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Shea B, Pardo JP, Grosskleg S, Beaton DE, Conaghan P, Goettsch W, Hofstetter C, Maxwell L, Musaus J, Ollendorf D, Schultz G, Stevens R, Strand V, Tugwell P, Williamson P, Tunis S, Simon LS. Increasing uptake through collaboration in the development of core outcome sets: Lessons learned at OMERACT 2023. Semin Arthritis Rheum 2024; 66:152438. [PMID: 38555726 DOI: 10.1016/j.semarthrit.2024.152438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE This manuscript highlights the importance of enhancing the uptake of Core Outcome Sets (COS) by building partnerships with Collaborators and addressing their needs in COS development. METHODS AND SETTING This session was structured as a simulation, resembling a format akin to a classic television game show. The moderator posed a series of questions to eight different Collaborator groups who briefly described the importance of COS within their areas of interest. Previous studies examining the uptake of individual core outcomes revealed disparities in uptake rates. The Identified barriers to the uptake of COS include the lack of recommendations for validated instruments for each domain, insufficient involvement of patients and key Collaborator groups in COS development, and a lack of awareness regarding the existence of COS. CONCLUSIONS This analysis underscores the need for COS development approaches that prioritize the inclusion of patients and diverse Collaborator groups at every stage. While current studies on COS uptake are limited, future research should explore the broader implementation of COS across diverse disease categories and delve into the factors that hinder or facilitate their uptake such as, the importance of COS developers extending their work to recommending domains with well validated instruments. Embracing patient leadership and multifaceted engagement is essential for advancing the relevance and impact of COS in clinical research.
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Affiliation(s)
- Beverley Shea
- Ottawa Hospital Research Institute, Clinical Epidemiology Program, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada; Bruyère Research Institute, Ottawa, Canada; University of Ottawa, School of Epidemiology and Public Health, Faculty of Medicine, Ottawa, Canada.
| | - Jordi Pardo Pardo
- Centre for Practice Changing Research and Faculty of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | | | - Dorcas E Beaton
- Institute for Work & Health, Institute Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Philip Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR, UK
| | - Wim Goettsch
- HTA, National Health Care Institute & HTA of Pharmaceuticals, WHO Collaborating Centre of Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Diemen, the Netherlands
| | | | - Lara Maxwell
- Centre for Practice Changing Research and Faculty of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | | | - Daniel Ollendorf
- Value Measurement & Global Health Initiatives Center for the Evaluation of Value and Risk in Health Institute for Clinical Research and Health Policy Studies, UK
| | | | | | - Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University School of Medicine, USA
| | - Peter Tugwell
- University of Ottawa, Department of Medicine, Faculty of Medicine, Ottawa, Canada; Bruyère Research Institute, Ottawa, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada
| | - Paula Williamson
- MRC-NIHR Trials Methodology Research Partnership, Department of Health Data Science, University of Liverpool, Liverpool, UK
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Maxwell LJ, Jones C, Bingham CO, Boers M, Boonen A, Choy E, Christensen R, Conaghan PG, D'Agostino MA, Doria AS, Grosskleg S, Hill CL, Hofstetter C, Horgan B, Kroon F, Leung YY, Mackie S, Meara A, Shea BJ, Simon LS, Touma Z, Tugwell P, Wells GA, Beaton DE. Defining domains: developing consensus-based definitions for foundational domains in OMERACT core outcome sets. Semin Arthritis Rheum 2024; 66:152423. [PMID: 38460282 DOI: 10.1016/j.semarthrit.2024.152423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/15/2024] [Accepted: 02/20/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE To develop a set of detailed definitions for foundational domains commonly used in OMERACT (Outcome Measures in Rheumatology) core domain sets. METHODS We identified candidate domain definitions from prior OMERACT publications and websites and publications of major organizations involved in outcomes research for six domains commonly used in OMERACT Core Domain Sets: pain intensity, pain interference, physical function, fatigue, patient global assessment, and health-related quality of life. We conducted a two-round survey of OMERACT working groups, patient research partners, and then the OMERACT Technical Advisory Group to establish their preferred domain definitions. Results were presented at the OMERACT 2023 Methodology Workshop, where participants discussed their relevant lived experience and identified potential sources of variability giving the needed detail in our domain definitions. RESULTS One-hundred four people responded to both rounds of the survey, and a preferred definition was established for each of the domains except for patient global assessment for which no agreement was reached. Seventy-five participants at the OMERACT 2023 Methodology Workshop provided lived experience examples, which were used to contextualise domain definition reports for each of the five domains. CONCLUSION Using a consensus-based approach, we have created a detailed definition for five of the foundational domains in OMERACT core domain sets; patient global assessment requires further research. These definitions, although not mandatory for working groups to use, may facilitate the initial domain-match assessment step of instrument selection, and reduce the time and resources required by future OMERACT groups when developing core outcome sets.
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Affiliation(s)
- Lara J Maxwell
- Faculty of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Centre for Practice Changing Research, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada.
| | - Caitlin Jones
- Sydney Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, Baltimore MD, USA
| | - Maarten Boers
- Emeritus Professor of Clinical Epidemiology, Department of Epidemiology & Data Science, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Annelies Boonen
- Professor of Rheumatology, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht; Care and Public Health Research Institute Caphri, Maastricht University, Maastricht, the Netherlands
| | - Ernest Choy
- Professor of Rheumatology, CREATE Centre, Section of Rheumatology, Division of Infection and Immunity, Cardiff University, UK
| | - Robin Christensen
- Professor of Biostatistics, Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, & Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds & NIHR Leeds Biomedical Research Centre, UK
| | - Maria Antonietta D'Agostino
- Professor of Rheumatology, Rheumatology Department, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Andrea S Doria
- Department of Diagnostic Imaging and Research Institute, The Hospital for Sick Children; Department of Medical Imaging, University of Toronto, Toronto, Canada
| | | | - Catherine L Hill
- Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | | | | | - Féline Kroon
- Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden; Rheumatology, Zuyderland Medical Centre Heerlen, Heerlen, the Netherlands
| | - Ying Ying Leung
- Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - Sarah Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alexa Meara
- Assistant Professor, Division of Rheumatology, The Ohio State University, Columbus, USA
| | - Beverley J Shea
- Clinical Scientist, Bruyère Research Institute, Senior Methodologist, Ottawa Hospital Research Institute, Adjunct Professor, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | | | - Zahi Touma
- Associate Professor, Division of Rheumatology, Department of Medicine, University of Toronto, Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital Lupus Clinic, Toronto, Canada
| | - Peter Tugwell
- Professor, University of Ottawa, Division of Rheumatology, Department of Medicine, Faculty of Medicine, Ottawa, Canada; Bruyère Research Institute, Ottawa, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada; University of Ottawa, School of Epidemiology and Public Health, Faculty of Medicine, Ottawa, Canada; WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Bruyère Research Institute, Ottawa, Canada
| | - George A Wells
- Director, Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Canada; Professor, School of Epidemiology and Public Health, University of Ottawa, Canada; Professor, Department of Medicine, University of Ottawa, Canada
| | - Dorcas E Beaton
- Senior Scientist, Institute for Work & Health; Associate Professor, Institute Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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3
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Maxwell LJ, Wright GC, Schultz G, Grosskleg S, Barton JL, Campbell W, Guillemin F, Hofstetter C, Shea BJ, Simon LS, Adebajo A, Barnabe C, Goel N, Hurley P, Nikiphorou E, Petkovic J, Tugwell P. Embracing unity at OMERACT: Valuing equity, promoting diversity, fostering inclusivity. Semin Arthritis Rheum 2024; 66:152422. [PMID: 38461757 DOI: 10.1016/j.semarthrit.2024.152422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To increase awareness and understanding of the principles of Equity, Diversity, and Inclusivity (EDI) within Outcome Measures in Rheumatology's (OMERACT) members. For this, we aimed to obtain ideas on how to promote and foster these principles within the organization and determine the diversity of the current membership in order to focus future efforts. METHODS We held a plenary workshop session at OMERACT 2023 with roundtable discussions on barriers and solutions to increased diversity within OMERACT. We conducted an anonymous, web-based survey of members to record characteristics including population group, gender identity, education level, age, and ability. RESULTS The workshop generated ideas to increase diversity of participants across the themes of building relationships [12 topics], materials and methods [5 topics], and conference-specific [6 topics]. Four hundred and seven people responded to the survey (25 % response rate). The majority of respondents were White (75 %), female (61 %), university-educated (94 %), Christian (42 %), spoke English at home (60 %), aged 35 to 55 years (50 %), and did not report a disability (64 %). CONCLUSION OMERACT is committed to improving its diversity. Next steps include strategic recruitment of members to the EDI working group, drafting an EDI mission statement centering equity and inclusivity in the organization, and developing guidance for the OMERACT Handbook to help all working groups create actionable plans for promoting EDI principles.
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Affiliation(s)
- Lara J Maxwell
- Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Centre for Practice Changing Research, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada.
| | - Grace C Wright
- Consultant Rheumatologist at Grace C Wright MD PC, Association of Women in Rheumatology, New York, USA
| | | | | | - Jennifer L Barton
- Division of Arthritis and Rheumatic Diseases, Oregon Health & Science University, VA Portland Health Care System
| | - Willemina Campbell
- Patient Research Partner, Toronto Western Hospital, University Health Network, Toronto ON Canada
| | | | | | - Beverley J Shea
- Clinical Scientist, Bruyère Research Institute, Senior Methodologist, Ottawa Hospital Research Institute, Adjunct Professor, Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada
| | | | - Adewale Adebajo
- Faculty of Medicine, Dentistry and Health, University of Sheffield and Co-Lead for Ethnicity, Diversity and Health, NIHR Biomedical Research Centre, Sheffield, United Kingdom
| | - Cheryl Barnabe
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada
| | - Niti Goel
- Patient Research Partner, Caduceus Biomedical Consulting, LLC, and Adjunct Assistant Professor of Medicine, Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | | | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King's College London, UK and Rheumatology Department, King's College Hospital, London, UK
| | - Jennifer Petkovic
- Bruyere Research Institute, Ottawa Hospital Research Institute, Centre for Practice Changing Research and Centre for Global Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Professor, University of Ottawa, Division of Rheumatology, Department of Medicine, Faculty of Medicine, Ottawa, Canada; Bruyère Research Institute, Ottawa, Canada; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada; University of Ottawa, School of Epidemiology and Public Health, Faculty of Medicine, Ottawa, Canada; WHO Collaborating Centre for Knowledge Translation and Health Assessment Technology in Health Equity, Bruyère Research Institute, Ottawa, Canada
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Elsman EBM, Smith M, Hofstetter C, Gavin F, Jobson E, Markham S, Ricketts J, Baba A, Butcher NJ, Offringa M. A blueprint for patient and public involvement in the development of a reporting guideline for systematic reviews of outcome measurement instruments: PRISMA-COSMIN for OMIs 2024. Res Involv Engagem 2024; 10:33. [PMID: 38515153 PMCID: PMC10956212 DOI: 10.1186/s40900-024-00563-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND In recent years, projects to develop reporting guidelines have attempted to integrate the perspectives of patients and public members. Best practices for patient and public involvement (PPI) in such projects have not yet been established. We recently developed an extension of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), to be used for systematic reviews of outcome measurement instruments (OMIs): PRISMA-COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) for OMIs 2024. Patients and public members formed a small but impactful stakeholder group. We critically evaluated the PPI component in this project and developed recommendations for conducting PPI when developing reporting guidelines. MAIN TEXT A patient partner was an integral research team member at the project development and grant application stage. Once the project started, five patient and public contributors (PPCs) were recruited to participate in the Delphi study; three PPCs contributed to subsequent steps. We collected quantitative feedback through surveys; qualitative feedback was garnered through a focus group discussion after the Delphi study and through debrief meetings after subsequent project activities. Feedback was thematically combined with reflections from the research team, and was predominantly positive. The following themes emerged: importance of PPI partnership, number of PPCs involved, onboarding, design of Delphi surveys, flexibility in the process, complexity of PPI in methodological research, and power imbalances. Impacts of PPI on the content and presentation of the reporting guideline were evident, and reciprocal learning between PPCs and the research team occurred throughout the project. Lessons learned were translated into 17 recommendations for future projects. CONCLUSION Integrating PPI in the development of PRISMA-COSMIN for OMIs 2024 was feasible and considered valuable by PPCs and the research team. Our approach can be applied by others wishing to integrate PPI in developing reporting guidelines.
