What is the best source of state arthritis data?
We recommend using data from the Behavioral Risk Factor Surveillance System (BRFSS)
for state estimates of the burden of arthritis.
A note about combining years of data.
Different questions
and case definitions were used to
collect data between 1996–2001 and from
2002 forward. For this reason, it is not valid to look at trends that cross from 2001
into 2002. An overview of
BRFSS arthritis question changes is available. Read more
about the arthritis case definition.
View the summary of these
state-specific 2003, 2005, and 2007 BRFSS prevalence data.
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What are the best sources of data for arthritis
prevalence for the nation?
The best source for national arthritis prevalence estimates is the National
Health Interview Survey (NHIS), an annual survey conducted by the National
Center for Health Statistics. Each year, the NHIS samples U.S. households and
gathers information on select adult and child members living in each
household. Estimates of health conditions and behaviors from the NHIS are
representative of the U.S. civilian, noninstitutionalized population.
In 2002, new questions (identical to the 2002
BRFSS Arthritis Burden Questions) were included on the NHIS survey to estimate arthritis prevalence in the United States. Cases
are defined in the same way as by BRFSS. Self-reported, doctor-diagnosed
arthritis is estimated using the question: “Have you ever been told by a
doctor or other health professional that you have some form of arthritis,
rheumatoid arthritis, gout, lupus, or fibromyalgia?”
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Where should I go for help when I have a question
about using NHIS/BRFSS arthritis data?
Your first step should be to review these FAQs. For questions about the
mechanics of using the BRFSS, you should check with your state BRFSS
coordinator. A list of links and contact information for BRFSS and NHIS are
available below.
Toll-Free Data Inquiries: 1–866–441–6247 (NCHS)
For questions about the arthritis case definition, concepts, and interpretation,
contact us at the Arthritis Program.
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Does the CDC recommend using Medicare and Medicaid
data for surveillance or to generate cost estimates?
No. Dr. Ken Powell from the Georgia
Department of Human Resources explored
the use of these data (Powell KE, Diseker RA, Presley RJ,
et al. Administrative data as a tool for arthritis surveillance: Estimating
prevalence and utilization of services. Journal of Public Health Management
and Practice. 2003;9(4):291–298). He found
one can obtain different answers, depending on
1) how variables are defined, 2) the number of years included, and 3) how enrollment is defined. He also
found that using these data was very labor intensive and was difficult
to justify.
In the absence of a clear link to a project, or to your state arthritis plan,
we recommend you do not analyze Medicaid or Medicare data, especially if it
takes program resources.
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Does the CDC recommend the use of pharmacy data for
arthritis surveillance or to make cost estimates?
No. One problem is that very few arthritis medications are used only for
arthritis; most are used for other conditions as well. For example, some of the biologics can
cost $15,000 to $20,000 a year and are used for other conditions like
inflammatory bowel disease. This is an issue that needs to be further
explored to determine the utility of these data.
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Does the CDC recommend using Veterans Administration
(VA) data for arthritis surveillance?
No. VA data would be relevant only to the special population using the VA, and
cannot be generalized to the whole population.
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Does the CDC recommend the use of hospital discharge
data for arthritis surveillance?
In general the answer is no. The data are not
useful for community prevalence estimates. We
recommend this only if such an analysis will make a difference in your program
activities or program plans.
At the national level, we have determined arthritis impact on hospitalizations
by looking at the National Hospital Discharge Survey. We will do similar
impact studies for lupus, rheumatoid arthritis, and osteoarthritis. At the
state level, similar impact studies could be done if there were a complete
source of hospital discharges. However, states are discouraged from
pursuing these activities unless there is a direct link to program activities
and are consistent with state arthritis plans.
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Does CDC have plans to collect or analyze data on
juvenile arthritis?
Estimating arthritis prevalence and impact among children and teens is very
difficult. Juvenile arthritis is relatively uncommon and it is not sensible
to try to collect information through general self-report surveys because it
is so rare. After considerable effort, working with experts in this
contentious field, we have an approach that we think will work for national
surveillance. Sacks JJ, Helmick CG, Luo YH, Ilowite NT, Bowyers S.
Prevalence of an annual ambulatory health core visits for pediatric
arthritis and other rheumatic conditions—United States, 2001-2004.
Arthritis Care Res 2007;57(8):1439-1445.
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How do BRFSS arthritis prevalence estimates compare
with those from NHIS?
Although the two surveys used identical questions in 2002 and 2003, they
generated different national estimates. Some of the
reasons may be:
- Different survey modes: NHIS is administered in person, for the most part, while BRFSS is a phone survey.
- Additional, interspersed questions in NHIS: Compared with the BRFSS, the NHIS
in 2002-2003 interspersed some additional questions about arthritis that
might influence respondents’ answers.
- Cumulative error: from
combining 50 independent BRFSS surveys.
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- Where can I learn more about the Arthritis Conditions Health Effects
Survey (ACHES)?
The Arthritis Conditions Health Effects Survey (ACHES)
developed and funded by the Centers for Disease Control and Prevention
surveyed 2,238 persons with arthritis or chronic joint symptoms aged 45
years or older found by using random digit dialing between June 2005 and
March 2006. Data were gathered on symptoms, limitations, levels of physical
functioning, effects of arthritis on work, knowledge and attitudes about
arthritis, self-management of arthritis, physical activity, anxiety and
depression, and demographics. Data from ACHES are now available for public
use.
Procedure: Proposed research activities involving the use of ACHES data
are reviewed and approved by the Arthritis Team. A special use dataset will
be generated from a subset of the ACHES dataset and will be provided in an
appropriate format determined for each request. Data may be restricted based
on completeness, quality and applicability to requested use, or sensitivity
of release. To obtain access to ACHES survey documentation ( screening and
consent script, questionnaire (English), questionnaire (Spanish), code book,
ACHES final report volume one and/or ACHES final report volume two), email
us at arthritis@cdc.gov and specify the documents you require. To obtain
access to the data applicants must complete the 1)
project summary form
(PDF–10K) and 2)
data sharing use agreement
(PDF–12K)
and return them to:
Chief, Arthritis Program
Division of Adult and Community Health, Arthritis Team
NCCDPHP, Centers for Disease Control and Prevention
4770 Buford Hwy, N.E., Mailstop K-51
Atlanta, GA 30341-3724
Phone: (770) 488-5464 Fax: (770) 488-5486
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