objective: To estimate the future risk and time trends of newly diagnosed venous thromboembolism (VTE) in individuals with incident systemic lupus erythematosus (SLE) in the general population. Methods: Using a population-based database that includes all residents of British Columbia, Canada we conducted a study cohort of all patients with incident SLE and up to 10 age-, sex-, and entry-time-matched individuals from the general population. We compared incidence rates of pulmonary embolism (PE), deep venous thrombosis (DVT), and VTE between the two groups according to SLE disease duration. We calculated hazards ratios (HR), adjusting for confounders. Results: Among 4863 individuals with SLE (86% female; mean age, 48.9 years), the incidence rates (IRs) of PE, DVT, and VTE were 2.58, 3.33, and 5.32 per 1000 person-years, respectively, whereas the corresponding rates in the comparison cohort were 0.67, 0.57, and 1.11 per 1000 person-years. Compared with non-SLE individuals, the multivariable HRs among SLE patients were 3.04 (95% CI: 2.08-4.45), 4.46 (95% CI: 3.11-6.41), and 3.55 (95% CI: 2.69-4.69), respectively. The age-, sex-, and entry-time-matched HRs for PE, DVT, and VTE were highest during the first year after SLE diagnosis [13.57 (95% CI: 7.66-24.02), 11.13 (95% CI: 6.55-18.90), and 12.89 (95% CI: 8.56-19.41), respectively]. Conclusion: These findings provide population-based evidence that patients with SLE have a substantially increased risk of VTE, especially in the first year after SLE diagnosis. Awareness and increased vigilance of this potentially fatal, but preventable, complication is recommended.
    Full-text · Article · May 2015 · Seminars in arthritis and rheumatism
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    ABSTRACT: To explore rheumatologists' perception of patient decision aids (PtDAs) and identify barriers to using them in clinical practice. A cross-sectional online survey was conducted with all members of the Canadian Rheumatology Association (CRA; N=459). We subsequently invited 10 respondents to participate in a 30-minute telephone interview to further explore their views on using PtDAs in clinical practice. Interview participants were purposefully sampled to achieve a balance in sex, years in clinical practice, and types of practice. In August - September 2013, 153 CRA members responded to the survey (response rate=33.3%); of those, 113 completed the entire questionnaire. 63 respondents (55.8%) were male, 54 (47.8%) were age 50 or older, and 55 (48.7%) practiced in a multidisciplinary setting. When asked their intention to use PtDAs, participants on average rated 5.7 (SD=2.9; 0=not likely, 10=very likely). 56.6% (n=64) believed that rheumatologists were unfamiliar with PtDAs, and 67.3% (n=76) thought that PtDAs would disturb their workflow. In-depth interviews revealed: 1) the perception that PtDAs were no different from any patient education tools, 2) the concern that PtDAs were of limited value in real life since they relied solely on randomized controlled trial data, and 3) the fear that PtDAs could impair doctor-patient communication. There was a sense of ambivalence among rheumatologists about PtDAs. Our interviews further revealed concerns regarding the utility and benefits of PtDAs in clinical practice. The results showed a need to familiarize physicians with PtDAs, and to develop strategies to support their integration in clinical practice. This article is protected by copyright. All rights reserved. © 2015, American College of Rheumatology.
    No preview · Article · May 2015
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    Full-text · Article · Apr 2015 · Osteoarthritis and Cartilage
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    ABSTRACT: Objectives: The CAT-5D-QOL is a previously reported item response theory (IRT)-based computerized adaptive tool to measure five domains (attributes) of health-related quality of life. The objective of this study was to develop and validate a multiattribute health utility (MAHU) scoring method for this instrument. Study design and setting: The MAHU scoring system was developed in two stages. In phase I, we obtained standard gamble (SG) utilities for 75 hypothetical health states in which only one domain varied (15 states per domain). In phase II, we obtained SG utilities for 256 multiattribute states. We fit a multiplicative regression model to predict SG utilities from the five IRT domain scores. The prediction model was constrained using data from phase I. We validated MAHU scores by comparing them with the Health Utilities Index Mark 3 (HUI3) and directly measured utilities and by assessing between-group discrimination. Results: MAHU scores have a theoretical range from -0.842 to 1. In the validation study, the scores were, on average, higher than HUI3 utilities and lower than directly measured SG utilities. MAHU scores correlated strongly with the HUI3 (Spearman ρ = 0.78) and discriminated well between groups expected to differ in health status. Conclusion: Results reported here provide initial evidence supporting the validity of the MAHU scoring system for the CAT-5D-QOL.
    No preview · Article · Apr 2015 · Journal of clinical epidemiology
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    ABSTRACT: We would like to thank Dr Moiseev1 for his interest in our recent paper on the risk of venous thromboembolism (VTE) in patients with giant cell arteritis (GCA).2 We agree that all systemic autoimmune rheumatic diseases (SARDs) are associated with an increased risk of VTE, as we and others have reported.3-6 Additionally, we have confirmed the increased risk of VTE in patients with GCA in another sample, and those … [Full text of this article]
    Full-text · Article · Nov 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Identifying persons with early rheumatoid arthritis (RA) is a major challenge. The role of the Internet in making decisions about seeking care has not been studied. We developed a method for early diagnosis and referral using the Arthritis Foundation's website. A person with less than 3 months of joint pain symptom who has not yet sought medical attention was screened. Prescreened persons are linked to a self-scoring questionnaire and get a "likelihood" of RA statement. If "likely," the person is offered a free evaluation and biomarker testing performed by Quest Diagnostics. The system available only to Massachusetts's residents yielded a small steady flow of screen-positive individuals. Over 21 months, 43,244 persons took the Arthritis Foundation website prescreening questionnaire; 196 were from Massachusetts and 60 took the self-scoring algorithm. Of the 48 who screened positive, 29 set up an appointment for a free evaluation, but six never came in. Twenty-four subjects were evaluated and diagnosed independently by three rheumatologists. One met the 1987 American College of Rheumatology (ACR) criteria for RA and two met the 2010 ACR/EULAR RA criteria. The 24 examined individuals were contacted at a minimum of 1 year and asked to redo the case-finding questionnaire and asked about their health resource utilization during the interval. Seventeen of the 24 subjects responded, and 10 had seen a health professional. Three of the 17 had a diagnosis of RA; all were on at least methotrexate. Internet case finding was useful in identifying new potential RA cases. The system's performance characteristics are theoretically limited only by the number of study sites available. However, the major barrier may be that seeing a health professional is not a priority for many individuals with early symptoms.
    No preview · Article · Oct 2014 · Clinical Rheumatology