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Affiliation(s)
- Ellen B M Elsman
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Epidemiology & Data Science, Amsterdam, Netherlands
| | - Maureen Smith
- Patient Partner, Cochrane Consumer Network, Ottawa, ON, Canada
| | - Catherine Hofstetter
- Patient and Public Contributor/Advisor, OMERACT Patient Research Partner, Toronto, ON, Canada
| | - Frank Gavin
- Patient and Public Contributor, Chair of the Public Advisory Council of The Health Data Research Network (Canada), Toronto, ON, Canada
| | - Estelle Jobson
- Patient and Public Contributor, EUPATI Fellow, Nyon, Switzerland
| | - Sarah Markham
- Patient and Public Contributor, King's College London, London, UK
| | | | - Ami Baba
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Martin Offringa
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
- Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
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Benavent D, Carmona L, Lopez-Olivo MA, Hill CL, Westrich-Robertson T, Goel N, Strand V, Shea B, Grosskleg S, Leong A, Hofstetter C, Bingham C, Meyer D, Constien D, Berthelsen DB, Schultz G, de Groot I, Weiner J, Mather K, de Wit M, Böhm P, Cembalo SM, Tugwell P, Bruera S, Suarez-Almazor ME. Patient outcomes in longitudinal observational studies (POLOS) of rheumatoid arthritis: Determining the OMERACT core domain set. Semin Arthritis Rheum 2024; 64:152343. [PMID: 38118370 DOI: 10.1016/j.semarthrit.2023.152343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/18/2023] [Accepted: 12/05/2023] [Indexed: 12/22/2023]
Abstract
OBJECTIVE To define and select rheumatoid arthritis (RA)-specific core domain set for Longitudinal Observational Studies (LOS) within the Outcome Measures in Rheumatology (OMERACT) framework. METHODS A three-round online Delphi exercise, including patient research partners (PRPs) and other community partners in healthcare, was conducted. Domains scored 7-9 (i.e., critically important to include) by ≥ 70 % of participants in both groups were included. Items were consolidated in a subsequent dedicated meeting. RESULTS Nineteen domains scored ≥ 70 % consensus in both groups. The focus group refined these into a list of twelve domains. CONCLUSION The achieved consensus will inform the next steps of developing the core domain set for LOS in RA.
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Affiliation(s)
- Diego Benavent
- Rheumatology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
| | | | - Maria A Lopez-Olivo
- Section of Rheumatology and Clinical Immunology, University of Texas MD Anderson Cancer Center, Texas, USA
| | - Catherine L Hill
- Discipline of Medicine, University of Adelaide; Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia
| | | | - Niti Goel
- Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Vibeke Strand
- Division of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Beverley Shea
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Shawna Grosskleg
- Secretariat, OMERACT, University of Ottawa, Ottawa, Ontario, Canada
| | - Amye Leong
- Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Clifton Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore MD, USA
| | | | | | - Dorthe B Berthelsen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark; Department of Rehabilitation, Municipality of Guldborgsund, Nykoebing F, Denmark
| | | | | | | | | | - Maarten de Wit
- Amsterdam University Medical Centre, Department of Medical Humanities, Amsterdam Public Health
| | | | | | - Peter Tugwell
- Department of Medicine and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Sebastian Bruera
- Department of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Maria E Suarez-Almazor
- Section of Rheumatology and Clinical Immunology, University of Texas MD Anderson Cancer Center, Texas, USA
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Chapman LS, Flurey CA, Redmond AC, Richards P, Hofstetter C, Tapster B, Emmel J, Helliwell PS, Menz HB, Hannan MT, Shea B, Siddle HJ. Living with foot and ankle disorders in rheumatic and musculoskeletal diseases: A systematic review of qualitative studies to inform the work of the OMERACT Foot and Ankle Working Group. Semin Arthritis Rheum 2023; 61:152212. [PMID: 37207417 DOI: 10.1016/j.semarthrit.2023.152212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVES This study aimed to determine outcome domains of importance to patients living with foot and ankle disorders in rheumatic and musculoskeletal diseases (RMDs), by exploring the symptoms and impact of these disorders reported in existing qualitative studies. METHODS Six databases were searched from inception to March 2022. Studies were included if they used qualitative interview or focus group methods, were published in English, and involved participants living with RMDs (inflammatory arthritis, osteoarthritis, crystal arthropathies, connective tissue diseases, and musculoskeletal conditions in the absence of systemic disease) who had experienced foot and ankle problems. Quality was assessed using the Critical Appraisal Skills Programme qualitative tool and confidence in the findings was assessed using the Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach. All data from the results section of included studies were extracted, coded and synthesised to develop themes. RESULTS Of 1,443 records screened, 34 studies were included, with a total of 503 participants. Studies included participants with rheumatoid arthritis (n = 18), osteoarthritis (n = 5), gout (n = 3), psoriatic arthritis (n = 1), lupus (n = 1), posterior tibial tendon dysfunction (n = 1), plantar heel pain (n = 1), Achilles tendonitis (n = 1), and a mixed population (n = 3), who live with foot and ankle disorders. Seven descriptive themes were generated from the thematic synthesis: pain, change in appearance, activity limitations, social isolation, work disruption, financial burden and emotional impact. Descriptive themes were inductively analysed further to construct analytical themes relating to potential outcome domains of importance to patients. Foot or ankle pain was the predominant symptom experienced by patients across all RMDs explored in this review. Based on grading of the evidence, we had moderate confidence that most of the review findings represented the experiences of patients with foot and ankle disorders in RMDs. CONCLUSIONS Findings indicate that foot and ankle disorders impact on multiple areas of patients' lives, and patients' experiences are similar regardless of the RMD. This study will inform the development of a core domain set for future foot and ankle research and are also useful for clinicians, helping to focus clinical appointments and measurement of outcomes within clinical practice.
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Affiliation(s)
- Lara S Chapman
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, UK.
| | - Caroline A Flurey
- School of Social Sciences, College of Health, Science, and Society, University of the West of England, Bristol, UK
| | - Anthony C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, UK; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK
| | | | | | - Bethany Tapster
- Library and Information Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Jenny Emmel
- Library Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Philip S Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Marian T Hannan
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Beverley Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Heidi J Siddle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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7
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Chapman LS, Jones J, Redmond AC, Flurey CA, Richards P, Hofstetter C, Smith TO, Arnold JB, Hannan MT, Maxwell LJ, Menz HB, Shea B, Golightly YM, Tugwell P, Beaton D, Conaghan PG, Helliwell PS, Siddle HJ. Developing a core outcome set for foot and ankle disorders in rheumatic and musculoskeletal diseases: A scoping review and report from the OMERACT 2022 foot and ankle special interest group session. Semin Arthritis Rheum 2023; 61:152210. [PMID: 37156170 DOI: 10.1016/j.semarthrit.2023.152210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVES Foot and ankle involvement is common in rheumatic and musculoskeletal diseases, yet high-quality evidence assessing the effectiveness of treatments for these disorders is lacking. The Outcome Measures in Rheumatology (OMERACT) Foot and Ankle Working Group is developing a core outcome set for use in clinical trials and longitudinal observational studies in this area. METHODS A scoping review was performed to identify outcome domains in the existing literature. Clinical trials and observational studies comparing pharmacological, conservative or surgical interventions involving adult participants with any foot or ankle disorder in the following rheumatic and musculoskeletal diseases (RMDs) were eligible for inclusion: rheumatoid arthritis (RA), osteoarthritis (OA), spondyloarthropathies, crystal arthropathies and connective tissue diseases. Outcome domains were categorised according to the OMERACT Filter 2.1. RESULTS Outcome domains were extracted from 150 eligible studies. Most studies included participants with foot/ankle OA (63% of studies) or foot/ankle involvement in RA (29% of studies). Foot/ankle pain was the outcome domain most commonly measured (78% of studies), being the most frequently specified outcome domain across all RMDs. There was considerable heterogeneity in the other outcome domains measured, across core areas of manifestations (signs, symptoms, biomarkers), life impact, and societal/resource use. The group's progress to date, including findings from the scoping review, was presented and discussed during a virtual OMERACT Special Interest Group (SIG) in October 2022. During this meeting, feedback was sought amongst delegates regarding the scope of the core outcome set, and feedback was received on the next steps of the project, including focus group and Delphi methods. CONCLUSION Findings from the scoping review and feedback from the SIG will contribute to the development of a core outcome set for foot and ankle disorders in RMDs. The next steps are to determine which outcome domains are important to patients, followed by a Delphi exercise with key stakeholders to prioritise outcome domains.
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Affiliation(s)
- Lara S Chapman
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, UK
| | - Jennifer Jones
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK
| | - Anthony C Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, UK; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK
| | - Caroline A Flurey
- Department of Health and Social Sciences, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | | | | | - John B Arnold
- Alliance for Research in Exercise, Nutrition & Activity (ARENA), Allied Health & Human Performance Unit, University of South Australia, Adelaide, Australia
| | - Marian T Hannan
- Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Lara J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Hylton B Menz
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Beverley Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA; College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Peter Tugwell
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dorcas Beaton
- Department of Occupational Science and Occupational Therapy, Institute for Work and Health, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK; Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, UK; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK
| | - Philip S Helliwell
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK
| | - Heidi J Siddle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds LS7 4SA, UK.
