The Arthritis Research Institute of America Post

Paul E. Leaverton, PhD, Special Consultant

Paul E. Leaverton, PhD, Special Consultant

Retired ARIA Director of Research

My relationship with ARIA began in 1985, when I was Acting Director for Epidemiology and Biometry at the National Heart, Lung and Blood Institute at of the National Institutes of Health in Bethesda, Maryland. I had just accepted a new position as founding chairman of the Department of Epidemiology and Biostatistics in the new College of Public Health at the University of South Florida (USF) in Tampa. Early that summer, a quiet young man appeared at my door and asked for a few minutes of my time. He was Brian Burke, who had just begun working for a brand new research institute, ARIA, in Clearwater. Because I was administratively responsible for the Framingham (Massachusetts) Heart Study, upon which ARIA was modeled, he wanted to discuss some of the study design and data management issues. He was surprised to learn that I would soon be moving to the Tampa Bay area; a happy coincidence. I readily agreed to meet with Dr. Barrett and his staff shortly after that time. Thus began a long and, though intermittent, fruitful collaboration. Sometime after my retirement (2001) from USF, Dr. Barrett informed me that “I had flunked retirement” and would I become the new director of research at ARIA? Once again, I readily agreed. There was one caveat; I would continue in this capacity as long as it was fun. Now, after 18 months on the job, it is more gratifying than I could have imagined. Although all three of us on the research staff are part-time, we all very much enjoy working together and analyzing the valuable and voluminous ARIA data sets.

In the late 1980s, under the clear leadership of Dr. Barrett, with the advice of many scientists from around the country, the Clearwater Osteoarthritis Study (COS) took shape and became a reality. There is no question that the COS has become one of the most (if not the most) valuable data sets in the world by which to investigate the onset and natural progression of osteoarthritis (OA). Approximately 500 different variables have been recorded on over 3,700 volunteers over a 22-year period of time. Several subjects have data available for over ten years. Such longitudinal information is in persons with varying stages of OA provides the backbone of this epidemiologic study.

To date, there have been several ARIA publications adding to the scientific literature on the causes and progression of OA. However, in my opinion, the potential of the full data set has hardly been tapped. It is clear to all of us that many outstanding scientific contributions to the field are on the horizon. To ensure a scrupulously “clean” data set as we began new analyses, a project was launched a few months ago. We have labeled it the “Data Integrity Project” (DIP) and, with the unswerving, ongoing devotion of many ARIA volunteers, the entire COS data set is being re-entered and checked. A special report on the DIP will appear in a later newsletter.

The ARIA research staff consists of Epidemiologist Lissa Fahlman, DC, MSPH, Biostatistician Emmeline Sangeorzan, MPH, and me. To augment our capabilities, and taking advantage of the growing recognition of COS’s value, we have been gradually increasing our collaborative arrangements with scientists from other institutions. At this time, established investigators from the Universities of South Florida (Colleges of Medicine and Public Health), Georgia, Miami, Oxford University (UK), the National Center for Health Statistics, and The Florida Knee and Orthopedic Center, are involved in cooperative COS studies with ARIA staff. We are also ably assisted by a succession of graduate students from the
Department of Epidemiology and Biostatistics of the USF College of Public Health.

Enough of the Data Integrity Project has been completed that we are currently in the process of analyzing factors related to the early onset of knee osteoarthritis. Special reports on these and other important ARIA investigations will appear in forthcoming issues. Pardon the cliché, but it truly is an exciting time at ARIA. Every day, my staff and I are grateful for the many volunteers who are working so diligently to make possible all the current and forthcoming studies.

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  • Sep 26, 2011


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  • Paulette

    Sep 27, 2011


    Dear Dr. Leaverton, Does epidemiology also study skin diseases? I have eczema. Also, my knees hurt alot in the morning. Are these two things related? Thank you for your time- Paulette

  • Dr. Leaverton

    Sep 28, 2011


    Dear Paulette- Your question covers research, which is my specialty, and medicine, which is not. So, I will answer the first, research related part of your question and Dr. Lissa Fahlman will address the second part. People often ask about epidemiology and skin issues. I think it has to do with the similarity the terms "epidemiology" and "epidermis". These words are both of Greek origin. Breaking them into parts, we can see how they are related and how they are different. "Epi" means: on, upon, at, by, near, over, on top of, toward, against, or among. "Derma" means: skin "Dem" means: the people (as in democracy, demography) "ology" means: the study of So "Epidermis" literally means "on top of the skin", which makes sense, as it is the outer layer of the skin. And "Epidemiology" literally translates to "study of that which is upon or among the people" - the study of diseases as they affect populations, not individuals. So we can see that the terms are related, but do not mean the same thing. I agree with Paul, that the broad category of "epidemiology" includes the study of skin diseases, but that we at ARIA focus on the study of Osteoarthritis (OA). Thanks for your question! Dr. Leaverton From Dr. Fahlman, I am not aware of a direct link between osteoarthritis and eczema. Some medications used for arthritis have rarely caused eczema as a side effect. However, there is much that we don't know and it could be that something in your environment causes both the eczema and the knee pain. Have you noticed something that makes you think they might be related? It is a bit unusual that osteoarthritis would cause pain in both knees at the same time. Exceptions might be if you are elderly, have injured both your knees at some point, you are overweight, or you have an alignment problem. It can be a bit of a challenge to track down causes of knee pain. First I would ask if the knee pain significantly impacts your life or is a slight bother. Do you have other problems with you knees? Are you worried about what might be wrong? If the answer is yes to any of these questions, you probably want to pursue a diagnosis. Do you have a health care person who can help you figure it out? I would expect them to ask you lots of questions, do a physical exam, and some blood work. Based on the results, they may also recommend x-rays or an MRI. Since evidence of knee OA on knee x-rays isn't always related to knee pain, I would be cautious of only doing x-rays and not the rest of the diagnostic process. Hope this was helpful. As a research-only organization, we unfortunately do not have the capabilities to diagnosis and treat people. We can help with information, tho and are glad to do so. Best- Dr. Fahlman

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    Oct 07, 2011


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  • Hellen Parker

    Oct 08, 2011


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