  • No preview · Article · Oct 2014 · Quality of Life Research
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    ABSTRACT: Importance Patients with giant cell arteritis (GCA) may have an increased risk of pulmonary embolism (PE), similar to other systemic vasculitidies; however, no relevant population data are available to date. Objective To evaluate the future risk and time trends of new venous thromboembolism (VTE) in individuals with incident GCA at the general population level. Design Observational cohort study. Setting General population of British Columbia. Participants 909 patients with incident GCA and 9288 age-matched, sex-matched and entry-time-matched control patients without a history of VTE. Main outcome measures We calculated incidence rate ratios (IRR) overall, and stratified by GCA duration. We calculated HR of PE and deep vein thrombosis (DVT), adjusting for potential VTE risk factors. Results Among 909 individuals with GCA (mean age 76 years, 73% women), 18 developed PE and 20 developed DVT. Incidence rates (IR) of VTE, PE and DVT were 13.3, 7.7 and 8.5 per 1000 person-years (PY) in GCA cohort, versus 3.7, 1.9 and 2.2 per 1000 PY in the comparison cohort. The corresponding IRRs (95% CI) for VTE, PE and DVT were 3.58 (2.33 to 5.34), 3.98 (2.22 to 6.81) and 3.82 (2.21 to 6.34) with the highest IRR observed in the first year of GCA diagnosis (7.03, 7.23 and 7.85, respectively). Corresponding fully adjusted HRs (95% CI) were 2.49 (1.45 to 4.30), 2.71 (1.32 to 5.56) and 2.78 (1.39 to 5.54). Conclusions and significance These findings provide general population-based evidence that patients with GCA have an increased risk of VTE, calling for increased vigilance in preventing this serious, but preventable complication, especially within months after GCA diagnosis.
    Full-text · Article · Sep 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Background/objective Patients with polymyositis (PM) and dermatomyositis (DM) may have an increased risk of venous thromboembolism (VTE); however, no general population data are available to date. The purpose of this study was to estimate the future risk and time trends of new VTE (deep venous thrombosis (DVT) or pulmonary embolism (PE)) in individuals with incident PM/DM at the general population level. Methods We assembled a retrospective cohort of all patients with incident PM/DM in British Columbia and a corresponding comparison cohort of up to 10 age-matched, sex-matched and entry-time-matched individuals from the general population. We calculated incidence rate ratios (IRR) for VTE, DVT and PE and stratified by disease duration. We calculated HRs adjusting for relevant confounders. Results Among 752 cases with inflammatory myopathies, 443 had PM (58% female, mean age 60 years) and 355 had DM (65% female, mean age 56 years); 46 subjects developed both diseases. The corresponding IRRs (95% CI) for VTE, DVT and PE in PM were 8.14 (4.62 to 13.99), 6.16 (2.50 to 13.92) and 9.42 (4.59 to 18.70), respectively. Overall, the highest IRRs for VTE, DVT and PE were observed in the first year after PM diagnosis (25.25, 9.19 and 38.74, respectively). Fully adjusted HRs for VTE, DVT and PE remained statistically significant (7.0 (3.34 to 14.64), 6.16 (2.07 to 18.35), 7.23 (2.86 to 18.29), respectively). Similar trends were seen in DM. Conclusions These findings provide the first general population-based evidence that patients with PM/DM have an increased risk of VTE. Increased vigilance of this serious but preventable complication is recommended.
    Full-text · Article · Sep 2014 · Annals of the Rheumatic Diseases

  • No preview · Conference Paper · Jul 2014

  • No preview · Conference Paper · Jul 2014

Publication Stats

647 Citations
384.31 Total Impact Points

Institutions

  • 2006-2015
    • Arthritis Research Centre of Canada
      Ричмонд, British Columbia, Canada
  • 2005-2015
    • University of British Columbia - Vancouver
      • Department of Medicine
      Vancouver, British Columbia, Canada
  • 2006-2009
    • Simon Fraser University
      • Department of Statistics and Actuarial Sciences
      Burnaby, British Columbia, Canada
  • 2004
    • The Arthritis Society
      Toronto, Ontario, Canada