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Chapman LS, Redmond AC, Flurey CA, Richards P, Smith TO, Arnold JB, Beaton D, Conaghan PG, Golightly YM, Hannan MT, Hofstetter C, Maxwell LJ, Menz HB, Shea B, Tugwell P, Helliwell P, Siddle HJ. Developing an Outcome Measures in Rheumatology (OMERACT) Core set of Outcome Measures for FOot and ankle disorders in RheumaTic and musculoskeletal diseases (COMFORT): core domain set study protocol. Trials 2023; 24:65. [PMID: 36709309 PMCID: PMC9883911 DOI: 10.1186/s13063-023-07104-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/18/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Foot and ankle involvement is common in rheumatic and musculoskeletal diseases (RMDs). High-quality evidence is lacking to determine the effectiveness of treatments for these disorders. Heterogeneity in the outcomes used across clinical trials and observational studies hinders the ability to compare findings, and some outcomes are not always meaningful to patients and end-users. The Core set of Outcome Measures for FOot and ankle disorders in RheumaTic and musculoskeletal diseases (COMFORT) study aims to develop a core outcome set (COS) for use in all trials of interventions for foot and ankle disorders in RMDs. This protocol addresses core outcome domains (what to measure) only. Future work will focus on core outcome measurement instruments (how to measure). METHODS COMFORT: Core Domain Set is a mixed-methods study involving the following: (i) identification of important outcome domains through literature reviews, qualitative interviews and focus groups with patients and (ii) prioritisation of domains through an online, modified Delphi consensus study and subsequent consensus meeting with representation from all stakeholder groups. Findings will be disseminated widely to enhance uptake. CONCLUSIONS This protocol details the development process and methodology to identify and prioritise domains for a COS in the novel area of foot and ankle disorders in RMDs. Future use of this standardised set of outcome domains, developed with all key stakeholders, will help address issues with outcome variability. This will facilitate comparing and combining study findings, thus improving the evidence base for treatments of these conditions. Future work will identify suitable outcome measurement instruments for each of the core domains. TRIAL REGISTRATION This study is registered with the Core Outcome Measures in Effectiveness Trials (COMET) database, as of June 2022: https://www.comet-initiative.org/Studies/Details/2081.
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Affiliation(s)
- Lara S. Chapman
- grid.9909.90000 0004 1936 8403Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK ,grid.507369.eCentre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nottingham, UK
| | - Anthony C. Redmond
- grid.9909.90000 0004 1936 8403Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK ,grid.507369.eCentre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nottingham, UK ,grid.454370.10000 0004 0439 7412National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK
| | - Caroline A. Flurey
- grid.6518.a0000 0001 2034 5266Department of Health and Social Sciences, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | - Toby O. Smith
- grid.7372.10000 0000 8809 1613Warwick Clinical Trials Unit, University of Warwick, Warwick, UK
| | - John B. Arnold
- grid.1026.50000 0000 8994 5086IIMPACT in Health, Allied Health & Human Performance Unit, University of South Australia, Adelaide, Australia
| | - Dorcas Beaton
- grid.17063.330000 0001 2157 2938Institute for Work and Health, and Department of Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON Canada
| | - Philip G. Conaghan
- grid.9909.90000 0004 1936 8403Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK ,grid.507369.eCentre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nottingham, UK ,grid.454370.10000 0004 0439 7412National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds, UK
| | - Yvonne M. Golightly
- grid.10698.360000000122483208Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC USA ,grid.266813.80000 0001 0666 4105College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE USA
| | - Marian T. Hannan
- grid.239395.70000 0000 9011 8547Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | | | - Lara J. Maxwell
- grid.28046.380000 0001 2182 2255Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
| | - Hylton B. Menz
- grid.1018.80000 0001 2342 0938School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC Australia
| | - Beverley Shea
- grid.412687.e0000 0000 9606 5108Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Peter Tugwell
- grid.28046.380000 0001 2182 2255Department of Medicine, University of Ottawa, Ottawa, ON Canada
| | - Philip Helliwell
- grid.9909.90000 0004 1936 8403Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Heidi J. Siddle
- grid.9909.90000 0004 1936 8403Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Lopez-Olivo MA, Foreman JT, Leung C, Lin HY, Westrich-Robertson T, Hofstetter C, des Bordes JKA, Lyddiatt A, Leong A, Willcockson IU, Peterson SK, Suarez-Almazor ME. A randomized controlled trial evaluating the effects of social networking on chronic disease management in rheumatoid arthritis. Semin Arthritis Rheum 2022; 56:152072. [PMID: 35872394 PMCID: PMC9862615 DOI: 10.1016/j.semarthrit.2022.152072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/25/2022] [Accepted: 07/14/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Social networking has been shown to improve health outcomes in certain patient populations. While patients with rheumatoid arthritis (RA) increasingly use social networking to communicate with peers, the effects of these interactions are largely unknown. METHODS In a randomized controlled trial, we compared RA patients who participated in a social networking group moderated by peer leaders and who had access to a static website offering RA materials with a control group, who only had access to the website. The primary outcomes were patients' RA knowledge, self-efficacy and empowerment. Secondary outcomes included participation in desired health behaviors, and satisfaction with peer support, among others. Follow-up assessments were conducted at 3 and 6 months. Participants who never signed in were excluded from the primary analysis. RESULTS 105 participants were randomized to each group. Mean age was 52 (±12.4) and 92.4% were females. Knowledge scores improved in both groups, but only in the control group the differences observed at 3 and 6 months were significant (p≤0.02). Self-efficacy scores also improved in both groups, but only the differences observed at 6 months in the Facebook group were significant (p=0.02). When comparing groups, at 3 months the knowledge improvements observed in the control group were greater compared with those observed in the Facebook group (mean difference 0.4 versus 0.1; respectively, p=0.03). No other differences were observed in secondary outcomes between the 2 groups, except in peer support satisfaction. The Facebook® group reported greater peer support satisfaction in 3 out 5 subscales compared with the control group (p≤0.04). CONCLUSION Peer support satisfaction was higher in participants using an online social network, but this was not translated into greater disease knowledge or empowerment.
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Affiliation(s)
- Maria A Lopez-Olivo
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Jessica T Foreman
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Cheuk Leung
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Heather Y Lin
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | | | | | - Jude K A des Bordes
- Department of Family Medicine, McGovern Medical School, Houston, TX, United States
| | - Anne Lyddiatt
- Musculoskeletal Group, Cochrane Collaboration, Ontario, Canada
| | - Amye Leong
- Healthy Motivation and the Global Alliance for Musculoskeletal Health of the Bone and Joint Decade, Santa Barbara, CA, United States
| | - Irmgard U Willcockson
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, United States
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Maria E Suarez-Almazor
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
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Verstappen S, Boonen A, Wilkinson S, Beaton D, Bosworth A, Canas da Silva J, Crepaldi G, Dadoun S, Hofstetter C, Mihai C, Ramiro S, Sakellariou G, Meisalu S, Wallman JK, Lacaille D. POS0011 COMPARISON OF PSYCHOMETRIC PROPERTIES OF FOUR GLOBAL MEASURES OF PRESENTEEISM IN PATIENTS WITH OSTEOARTHRITIS AND INFLAMMATORY ARTHRITIS: A EULAR-PRO STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundWork is an important outcome for people with inflammatory arthritis (IA including PsA, RA, AxSpA) and osteoarthritis (OA). It is known that people with IA and OA are at increased risk of sick leave and have to stop working early due to ill health. In addition to being at increased risk of becoming work disabled and increased absenteeism, high levels of presenteeism (i.e. reduced productivity/limited ability to work due to ill health whilst at work) have also been reported. Several instruments exist to measure presenteeism, including single-item global measures and multi-item instruments. In some studies using single-item global instruments may be more feasible. However, available global instruments differ in concept, recall period and reference. It is important to understand which of the measures have good psychometric properties before using them in clinical studies.ObjectivesTo assess the psychometric properties of four global presenteeism instruments.MethodsPatients with IA or OA were recruited via rheumatology outpatient clinics to a large international, longitudinal observational study including 8 European countries and Canada. Participants completed a survey at baseline, 1, 2, 3, 4 wks, 2 months and 3 months. The four global measures of presenteeism included: Work Productivity and Activity Impairment Questionnaire (WPAI), Work Productivity Scale–Rheumatoid Arthritis (WPS-RA), Work Ability Index (WAI) and the Quality*Quantity questionnaire (QQtotal/10) scale. To facilitate score interpretation the WAI and QQtotal were reversed. Pain was measured using an 11-point Likert scale. Spearman correlations were calculated between the presenteeism measures and the Workplace Activity Limitations Scale (WALS), a validated multi-item measure of presenteeism, and HAQ to evaluate construct validity (validity: r <0.50=low; r >0.50-<0.70=moderate; r >0.70=high). Test-retest reliability of the 4 presenteeism scales (baseline-1wk) was measured applying ICC in patients with stable disease (i.e. same pain score at baseline and 1wk) (reliability: ICC<0.40=poor; ICC 0.40-0.75=fair to good; ICC >0.75=excellent). Responsiveness during 3 months was measured comparing patients with improvement in pain score (>1 point improvement in pain score (~MCID pain)) with patients with no change or worsening in pain score. The two groups were compared applying Mann Whitney U test.ResultsThis international study included 550 patients with a mean age of 47.8 (SD 9.9) yrs and 61.4% were female. Mean (SD) disease duration since diagnosis was 10.8 (10.4) yrs and 91.2% had IA. Mean (SD) presenteeism scores at baseline were: WPAI=2.9 (2.7); WPS-RA=3.4 (2.7); WAI=2.7 (2.4); and QQtotal=3.1 (3.2). The correlations between the global measures and with WALS and HAQ were moderate to good, except for QQtotal and HAQ which was low (Table 1). In patients with the same stable pain scores at baseline-1wk (n=141) ICC scores were good to excellent, respectively: WPAI (0.771), WPS-RA (0.752), WAI (0.663), and QQtotal (0.650). An improvement in pain during the 3 month study duration was observed in 145/381 (38%) of the patients. In these patients a significant reduction in mean (SD) change presenteeism was observed for all four presenteeism scales compared to those with no change or worsening of the pain score: WPAI (-1.0 (2.37) vs 0.68 (2.40), p<0.01); WPS-RA (-0.76 (2.57) vs 0.43 (2.10), p<0.001); WAI (-0.09 (2.34) vs 0.41 (2.46), p<0.001); QQtotal (-0.57 (3.16) vs 0.79 (3.1), p<0.01).Table 1.WPAIWPS-RAWAIQQtotalWALSHAQWPAI-0.81640.59920.51840.62690.5592WPS-RA-0.58360.52170.60550.5669WAI-0.58660.52310.5168QQtotal-0.50250.4367ConclusionThe psychometric properties of all 4 global presenteeism scales were moderate to good, with slightly better scores for both the WPS-RA and WPAI instruments both measuring the impact of OA and IA on productivity.Disclosure of InterestsSuzanne Verstappen Consultant of: EUOSHA, Grant/research support from: AbbVie, BMS. EULAR, Annelies Boonen Speakers bureau: Abbvie / Galapagos, Consultant of: Galapagos, Sarah Wilkinson: None declared, Dorcas Beaton: None declared, Ailsa Bosworth: None declared, José Canas da Silva: None declared, Gloria Crepaldi: None declared, Sabrina Dadoun: None declared, Cathie Hofstetter: None declared, Carina Mihai Speakers bureau: Boehringer-Ingelheim, Mepha, MED Talks Switzerland, Consultant of: Boehringer-Ingelheim, Janssen, Grant/research support from: Roche, Boehringer-Ingelheim, Sofia Ramiro Consultant of: AbbVie, Eli Lilly, MSD, Novartis, Pfizer, UCB, Sanofi, Grant/research support from: Grant: AbbVie, Galapagos, Novartis, Pfizer, UCB, Garifallia Sakellariou Consultant of: Abbvie, BMS and Galapagos., Grant/research support from: Abbvie, BMS and Galapagos., Sandra Meisalu: None declared, Johan K Wallman Consultant of: AbbVie, Amgen, Celgene, Eli Lilly, Novartis, Grant/research support from: AbbVie, Amgen, Eli Lilly, Novartis, Pfizer., Diane Lacaille: None declared
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Lenz M, Oikonomidis S, Hartwig R, Gramse R, Meyer C, Scheyerer MJ, Hofstetter C, Eysel P, Bredow J. Clinical outcome after lumbar spinal fusion surgery in degenerative spondylolisthesis: a 3-year follow-up. Arch Orthop Trauma Surg 2022; 142:721-727. [PMID: 33372234 PMCID: PMC8994725 DOI: 10.1007/s00402-020-03697-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 12/03/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Lumbar spinal fusion surgery is a widely accepted surgical treatment in degenerative causes of lumbar spondylolisthesis. The benefit of reduction of anterior displacement and restoration of sagittal parameters is still controversially debated. Purpose of the underlying publication was to analyze the influence of radiographic sagittal parameters of the spine in aspects of changes in postoperative clinical outcome. MATERIALS AND METHODS By prospective analysis, we included patients with low-grade degenerative lumbar spondylolisthesis (Meyerding grades I and II) with mono- or bisegmental fusion surgery with a minimum follow-up data of 3 years. For clinical outcome measures, COMI, ODI and EQ-5D were used. Spinopelvic parameters (sacral inclination, pelvic tilt, sacral slope and pelvic incidence, lumbar lordosis and lumbar index as well as anterior displacement and sagittal rotation) were measured on plain radiographs. RESULTS We could observe a significant benefit in clinical outcome after lumbar fusion surgery in low-grade spondylolisthesis in our mid-term follow-up data including 32 patients. By surgical reduction, we could see significant restoration of anterior displacement and sagittal rotation. Interestingly, a significant correlation between restoration of both sagittal rotation and sacral inclination and clinical outcome score was observed in the 3-year follow-up. CONCLUSION In low-grade spondylolisthesis, spinal fusion surgery is a well-established surgical procedure; however, the impact of sagittal parameters and reduction of anterior displacement remains controversial. Within our findings, restoration of sagittal parameters showed significant correlation to improvement in clinical outcome in our mid-term follow-up data.
