Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Is a life style change approach to patients/individuals with degenerative joint disease more effective than the traditional standard of care?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Two groups will be compared: control group will be exposed to the standard of care for patients/individuals with DJD of lower limbs (hip and knees). The experimental group will be immersed in a direct supervision approach with nutritionists, physical educational and conditioning. Both groups will be followed by a Musculo Skeletal clinician on a outpatient basis. Both groups will be evaluated and compared at the begining, 3 months, 6 months and 1 year as far as pain level (VAS), validated functional outcomes and overall satisfaction perceived.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

This question applies to middle aged adults, presenting with DJD of Hips and knees and consequent decreased function and quality of life. Both groups will be followed propectively and will be composed as much comparable as possible so a comparison can be applied. It is common that comorbities exist, but patients will be randomly selected into either group.

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

No subgroup is anticipated. Again, in the selection and randomization of patients an effort will be made to produce two comparable groups.

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Benefits will be improved pain level, functional level and overall quality of life.

Describe any health-related risks, side effects, or harms that you are concerned about.

Not anticipated risks, harms or side effects. All patients will be cleared by their respective PCP BEFORE starting in the program as condition to participate in the study.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Arthritis and nontraumatic joint disorders
• Functional limitations and disability
• Obesity

AHRQ Priority Populations

• Low income groups
• Elderly

Federal Health Care Program

• Medicare
• Other

Importance

Describe why this topic is important.

The projected number of ppatients/individual with DJD (Degenerative Joint Disease) will increase exponentially over the next decade; transforming this even more relevant.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

Poor results with the traditional standard of care for these patients.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

no

If yes, please explain:

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

Yes. If the null hypothesis proves to be true a more efective approach will be possibly considered.

Describe the timeframe in which an answer to your question is needed.

About a year. Given that the objective is to launch and test life style changes a one year period is the minimum acceptable.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

BMI, body weight, blood presure, incidence of Diabetes Melitus, presence and worsening DJD lower limbs to mention a few.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

Yes. If the null hypothesis proves to be true a more efective approach will be possibly considered.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program

through the internet US Dept Education.