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OBJECTIVE: To test for and estimate variation among rheumatologists in their prescribing of prednisone and second-line agents for the treatment of rheumatoid arthritis (RA), after taking into account the characteristics of their patients. METHODS: Multiple logistic regression incorporating random effects for rheumatologists, with adjustment for patient characteristics. RESULTS: Values for the likelihood-ratio statistic provided strong evidence of such variation. Random-effect variance estimates showed that the variation is of great magnitude. CONCLUSION: Even after patient characteristics have been taken into account, the data show that the rheumatologist may strongly influence the use of prednisone and second-line agents by a patient.
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Criswell et al. (1994) studied this question.
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