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Affiliation(s)
- Maximilian Lenz
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - S. Oikonomidis
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - R. Hartwig
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - R. Gramse
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - C. Meyer
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - M. J. Scheyerer
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - C. Hofstetter
- Department of Neurological Surgery, UW Medicine Seattle, Seattle, WA USA
| | - P. Eysel
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - J. Bredow
- Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
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Petkovic J, Umaefulam V, Wattiaux A, Bartels C, Barnabe C, Greer-Smith R, Hofstetter C, Maxwell L, Shea B, Barton J, Lee AYS, Humphreys J, Beaton D, Tugwell P. Development of an extension of the OMERACT Summary of Measurement Properties table to capture equity considerations: SOMP-Equity. Semin Arthritis Rheum 2021; 51:1300-1310. [PMID: 34625296 DOI: 10.1016/j.semarthrit.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop an equity extension of the OMERACT Summary of Measurement Properties (SOMP) Table, SOMP Equity to describe whether a patient reported outcome measure (PROM) works well among patients of diverse languages and cultures, education levels, and other population characteristics. METHODS We used the PROGRESS-Plus framework to categorize equity characteristics assessed in trials of PROM. PROGRESS refers to Place of residence, Race/ethnicity/culture/language, Occupation, Gender/sex, Religion, Education, Socioeconomic status, and Social Capital, while the 'plus' captures additional characteristics, such as age. We pilot tested our SOMP Equity Extension using the Health Assessment Questionnaire (HAQ) as a prototypical PROM. RESULTS The SOMP Equity Extension retains the same columns as the original OMERACT SOMP (domain match, feasibility, construct validity, test-retest reliability, longitudinal construct validity, clinical trial discrimination, thresholds of meaning) but uses the PROGRESS-Plus characteristics as rows. We found several examples of studies of the HAQ which had assessed one or more PROGRESS-Plus characteristics. CONCLUSIONS The most commonly reported equity considerations were related to language. OMERACT Equity virtual meeting participants were polled and they indicated that the SOMP Equity Extension is useful for highlighting and tracking equity considerations for OMERACT Core Outcome Measurement Instruments.
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Affiliation(s)
- Jennifer Petkovic
- Bruyère Research Institute, University of Ottawa, Ottawa, ON, Canada.
| | - Valerie Umaefulam
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Aimée Wattiaux
- University of Wisconsin School of Medicine and Public Health Madison, Wisconsin, USA.
| | - Christie Bartels
- University of Wisconsin School of Medicine and Public Health Madison, Wisconsin, USA.
| | - Cheryl Barnabe
- Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Regina Greer-Smith
- Healthcare Research Associates, LLC/The S.T.A.R. Initiative, Los Angeles, CA 90033, USA.
| | | | - Lara Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Beverley Shea
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
| | | | | | - Jennifer Humphreys
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, and NIHR Manchester Biomedical Research Centre.
| | - Dorcas Beaton
- Institute for Work and Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Canada.
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada.
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13
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D'Agostino MA, Beaton DE, Maxwell LJ, Cembalo SM, Hoens AM, Hofstetter C, Zabalan C, Bird P, Christensen R, de Wit M, Doria AS, Maksymowych WP, Oo WM, Østergaard M, Serban T, Sloan VS, Terslev L, van Rossum MA, Conaghan PG, Boers M. Improving domain definition and outcome instrument selection: Lessons learned for OMERACT from imaging. Semin Arthritis Rheum 2021; 51:1125-1133. [PMID: 34452758 DOI: 10.1016/j.semarthrit.2021.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/02/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Imaging is one of the most rapidly evolving fields in medicine. Unfortunately, many imaging technologies have been applied as measurement instruments without rigorous evaluation of the evidence supporting their truth, discriminatory capability and feasibility for that context of use. The Outcome Measures in Rheumatology (OMERACT) Filter 2.1 Instrument Selection Algorithm (OFISA) is used to evaluate such evidence for use of an instrument in a research setting. The objectives of this work are to: [1] define and describe the key conceptual aspects that are essential for the evaluation of imaging as an outcome measurement instrument and [2] describe how these aspects can be assessed through OFISA. METHODS Experts in imaging and/or methodology met to formalize concepts and define key steps. These concepts were discussed with a team of patient research partners with interest in imaging to refine technical and methodological aspects into comprehensible information. A workshop was held at OMERACT2020 and feedback was incorporated into existing OMERACT process for domain and instrument selection. RESULTS Three key lessons were identified: (1) a clear definition of the domain we want to measure is a necessary prerequisite to the selection of a good instrument, (2) the sources of variability that can directly influence the instrument should be clearly identified, (3) incorporating these first two lessons into OFISA improves the quality of every instrument selection process. CONCLUSIONS The incorporation of these lessons in the updated OMERACT Filter (now 2.2) will improve the quality of the selection process for all types of outcome measurement instruments.
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Affiliation(s)
- Maria Antonietta D'Agostino
- Università Cattolica del Sacro Cuore; Rheumatology UOC, Fondazione Policlinico Universitario Agostino Gemelli, IRCSS, Rome, Italy; UVSQ, Inserm U1173, Infection et inflammation, Laboratory of Excellence INFLAMEX, Université Paris-Saclay, Montigny-le-Bretonneux, France.
| | - Dorcas E Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto
| | - Lara J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Alison Maria Hoens
- OMERACT Patient Research Partner; University of British Columbia Faculty of Medicine Department of Physical Therapy, Canada; Patient Partner, Arthritis Research Canada
| | | | - Codruta Zabalan
- OMERACT Patient Research Partner; Romanian League against Rheumatism
| | - Paul Bird
- University of New South Wales, Sydney, Australia
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg, Frederiksberg Hospital, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark
| | | | - Andrea S Doria
- The Hospital for Sick Children, Medical Imaging Department, University of Toronto, Toronto, Canada
| | | | - Win Min Oo
- Rheumatology Department, Institute of Bone and Joint Disease, Kolling Institute, Sydney University, Sydney, Australia; Department of Physical Medicine and Rehabilitation, University of Medicine, Mandalay, Mandalay, Myanmar
| | - Mikkel Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Teodora Serban
- La Colletta Hospital, Rheumatology Department, ASL3 Genovese, Genoa, Italy
| | - Victor S Sloan
- Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA; The Peace Corps, USA
| | - Lene Terslev
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marion A van Rossum
- Amsterdam Rheumatology and Immunology Center
- Reade and Emma Children's Hospital Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, UK
| | - Maarten Boers
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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14
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Maxwell LJ, Beaton DE, Boers M, D'Agostino MA, Conaghan PG, Grosskleg S, Shea BJ, Bingham Iii CO, Boonen A, Christensen R, Choy E, Doria AS, Hill CL, Hofstetter C, Kroon FP, Leung YY, Mackie S, Meara A, Touma Z, Tugwell P, Wells GA. The evolution of instrument selection for inclusion in core outcome sets at OMERACT: Filter 2.2. Semin Arthritis Rheum 2021; 51:1320-1330. [PMID: 34544617 DOI: 10.1016/j.semarthrit.2021.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION OMERACT uses an evidence-based framework known as the 'OMERACT Filter Instrument Selection Algorithm' (OFISA) to guide decisions in the assessment of outcome measurement instruments for inclusion in a core outcome set for interventional and observational clinical trials. METHODS A group of OMERACT imaging and patient-centered outcome methodologists worked with imaging outcome groups to facilitate the selection of imaging outcome measurement instruments using the OFISA approach. The lessons learned from this work influenced the evolution to Filter 2.2 and necessitated changes to OMERACT's documentation and processes. RESULTS OMERACT has revised documentation and processes to incorporate the evolution of instrument selection to Filter 2.2. These revisions include creation of a template for detailed definitions of the target domain which is a necessary first step for instrument selection, modifications to the Summary of Measurement Properties (SOMP) table to account for sources of variability, and development of standardized reporting tables for each measurement property. CONCLUSIONS OMERACT Filter 2.2 represents additional modifications of the OMERACT guide for working groups in their rigorous assessment of measurement properties of instruments of various types, including imaging outcome measurement instruments. Enhanced reporting aims to increase the transparency of the evidence base leading to judgements for the endorsement of instruments in core outcome sets.
