Health outcomes represent all physical and social consequences of disease. These include symptoms, functioning, costs, complications of treatment, and mortality.

The overall goals of our research effort are to:

1. Understand the factors that influence health outcomes of patients with systemic lupus erythematosus, ankylosing spondylitis, and rheumatoid arthritis.
2. Develop new tools and techniques to measure outcomes in these diseases.
3. Assess rheumatic disease in an underserved minority community.
4. Compare outcomes among patients having orthopedic surgery.

Patient-related factors, such as demographic characteristics, genetic background, and treatment, influence health outcomes. Certain provider-related factors, including access to care, also influence health outcomes. We are studying genetic, clinical, and treatment influences on functional and structural outcomes in ankylosing spondylitis, and provider influences on outcomes in patients with lupus nephritis and hospitalized patients with systemic lupus erythematosus. Among measures of health outcomes, we are testing criteria for clinically important changes in symptoms in patients with rheumatoid arthritis, and are developing methods to quantify the progression of spinal fusion in patients with ankylosing spondylitis. We are examining associations between chronic bisphosphonate use and bone structure and risk of hip fracture.