A patient can have a bad reaction to a contaminant, such as a fungus, in an unauthorized preparation of marijuana. Therefore, the presenters recommended that healthcare providers ask the patient about everything he or she has ingested.
In supporting medical marijuana, Dr. Kavanaugh cited 12,000 years of data, including an ancient Chinese emperor who apparently declared that cannabis can “undo rheumatism.” Good research data show that marijuana reduces pain, said Dr. Kavanaugh.
However, Dr. Silverman stated that medical marijuana “is not ready for prime time.”
Improved Research Tools Needed
“A number of posters and presentations at this meeting showed that the tools we are using to assess our patients are not sufficient,” said Crawford. “Healthcare professionals are saying we don’t have the right tools, and so we are developing our own.”
At least two posters described efforts to obtain patients’ input about which outcomes to measure, using focus groups (abstract 1589) or consumer advisory councils (abstract 1586). In response to these efforts to develop patient-centered research tools, Crawford said, “This is the year of the real patient.”
Researchers must consider whether the data they are collecting in patient questionnaires are correct and meaningful to the patient, she added. For instance, a question asking, “Can you open a milk carton?” is not relevant to a lactose-intolerant arthritic patient, who likely will respond no, even if the patient has the functional ability to open a carton. “We are making clinical decisions for our patients and making changes based on what, I believe, in some cases are faulty data,” Crawford said.
Crawford has observed an important trend, said audience member Elizabeth Harsha-Strong, MPH, of Northwestern University Feinberg School of Medicine in Chicago.
“Some patients have voiced their frustration with questionnaires,” said Harsha-Strong, who administers these forms in her role as a rheumatology research coordinator at Northwestern. “The questions don’t always apply to everyone, and a reply explaining why they answered the way they did won’t be counted.”
Osteoarthritis Database
Dr. McLean called the Osteoarthritis Initiative, a database for knee osteoarthritis research, “an amazing gold mine of data” and “exciting research.”
This databank of approximately 4,700 patients with or at risk of knee osteoarthritis, as well as healthy controls, was described in an ARHP concurrent session by Michael C. Nevitt, MPH, PhD, and John Lynch, PhD, from the epidemiology department of the University of California, San Francisco. Obtained from a multicenter, four-year observational study, the database contains downloadable results of knee images, biomarkers for blood and urine, DNA and RNA, and joint replacement data. The researchers share this dataset, continually expand it, and encourage research collaboration using the data, Dr. McLean said.