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Affiliation(s)
- Lara J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Dorcas E Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Maarten Boers
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maria Antonietta D'Agostino
- Università Cattolica del Sacro Cuore, Rome, Italy; Rheumatology UOC, IRCSS, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy; Inserm U1173, Infection et inflammation, Laboratory of Excellence INFLAMEX, Université Paris-Saclay UVSQ, Montigny-le-Bretonneux, France
| | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, and NIHR Leeds Biomedical Research Centre, UK
| | | | - Beverley J Shea
- Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Clifton O Bingham Iii
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands; Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, Bispebjerg Frederiksberg Hospital, Copenhagen, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark
| | - Ernest Choy
- CREATE Centre and Section of Rheumatology, Division of Infection and Immunity, Cardiff University, Cardiff, UK
| | - Andrea S Doria
- The Hospital for Sick Children, Medical Imaging Department, University of Toronto, Toronto, Canada
| | - Catherine L Hill
- Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, Australia; Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | | | - Féline Pb Kroon
- Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands; Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ying Ying Leung
- Department of Rheumatology & Immunology, Singapore General Hospital; Duke-NUS Medical School, Singapore
| | - Sarah Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Alexa Meara
- Division of Rheumatology and Immunology, Ohio State University, Wexner Medical Centre, Columbus, Ohio, United States
| | - Zahi Touma
- Division of Rheumatology, Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Peter Tugwell
- Division of Rheumatology, Department of Medicine, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - George A Wells
- Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Department of Medicine, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
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15
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Grosskleg S, Beaton D, Conaghan P, Hofstetter C, Maxwell L, Shea B, Tugwell P, Bingham CO, Antonietta D'Agostino M, March L, Singh JA, Strand V, Wells G, Simon L. OMERACT 2020: A virtual (R)evolution. Semin Arthritis Rheum 2021; 51:588-592. [PMID: 33941384 DOI: 10.1016/j.semarthrit.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
Affiliation(s)
| | - Dorcas Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Canada
| | - Phil Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, UK
| | | | - Lara Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Bev Shea
- Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Clifton O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, 5200 Eastern Avenue MFL Center 4300, Baltimore, MD 21224, USA
| | - Maria Antonietta D'Agostino
- Università Cattolica del Sacro Cuore, Rheumatology Department, Fondazione Policlinico Universitario Agostino Gemelli, IRCSS, Rome, Italy
| | - Lyn March
- Florance and Cope Professorial Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Jasvinder A Singh
- Medicine Service, VA Medical Center, Department of Medicine at the School of Medicine, University of Alabama at Birmingham (UAB), Department of Epidemiology at the UAB School of Public Health, Birmingham, AL, USA
| | - Vibeke Strand
- Division of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - George Wells
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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16
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Widdifield J, Bernatsky S, Pope JE, Kuriya B, Barber CEH, Eder L, Ahluwalia V, Ling V, Gozdyra P, Hofstetter C, Lyddiatt A, Paterson JM, Thorne C. Evaluation of Rheumatology Workforce Supply Changes in Ontario, Canada, from 2000 to 2030. ACTA ACUST UNITED AC 2021; 16:119-134. [PMID: 33720829 PMCID: PMC7957360 DOI: 10.12927/hcpol.2021.26428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Rheumatology workforces are increasingly challenged by too few physicians in face of the growing burden of rheumatic and musculoskeletal diseases (RMDs). Rheumatology is one of the most frequent non-surgical specialty referrals and has the longest wait times for subspecialists. We used a population-based approach to describe changes in the rheumatology workforce, patient volumes and geographic variation in the supply of and access to rheumatologists, in Ontario, Canada, between 2000 and 2019, and projected changes in supply by 2030. Over time, we observed greater feminization of the workforce and increasing age of workforce members. We identified a large regional variation in rheumatology supply. Fewer new patients are seen annually, which likely contributes to increasing wait times and reduced access to care. Strategies and policies to raise the critical mass and improve regional distribution of supply to effectively provide rheumatology care and support the healthcare delivery of patients with RMDs are needed.
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Affiliation(s)
- Jessica Widdifield
- Scientist, Sunnybrook Research Institute Holland Bone & Joint Program; Assistant Professor, University of Toronto, Institute of Health Policy, Management & Evaluation Toronto, ON; Scientist, ICES Toronto, ON
| | - Sasha Bernatsky
- Rheumatologist and Scientist, Research Institute of the McGill University Health Centre; Associate Professor, Department of Epidemiology, McGill University, Montreal, QC
| | - Janet E Pope
- Rheumatologist, St Joseph's Health Care London; Professor of Medicine Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University London, ON
| | - Bindee Kuriya
- Rheumatologist, Sinai Health System; Assistant Professor, Department of Medicine, University of Toronto, Toronto, ON
| | - Claire E H Barber
- Rheumatologist, Assistant Professor, University of Calgary, Calgary, AB; Research Scientist, Arthritis Research Canada, Richmond, BC
| | - Lihi Eder
- Rheumatologist, Clinician Scientist, Women's College Research Institute, Toronto, ON
| | | | | | | | | | | | - J Michael Paterson
- Scientist, ICES, Toronto, ON; Assistant Professor, Department of Family Medicine, McMaster University, Hamilton, ON; Assistant Professor, University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, ON
| | - Carter Thorne
- Rheumatologist, Southlake Regional Health Centre, Newmarket, ON; Assistant Professor of Medicine, University of Toronto, Toronto, ON
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des Bordes JKA, Foreman J, Westrich-Robertson T, Lopez-Olivo MA, Peterson SK, Hofstetter C, Lyddiatt A, Willcockson I, Leong A, Suarez-Almazor ME. Interactions and perceptions of patients with rheumatoid arthritis participating in an online support group. Clin Rheumatol 2020; 39:1775-1782. [PMID: 32006180 DOI: 10.1007/s10067-020-04967-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/17/2020] [Accepted: 01/27/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Peer support is important for psychosocial well-being in patients with rheumatoid arthritis (RA). Our objective was to assess the interactions, engagement, and perceptions of participants in an online support group for patients with RA. METHODS Participants were 18 years or older, diagnosed with RA within 10 years, and residing in the USA or Canada. All participated in a closed Facebook online support group. Membership was by invitation only, and discussions were visible only to members, moderators, and two research staff. Each week, participants discussed a topic posted by a moderator. They also shared other disease-relevant information beside the topics posted. We assessed participants' engagement and qualitatively analyzed the content of their postings in the first 5 weeks of participation. RESULTS The group had 90 participants: 94% were female and 83% white. Median age was 54 (24-84) years. Mean number of contributors per week was 50 (range, 42-62); 10% of participants never contributed to the discussions. Participation in discussions declined over time. Over three-quarters of participant posting were about information sharing. Participants shared information on disease experiences, medications, social lives (including pictures of themselves, families, and pets), online resources on RA, frustrations, messages of encouragement, and satirical depictions of their disease experience. Many expressed gratitude for the social support provided. CONCLUSION Participants were generally enthusiastic and shared disease-related information and personal experiences. Social media groups may provide alternative means of providing education and peer support often lacking in traditional models of care.Key Points• The study examines how patients with rheumatoid arthritis engage in an online support group and the nature of their interactions.• This study reveals that social media platforms could provide viable options or complements to the traditional face-to-face small group patient support system.• It may be necessary to pay special attention to how to ensure a sustained participant interest in online social support group among patients with rheumatoid arthritis.
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Affiliation(s)
- Jude K A des Bordes
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 437, Houston, TX, 77030, USA
| | - Jessica Foreman
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 437, Houston, TX, 77030, USA
| | | | - Maria A Lopez-Olivo
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 437, Houston, TX, 77030, USA
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Anne Lyddiatt
- Patient Partners in Arthritis, Toronto, Ontario, Canada
| | - Irmgard Willcockson
- School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA
| | - Amye Leong
- Healthy Motivation and the Global Alliance for Musculoskeletal Health of the Bone and Joint Decade, Santa Barbara, CA, USA
| | - Maria E Suarez-Almazor
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 437, Houston, TX, 77030, USA.
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18
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Verstappen SMM, Lacaille D, Boonen A, Escorpizo R, Hofstetter C, Bosworth A, Leong A, Leggett S, Gignac MAM, Wallman JK, Ter Wee MM, Berghea F, Agaliotis M, Tugwell P, Beaton D. Considerations for Evaluating and Recommending Worker Productivity Outcome Measures: An Update from the OMERACT Worker Productivity Group. J Rheumatol 2019; 46:1401-1405. [PMID: 30936275 DOI: 10.3899/jrheum.181201] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The Outcome Measures in Rheumatology (OMERACT) Worker Productivity Group continues efforts to assess psychometric properties of measures of presenteeism. METHODS Psychometric properties of single-item and dual answer multiitem scales were assessed, as well as methods to evaluate thresholds of meaning. RESULTS Test-retest reliability and construct validity of single item global measures was moderate to good. The value of measuring both degree of difficulty and amount of time with difficulty in multiitems questionnaires was confirmed. Thresholds of meaning vary depending on methods and external anchors applied. CONCLUSION We have advanced our understanding of the performance of presenteeism measures and have developed approaches to describing thresholds of meaning.
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Affiliation(s)
- Suzanne M M Verstappen
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia. .,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto.
