Variation among rheumatologists in the use of prednisone and second‐line agents for the treatment of rheumatoid arthritis

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Abstract
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.