Okemos

This research evaluates anonymous, previously collected medical data to review the outcomes of different treatment methods for chronic pain. The study is a retrospective review involving multiple centers and independent patient groups to compare results across various subgroups. The study examines clinical outcomes related to the use of spinal cord stimulation, radiofrequency (RF), and other implantable device systems from Boston Scientific and other manufacturers. Multiple cohorts will be analyzed based on the type of treatment system used. Participants' medical charts will be reviewed to measure response rates through approximately two years of follow-up. The study focuses on clinical results documented in patient records without any new treatment or intervention administered during the study.

Researchers are evaluating treatment strategies for people with active rheumatoid arthritis (RA) who have not improved despite using tumor necrosis factor inhibitor (TNFi) biologic drugs. The study compares switching to a non-TNFi biologic drug (such as rituximab, abatacept, tocilizumab, or sarilumab) versus switching to a targeted synthetic disease-modifying antirheumatic drug (tsDMARD) like tofacitinib, baricitinib, or upadacitinib. This comparative effectiveness research addresses a critical gap in evidence, as current treatment choices are often based on physician experience or insurance preferences rather than strong data. The study uses patient-reported outcomes (PROs) to provide meaningful information for patient-centered care. Participants will be assigned to receive either a non-TNFi biologic or a tsDMARD as their new treatment for active RA after TNFi biologic therapy. The study allows participants to continue certain conventional synthetic DMARDs (such as methotrexate, sulfasalazine, hydroxychloroquine, or leflunomide) if they have been stable on these for a specified period. Treatment choice is supported by insurance or patient assistance programs to ensure access. This pragmatic trial is designed to reflect real-world practice and includes patients with comorbidities to assess effectiveness and safety in a broad population. During the study, participants will be monitored for changes in functional ability over 12 months using the Health Assessment Questionnaire (HAQ), a sensitive measure for RA impact. Researchers will also evaluate quality of life, productivity, and side effects. The study aims to generate evidence that helps patients and payers make informed decisions about RA treatments based on outcomes that matter most to patients. Total participation includes baseline assessments and follow-up evaluations throughout the 12-month treatment period.