| | - Diane Lacaille
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Annelies Boonen
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Reuben Escorpizo
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Catherine Hofstetter
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Ailsa Bosworth
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Amye Leong
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Sarah Leggett
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Monique A M Gignac
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Johan K Wallman
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Marieke M Ter Wee
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Florian Berghea
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Maria Agaliotis
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Peter Tugwell
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
| | - Dorcas Beaton
- From the Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; UK National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester University Hospitals National Health Service (NHS) Foundation Trust, Manchester Academic Health Science Centre, Manchester; Arthritis Research UK/Medical Research Council (MRC) Centre for Musculoskeletal Health and Work, University of Southampton, Southampton; National Rheumatoid Arthritis Society (NRAS), Maidenhead, UK; Department of Medicine, and the Division of Rheumatology, University of British Columbia, Vancouver; Arthritis Research Canada, Richmond, British Columbia; Institute for Work & Health; University of Toronto, Toronto; Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Rheumatology, Maastricht University Medical Center, Care and Public Health Research Institute (CAPHRI), Maastricht; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA; Swiss Paraplegic Research, Nottwil, Switzerland; Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology, Lund, Sweden; Carol Davila University of Medicine, Bucharest, Romania; School of Public Health and Community Medicine, University of New South Wales, Kensington, Australia.,S.M. Verstappen, PhD, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, and NIHR Manchester Biomedical Research Centre, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, and Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton; D. Lacaille, MDCM, FRCPC, MHSc, Department of Medicine, and the Division of Rheumatology, Department of Medicine, University of British Columbia, and Arthritis Research Canada; A. Boonen, MD, PhD, Division of Rheumatology, Maastricht University Medical Center, CAPHRI; R. Escorpizo, BSc, MSc, DPT, Department of Rehabilitation and Movement Science, University of Vermont, and Swiss Paraplegic Research; C. Hofstetter, OMERACT Patient Research Partner; A. Bosworth, MBE, OMERACT Patient Research Partner, NRAS; A. Leong, OMERACT Patient Research Partner; S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre; M.A. Gignac, PhD, Institute for Work & Health, and University of Toronto; J.K. Wallman, MD, PhD, Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Rheumatology; M.M. Ter Wee, PhD, MSc, Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, and Department of Rheumatology, Amsterdam Infection and Immunity Institute, Amsterdam Public Health; F. Berghea, MD, PhD, Carol Davila University of Medicine; M. Agaliotis, PhD, MSc, Australian Institute of Health Management Services, University of Tasmania; P. Tugwell, MD, MSc, Division of Rheumatology, Department of Medicine, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, and Clinical Epidemiology Program, Ottawa Hospital Research Institute; D. Beaton, PhD, Institute for Work & Health, and University of Toronto
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Sanders JO, Friedrich K, Gerlach R, Platz J, Miesbach W, Hanke AA, Hofstetter C, Weber CF. Stellenwert der Thrombelastometrie für das Monitoring von Faktor XIII. Hamostaseologie 2017; 31:111-7. [DOI: 10.5482/ha-1132] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
SummaryRecently published studies give evidence, that an increased maximum lysis in the APTEM® – test (ML60 > 12%) of the ROTEM® (Tem International GmbH, Munich, Germany) might indicate a factor XIII deficiency (FXIII < 70%). It was the aim of this study to investigate the feasibility of thrombelastometric measurements with the ROTEM device to reflect the isolated influence of FXIII on clot stability and therefore to indicate potential factor XIII deficiencies. Patients, method: After approval by the local Scientific and Ethic Review Board, 26 consecutive patients, scheduled for elective craniotomy for tumour resection, were prospectively enrolled into this study. Blood samples were taken for conventional laboratory coagulation analyses, FXIII analyses and thrombelastometric measurements (EXTEM, FIBTEM and APTEM tests) after induction of general anaesthesia (T1), before skin incision (T2) as well as at (T3) and 24 hours after (T4) postoperative admission to ICU, respectively. Statistical analyses included Spearman rank order correlations and multiple linear regressions. Results: FXIII concentrations did not correlate with the ML60 in the APTEM test at any measuring point. Neither platelet count nor fibrinogen nor FXIII concentrations were of predictive value for ML60 of the APTEM test. Conclusion: The results lead to the assumption that thrombelastometric measurements may not be appropriate for the perioperative monitoring of FXIII concentration.
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Petkovic J, Barton JL, Flurey C, Goel N, Bartels CM, Barnabe C, de Wit MPT, Lyddiatt A, Lacaille D, Welch V, Boonen A, Shea B, Christensen R, Maxwell LJ, Campbell W, Jull J, Toupin-April K, Singh JA, Goldsmith CH, Sreih AG, Pohl C, Hofstetter C, Beaton DE, Buchbinder R, Guillemin F, Tugwell PS. Health Equity Considerations for Developing and Reporting Patient-reported Outcomes in Clinical Trials: A Report from the OMERACT Equity Special Interest Group. J Rheumatol 2017; 44:1727-1733. [PMID: 28202740 DOI: 10.3899/jrheum.160975] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Despite advances integrating patient-centered outcomes into rheumatologic studies, concerns remain regarding their representativeness across diverse patient groups and how this affects equity. The Outcome Measures in Rheumatology (OMERACT) Equity Working Group aims to determine whether and how to address equity issues within the core outcome sets of domains and instruments. METHODS We surveyed current and previous OMERACT meeting attendees and members of the Campbell and Cochrane Equity Group regarding whether to address equity issues within the OMERACT Filter 2.0 Core Outcome Sets and how to assess the appropriateness of domains, instruments, and measurement properties among diverse patients. At OMERACT 2016, results of the survey and a narrative review of differential psychosocial effects of rheumatoid arthritis (i.e., on men) were presented to stimulate discussion and develop a research agenda. RESULTS We proposed 6 moments for which an equity lens could be added to the development, selection, or testing of patient-reported outcome measures (PROM): (1) recruitment, (2) domain selection, (3) feasibility in diverse settings, (4) instrument validity, (5) thresholds of meaning, and (6) consideration of statistical power of subgroup analyses for outcome reporting. CONCLUSION There is a need to (1) conduct a systematic review to assess how equity and population characteristics have been considered in PROM development and whether these differences influence the ranking of importance of outcome domains or a patient's response to questionnaire items, and (2) conduct the same survey described above with patients representing groups experiencing health inequities.
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Affiliation(s)
- Jennifer Petkovic
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France. .,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work. .,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa.
| | - Jennifer L Barton
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Caroline Flurey
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Niti Goel
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Christie M Bartels
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Cheryl Barnabe
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Maarten P T de Wit
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Anne Lyddiatt
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Diane Lacaille
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Vivian Welch
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Annelies Boonen
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Beverley Shea
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Robin Christensen
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Lara J Maxwell
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Willemina Campbell
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Janet Jull
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Karine Toupin-April
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Jasvinder A Singh
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Charles H Goldsmith
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Antoine G Sreih
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Christoph Pohl
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Catherine Hofstetter
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Dorcas E Beaton
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Rachelle Buchbinder
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Francis Guillemin
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
| | - Peter S Tugwell
- From the Bruyère Research Institute, University of Ottawa; Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; Cochrane Musculoskeletal Group, University of Ottawa; Children's Hospital of Eastern Ontario Research Institute; Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; Department of Medicine, Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Work and Health; Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario; Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta; Division of Rheumatology Department of Medicine, University of British Columbia (UBC); Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC, Vancouver; Arthritis Research Canada, Richmond; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada; Veterans Affairs Portland Health Care System, Oregon Health and Science University, Portland, Oregon; Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina; Quintiles IMS, Denver, Colorado; Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; University of Alabama at Birmingham; Birmingham Veterans Affairs Medical Center, Birmingham, Alabama; Department of Orthopedics, Mayo Clinic College of Medicine, Rochester, Minnesota; Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania, Philadelphia, Pennsylvania, USA; University of the West of England, Bristol, UK; VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute, Amsterdam; Department Internal Medicine, Division of Rheumatology, Maastricht University Medical Center; Caphri Graduate School Maastricht University, Maastricht, the Netherlands; Musculoskeletal Statistics Unit, The Parker Institute; Frederiksberg Hospital, Copenhagen, Denmark; Department Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, Charité - Medical University Berlin, Berlin, Germany; Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; University of Lorraine, Nancy, France.,J.A. Singh has received research grants from Takeda and Savient, and consultant fees from Savient, Takeda, Regeneron, Merz, Iroko, Bioiberica, Crealta and Allergan pharmaceuticals, WebMD, UBM LLC, and the American College of Rheumatology. J.A. Singh serves as the principal investigator for an investigator-initiated study funded by Horizon pharmaceuticals through a grant to DINORA Inc., a 501 (c)(3) entity. J.A. Singh is a member of the executive of OMERACT, an organization that develops outcome measures in rheumatology and receives arms-length funding from 36 companies; a member of the American College of Rheumatology's (ACR) Annual Meeting Planning Committee; Chair of the ACR Meet-the-Professor Workshop and Study Group Subcommittee; and a member of the Veterans Affairs Rheumatology Field Advisory Committee. C. Bartels receives institutional peer-reviewed grant support from Independent Grants for Learning and Change (Pfizer) unrelated to this work.,J. Petkovic, MSc, Bruyère Research Institute, University of Ottawa; J.L. Barton, MD, Veterans Affairs Portland Health Care System, Oregon Health and Science University; C. Flurey, PhD, University of the West of England; N. Goel, MD, Division of Rheumatology, Duke University School of Medicine, and Advisory Services, Quintiles IMS, and Patient Research Partner; C.M. Bartels, MD, MS, Department of Medicine, Rheumatology Division, University of Wisconsin School of Medicine and Public Health; C. Barnabe, MD, Departments of Medicine and Community Health Sciences, University of Calgary; M.P. de Wit, PhD, Patient Researcher, VU University Medical Centre, Department Medical Humanities, EMGO+ Research Institute; A. Lyddiatt, Patient Research Partner; D. Lacaille, MD, MHSc, Professor, Division of Rheumatology Department of Medicine, UBC, and Senior Scientist, Arthritis Research Canada; V. Welch, PhD, Bruyère Research Institute, University of Ottawa; A. Boonen, MD, PhD, Department Internal Medicine, Division of Rheumatology Maastricht, University Medical Center, and Caphri Graduate School Maastricht University; B. Shea, PhD, Ottawa Hospital Research Institute and School of Epidemiology, Public Health and Preventative Medicine, University of Ottawa; R. Christensen, MSc, PhD, Musculoskeletal Statistics Unit, The Parker Institute, and Frederiksberg Hospital; L.J. Maxwell, PhD, Cochrane Musculoskeletal Group, University of Ottawa; W. Campbell, LLB, Patient Research Partner; J. Jull, PhD, Bruyere Research Institute; K. Toupin-April, PhD, Children's Hospital of Eastern Ontario Research Institute, and Department of Pediatrics and School of Rehabilitation Sciences, University of Ottawa; J.A. Singh, MBBS, MPH, Professor of Medicine and Epidemiology, University of Alabama at Birmingham, and Staff Physician, Birmingham Veterans Affairs Medical Center, and Research Collaborator, Department of Orthopedics, Mayo Clinic College of Medicine; C.H. Goldsmith, BSc, MSc, PhD, Faculty of Health Sciences, Simon Fraser University, and Adjunct Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, UBC; A.G. Sreih, MD, Penn Vasculitis Center, Division of Rheumatology, The University of Pennsylvania; C. Pohl, MD, Department of Internal Medicine II, Rheumatology, Schlosspark-Klinik Berlin, University Medicine Berlin; C. Hofstetter, Patient Research Partner; D.E. Beaton, PhD, Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, and Institute for Work and Health, and Occupational Science and Occupational Therapy, Rehabilitation Sciences Institute, Institute of Health Policy Management and Evaluation, University of Toronto; R. Buchbinder, PhD, Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; F. Guillemin, MD, PhD, University of Lorraine; P.S. Tugwell, MD, MSc, Department of Medicine, Faculty of Medicine, University of Ottawa, and Ottawa Hospital Research Institute, Clinical Epidemiology Program, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa
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Widdifield J, Tu K, Carter Thorne J, Bombardier C, Michael Paterson J, Liisa Jaakkimainen R, Wing L, Butt DA, Ivers N, Hofstetter C, Lyddiatt A, Ahluwalia V, Bernatsky S. Patterns of Care Among Patients Referred to Rheumatologists in Ontario, Canada. Arthritis Care Res (Hoboken) 2016; 69:104-114. [PMID: 27110847 DOI: 10.1002/acr.22910] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 03/17/2016] [Accepted: 04/05/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Our aim was to characterize referrals to rheumatologists, the early care management of patients with rheumatic diseases, and timeliness of care and treatment. METHODS We conducted a retrospective observational study involving patients with first-time rheumatology referrals between 2000 and 2013 in the primary care Electronic Medical Record Administrative data Linked Database (EMRALD) in Ontario, Canada. Referrals were characterized in terms of diagnoses, patient demographics, diagnostic tests, treatment initiated by family physicians and rheumatologists, and other specialists seen prior to rheumatology consultation. Timeliness of referrals, rheumatologist consultations, and treatment were determined overall and for each diagnostic category. RESULTS Among 2,430 patients referred to a rheumatologist, 69% were female, with an average age of 53 years. The principal diagnosis associated with the referral included osteoarthritis (32%), systemic inflammatory rheumatic diseases (31%), regional musculoskeletal conditions (16%), chronic pain conditions (14%), osteoporosis (2%), and other/miscellaneous (5%). Family physicians most frequently prescribed nonsteroidal antiinflammatory drugs/cyclooxygenase 2 inhibitors (38%), and their pre-referral diagnostic testing practice varied considerably. The duration of time from symptom onset to rheumatology consultation varied by diagnoses, with the shortest being for patients with systemic rheumatic diseases; for rheumatoid arthritis (RA), the median time to consultation was 327 days. Most of the delay occurred prior to referral; 36% of RA patients initiated a disease-modifying antirheumatic drug within 6 months of symptom onset. CONCLUSION Approximately 1 in 3 referrals to rheumatologists were for a systemic inflammatory rheumatic disease. We observed substantial delays to rheumatology consultations and variations in patterns of care that could be amenable to quality improvement interventions.
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Affiliation(s)
- Jessica Widdifield
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada, and McGill University, Montreal, Quebec, Canada
| | - Karen Tu
- Institute for Clinical Evaluative Sciences, University of Toronto, and University Health Network, Toronto Western Hospital Family Health Team, Toronto, Ontario, Canada
| | | | | | - J Michael Paterson
- Institute for Clinical Evaluative Sciences and University of Toronto, Toronto, Ontario, Canada, and McMaster University, Hamilton, Ontario, Canada
| | - R Liisa Jaakkimainen
- Institute for Clinical Evaluative Sciences and University of Toronto, Toronto, Ontario, Canada
| | - Laura Wing
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Debra A Butt
- University of Toronto and Scarborough Hospital, Toronto, Ontario, Canada
| | - Noah Ivers
- Institute for Clinical Evaluative Sciences and Women's College Hospital, Toronto, Ontario, Canada
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Widdifield J, Bernatsky S, Thorne JC, Bombardier C, Jaakkimainen RL, Wing L, Paterson JM, Ivers N, Butt D, Lyddiatt A, Hofstetter C, Ahluwalia V, Tu K. Wait times to rheumatology care for patients with rheumatic diseases: a data linkage study of primary care electronic medical records and administrative data. CMAJ Open 2016; 4:E205-12. [PMID: 27398365 PMCID: PMC4933643 DOI: 10.9778/cmajo.20150116] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The Wait Time Alliance recently established wait time benchmarks for rheumatology consultations in Canada. Our aim was to quantify wait times to primary and rheumatology care for patients with rheumatic diseases. METHODS We identified patients from primary care practices in the Electronic Medical Record Administrative data Linked Database who had referrals to Ontario rheumatologists over the period 2000-2013. To assess the full care pathway, we identified dates of symptom onset, presentation in primary care and referral from electronic medical records. Dates of rheumatologist consultations were obtained by linking with physician service claims. We determined the duration of each phase of the care pathway (symptom onset to primary care encounter, primary care encounter to referral, and referral to rheumatologist consultation) and compared them with established benchmarks. RESULTS Among 2430 referrals from 168 family physicians, 2015 patients (82.9%) were seen by 146 rheumatologists within 1 year of referral. Of the 2430 referrals, 2417 (99.5%) occurred between 2005 and 2013. The main reasons for referral were osteoarthritis (32.4%) and systemic inflammatory rheumatic diseases (30.6%). Wait times varied by diagnosis and geographic region. Overall, the median wait time from referral to rheumatologist consultation was 74 (interquartile range 27-101) days; it was 66 (interquartile range 18-84) days for systemic inflammatory rheumatic diseases. Wait time benchmarks were not achieved, even for the most urgent types of referral. For systemic inflammatory rheumatic diseases, most of the delays occurred before referral. INTERPRETATION Rheumatology wait times exceeded established benchmarks. Targeted efforts are needed to promote more timely access to both primary and rheumatology care. Routine linkage of electronic medical records with administrative data may help fill important gaps in knowledge about waits to primary and specialty care.
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Affiliation(s)
- Jessica Widdifield
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Sasha Bernatsky
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - J Carter Thorne
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Claire Bombardier
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - R Liisa Jaakkimainen
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Laura Wing
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - J Michael Paterson
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Noah Ivers
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Debra Butt
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Anne Lyddiatt
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Catherine Hofstetter
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Vandana Ahluwalia
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
| | - Karen Tu
- Department of Clinical Epidemiology (Widdifield, Bernatsky), McGill University Health Centre, Montréal, Que.; Department of Epidemiology, Biostatistics and Occupational Health (Widdifield, Bernatsky), McGill University, Montréal, Que.; Department of Rheumatology (Thorne), Southlake Regional Health Centre, Newmarket, Ont.; Departments of Family and Community Medicine (Jaakkimainen, Ivers, Butt, Tu) and Rheumatology (Bombardier), University of Toronto, Toronto, Ont.; Department of Family Medicine (Paterson), McMaster University, Hamilton, Ont.; Department of Family and Community Medicine (Ivers), Women's College Hospital, Toronto, Ont.; Department of Family Medicine (Butt), Scarborough Hospital, Toronto, Ont.; Patient representative (Lyddiatt), Ingersoll, Ont.; Patient representative (Hofstetter), Toronto, Ont.; Department of Rheumatology (Ahluwalia), William Osler Health Centre, Brampton, Ont
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23
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Leggett S, van der Zee-Neuen A, Boonen A, Beaton D, Bojinca M, Bosworth A, Dadoun S, Fautrel B, Hagel S, Hofstetter C, Lacaille D, Linton D, Mihai C, Petersson IF, Rogers P, Sciré C, Verstappen SMM. Content validity of global measures for at-work productivity in patients with rheumatic diseases: an international qualitative study. Rheumatology (Oxford) 2016; 55:1364-73. [PMID: 26796771 DOI: 10.1093/rheumatology/kev435] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES To identify from a patient's perspective, difficulties and differences in the comprehension of five global presenteeism measures in patients with inflammatory arthritis and OA across seven countries. METHODS Seventy patients with a diagnosis of inflammatory arthritis or OA in paid employment were recruited from seven countries across Europe and Canada. Patients were randomly allocated to be cognitively debriefed on 3/5 global measures [Work Productivity Scale - Rheumatoid Arthritis, Work Productivity and Activity Impairment Questionnaire (WPAI), Work Ability Index, Quality and Quantity questionnaire, and WHO Health and Work Performance Questionnaire (HPQ)], with the WPAI debriefed in all patients as a standard measure of comparison between countries and patients. NVivo was used to code the data into four themes: construct and anchor, time recall, reference frame, and attribution. RESULTS Discrepancies were found in the interpretation of the word performance (HPQ) between countries, with Romania and Sweden relating performance to sports rather than work. Seventy percent of patients considered that a 7-day recall (WPAI) can accurately represent how their disease affects work productivity. The compared to normal reference (Quality and Quantity questionnaire) was reportedly too ambiguous, and the comparison with colleagues (HPQ), made many feel uncomfortable. Overall, 29% of patients said the WPAI was the most relevant to them, making it the most favoured measure. CONCLUSION Overall, patients across countries agree that the construct of work productivity in the last 7 days can accurately reflect the impact of disease while at work. Some current constructs to assess at-work productivity are not interchangeable between languages.
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Affiliation(s)
- Sarah Leggett
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK,
| | - Antje van der Zee-Neuen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Dorcas Beaton
- Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Mihai Bojinca
- Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Sabrina Dadoun
- Department of Rheumatology, Université Pierre et Marie Curie, Paris, France
| | - Bruno Fautrel
- Department of Rheumatology, Université Pierre et Marie Curie, Paris, France
| | - Sofia Hagel
- Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden
| | | | - Diane Lacaille
- Arthritis Research Centre of Canada, University of British Columbia, Vancouver, BC, Canada
| | - Denise Linton
- Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, ON, Canada
| | - Carina Mihai
- Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Pam Rogers
- Arthritis Research Centre of Canada, University of British Columbia, Vancouver, BC, Canada
| | - Carlo Sciré
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy and
| | - Suzanne M M Verstappen
- Arthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, Institute of Inflammation and Repair, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK, Arthritis Research UK/MRC Centre for Work and Health, University of Southampton, Southampton, UK
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24
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Leggett S, van der Zee-Neuen A, Boonen A, Beaton DE, Bojinca M, Bosworth A, Dadoun S, Fautrel B, Hagel S, Hofstetter C, Lacaille D, Linton D, Mihai C, Petersson IF, Rogers P, Sergeant JC, Sciré C, Verstappen SMM. Test-retest Reliability and Correlations of 5 Global Measures Addressing At-work Productivity Loss in Patients with Rheumatic Diseases. J Rheumatol 2015; 43:433-9. [PMID: 26628608 DOI: 10.3899/jrheum.141605] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Several global measures to assess at-work productivity loss or presenteeism in patients with rheumatic diseases have been proposed, but the comparative validity is hampered by the lack of data on test-retest reliability and comparative concurrent and construct validity. Our objective was to test-retest 5 global measures of presenteeism and to compare the association between these scales and health-related well-being. METHODS Sixty-five participants with inflammatory arthritis or osteoarthritis in paid employment were recruited from 7 countries (UK, Canada, Netherlands, France, Sweden, Romania, and Italy). At baseline and 2 weeks later, 5 global measures of presenteeism were evaluated: the Work Productivity Scale-Rheumatoid Arthritis (WPS-RA), Work Productivity and Activity Impairment Questionnaire (WPAI), Work Ability Index (WAI), Quality and Quantity questionnaire (QQ), and the WHO Health and Performance Questionnaire (HPQ). Agreement between the 2 timepoints was assessed using single-measure intraclass correlations (ICC) and correlated between each other and with visual analog scale general well-being scores at followup by Spearman correlation. RESULTS ICC between measures ranged from fair (HPQ 0.59) to excellent (WPS-RA 0.78). Spearman correlations between measures were moderate (Qquality vs WAI, r = 0.51) to strong (WPS-RA vs WPAI, r = 0.88). Correlations between measures and general well-being were low to moderate, ranging from -0.44 ≤ r ≤ 0.66. CONCLUSION Test-retest results of 4 out of 5 global measures were good, and the correlations between these were moderate. The latter probably reflect differences in the concepts, recall periods, and references used in the measures, which implies that some measures are probably not interchangeable.
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Affiliation(s)
- Sarah Leggett
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Antje van der Zee-Neuen
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Annelies Boonen
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Dorcas E Beaton
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Mihai Bojinca
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Ailsa Bosworth
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Sabrina Dadoun
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Bruno Fautrel
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Sofia Hagel
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Catherine Hofstetter
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Diane Lacaille
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Denise Linton
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Carina Mihai
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Ingemar F Petersson
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Pam Rogers
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Jamie C Sergeant
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Carlo Sciré
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Suzanne M M Verstappen
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
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Hofstetter C, Cadieux C, Canter Z, Cerasoli D. Characterization of Serum Carboxylesterase Knockout Mice as a Model for Organophosphorous Nerve Agent Research. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.774.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Catherine Hofstetter
- Physiology and Immuniology U.S. Army Medical Research Institute of Chemical DefenseAberdeen Proving GroundMDUnited States
| | - C Cadieux
- Physiology and Immuniology U.S. Army Medical Research Institute of Chemical DefenseAberdeen Proving GroundMDUnited States
| | - Zachary Canter
- Physiology and Immuniology U.S. Army Medical Research Institute of Chemical DefenseAberdeen Proving GroundMDUnited States
| | - Douglas Cerasoli
- Physiology and Immuniology U.S. Army Medical Research Institute of Chemical DefenseAberdeen Proving GroundMDUnited States
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Kaptein SA, Backman CL, Badley EM, Lacaille D, Beaton DE, Hofstetter C, Gignac MAM. Choosing where to put your energy: a qualitative analysis of the role of physical activity in the lives of working adults with arthritis. Arthritis Care Res (Hoboken) 2013; 65:1070-6. [PMID: 23335584 DOI: 10.1002/acr.21957] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 01/08/2013] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research points to many potential benefits of physical activity (PA) for those with arthritis. However, PA has not typically been examined within the context of other life roles. This study examined the perceptions of PA among individuals managing arthritis in addition to employment and other role demands. METHODS Eight focus groups were conducted with 24 women and 16 men (age range 29-72 years) who were currently or recently employed (within 2 years) and had osteoarthritis or inflammatory arthritis. Participants were recruited from community newspaper advertisements, rheumatology clinics, and arthritis groups. Discussions were audiotaped and transcribed. Transcripts were analyzed using qualitative content analysis. RESULTS All groups discussed the impact of arthritis on a range of PAs. Overall, participants discussed PA as positively influencing their health and well-being. Yet, several overarching themes highlighted the complexity of PA, including 1) PA as a potential cause of arthritis; 2) the reciprocal impact of arthritis on PA and PA on arthritis; 3) physical and psychological benefits and harms of PA, such as difficulty making PA decisions when living in pain or when faced with episodic symptoms; 4) perceived choices about engagement in PA (e.g., role overload); and 5) social support. CONCLUSION The relationships among work, health, and other roles were complex. Competing demands, pain, energy, episodic symptoms, support, and decisions to disclose one's illness at work influenced PA. Changes to PA not only affected physical health but also people's self-identity. PA interventions may be improved by taking into account the demands of multiple life roles.
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Hofstetter C. Videolaryngoskopie. Anaesthesist 2012. [DOI: 10.1007/s00101-012-2109-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Brem S, Richardson U, Bach S, Hofstetter C, Martin E, Brandeis D. Audiovisual integration of print and speech emerges when children learn to read: A developmental neuroimaging study. Int J Psychophysiol 2012. [DOI: 10.1016/j.ijpsycho.2012.06.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Jakimovski D, Bonci G, Attia M, Shao H, Hofstetter C, Tsiouris A, Anand V, Schwartz T. Incidence and Significance of Intraoperative CSF Leak in Endoscopic Pituitary Surgery Using Intrathecal Fluorescein. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Gignac MAM, Backman CL, Kaptein S, Lacaille D, Beaton DE, Hofstetter C, Badley EM. Tension at the borders: perceptions of role overload, conflict, strain and facilitation in work, family and health roles among employed individuals with arthritis. Rheumatology (Oxford) 2011; 51:324-32. [PMID: 22039223 PMCID: PMC3262164 DOI: 10.1093/rheumatology/ker317] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective. To examine inter-relationships among arthritis (A), work (W) and personal life (P) roles and their reciprocal influences, especially experiences of role balance/imbalance among individuals with inflammatory arthritis (IA) and OA. Methods. Eight focus groups were conducted with 24 women and 16 men (aged 29–72 years). A purposive sample was recruited from community advertising. Eligibility included current employment or having been employed within the previous year. Participants were asked about ways arthritis, work and personal life roles intersected and their impact. A standardized questionnaire collected demographic, symptom and employment data for descriptive purposes. Results. Participants noted that having arthritis affected their identity and intersected with work and personal roles, creating role overload, role conflict, role strain and role facilitation. Role overload highlighted that arthritis both affected and was impacted by work and personal life (A → W; A → P; W → A; P → A). Role conflict focused on A → W and A → P difficulties, whereas role facilitation emphasized the positive impact of work and personal life roles on arthritis (W → A; P → A). Role strain was pervasive and arose from numerous sources. Personal strategies (e.g. positive framing) and contextual factors (e.g. support) were important in contributing to or ameliorating role balance/imbalance. Conclusions. By comprehensively examining multiple types of role balance/imbalance and the context within which it occurs, this study identifies gaps in patient-oriented measurement of the impact of arthritis and areas of need in the development of arthritis intervention.
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Affiliation(s)
- Monique A M Gignac
- The Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, Main Pavilion 10-316, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada.
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Revermann M, Schloss M, Mieth A, Babelova A, Schröder K, Neofitidou S, Buerkl J, Kirschning T, Schermuly RT, Hofstetter C, Brandes RP. Levosimendan attenuates pulmonary vascular remodeling. Intensive Care Med 2011; 37:1368-77. [DOI: 10.1007/s00134-011-2254-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 03/18/2011] [Indexed: 12/22/2022]
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He H, Emmett MR, Marshall AG, Ji Y, Conrad CA, Priebe W, Colman H, Lang FF, Madden TL, Kristoffersen K, Stockhausen MT, Poulsen HS, Binder ZA, Orr B, Lim M, Weingart JD, Brem H, Olivi A, Riggins GJ, Gallia GL, Litofsky NS, Miller DC, Rath P, Anthony DC, Feng Q, Franklin C, Pei L, Free A, Kirk MD, Shi H, Timmer M, Theiss H, Juerchott K, Ries C, Paron I, Franz W, Selbig J, Guo K, Tonn JC, Schichor C, Zhou YH, Hu Y, Pioli PD, Rajneesh K, Limoli CL, Yu L, Hess KR, Linskey ME, Faber F, Guo K, Jaeger D, Thorsteinsdottir J, Albrecht V, Tonn JC, Schichor C, Price R, Song J, Zimmerman P, Duale H, Rivera A, Kaur B, Parada L, Cook C, Chiocca EA, Kwon CH, Munoz DM, Guha A, Estrada-Bernal A, Van Brocklyn JR, Gu C, Mahasenan KV, Joshi K, Gupta S, Mattson A, Li C, Nakano I, Chi AS, Rheinbay E, Wakimoto H, Gillespie S, Kasif S, Rabkin SD, Martuza RL, Bernstein BE, Skirboll SL, Wurdak H, Zhu S, Romero A, Lorger M, Watson J, Chiang CY, Zhang J, Natu VS, Lairson LL, Walker JR, Trussell CM, Harsh GR, Vogel H, Felding-Habermann B, Orth AP, Miraglia LJ, Rines DR, Schultz PG, Hide T, Takezaki T, Nakamura H, Makino K, Kuratsu JI, Kondo T, Yao J, Kim YW, Koul D, Almeida JS, Weinstein JN, Alfred Yung WK, Joshi K, Miyazaki T, Chaudhury AR, Nakano I, Wong AJ, Del Vecchio C, Mitra S, Han SY, Holgado-Madruga M, Gupta P, Golebiewska A, Brons NH, Bjerkvig R, Niclou SP, Ramm P, Vollmann-Zwerenz A, Beier C, Aigner L, Bogdahn U, Kalbitzer HR, Hau P, Sanzey M, Golebiewska A, Vallar L, Niclou SP, Tamura K, Aoyagi M, Ando N, Ogishima T, Wakimoto H, Yamamoto M, Ohno K, Perin A, Fung KH, Longatti P, Guiot MC, Del Maestro RF, Rossi S, Stechishin O, Weiss S, Stifani S, Goodman L, Gao F, Gumin J, Ezhilarasan R, Love P, George A, Colman H, Lang F, Aldape K, Sulman EP, Soeda A, Lee DH, Shaffrey ME, Oldfield EH, Park DM, Dietrich J, Han R, Noble M, Yang MY, Liu X, Madhankumar AB, Sheehan J, Slagle-Webb B, Connor JR, Fu J, Shen RJ, Colman H, Lang FF, Alfred Yung WK, Koul D, Kaluzova M, Machaidze R, Nduom ENK, Burden CT, Hadjipanayis CG, Lei L, Sonabend A, Guarnieri P, Ludwig T, Rosenfeld S, Bruce J, Canoll P, Vaillant BD, Bhat K, Balasubramaniyam V, Wang S, Gumin J, Sulman E, Lang F, Aldape K, Colman H, Sulman EP, Ezhilarasan R, Goodman LD, Love PN, George A, Aldape K, Soules M, Zhu T, Flack C, Talsma C, Hamm L, Muraszko K, Fan X, Aoyagi M, Matsuoka Y, Tamura K, Ando N, Kawano Y, Ohno K, Kobayashi D, Kumagai J, Frank RT, Najbauer J, Aboody KS, Aboody KS, Najbauer J, Metz M, Garcia E, Aramburo S, Valenzuela V, Gutova M, Annala AJ, Barish M, Danks M, Kim SU, Portnow J, Hofstetter C, Gursel D, Mubita L, Holland E, Boockvar J, Monje M, Freret M, Masek M, Edwards MS, Fisher PG, Vogel H, Beachy P. Stem Cells. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Flondor M, Hoegl S, Scheiermann P, Boost K, Zwissler B, Hofstetter C. Wirkung von inhaliertem Iloprost auf systemische Inflammation und beatmungsinduzierten Lungenschaden. Pneumologie 2010. [DOI: 10.1055/s-0029-1215182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ziesché E, Scheiermann P, Bachmann M, Sadik CD, Hofstetter C, Zwissler B, Pfeilschifter J, Mühl H. Dexamethasone suppresses interleukin-22 associated with bacterial infection in vitro and in vivo. Clin Exp Immunol 2009; 157:370-6. [PMID: 19664145 PMCID: PMC2745031 DOI: 10.1111/j.1365-2249.2009.03969.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2009] [Indexed: 01/24/2023] Open
Abstract
Interleukin (IL)-22 production triggered by innate immune mechanisms has been identified as key to efficient intestinal anti-bacterial host defence and preservation of homeostasis. We hypothesized that glucocorticoid therapy may impair IL-22 expression, which should promote intestinal epithelial damage with the potential of subsequent bacterial translocation. High-dose corticosteroid therapy in Crohn's disease has been associated with an increased rate of abscess formation and ultimately with a higher risk of developing postoperative infectious complications, including abdominal sepsis. Thus, we sought to investigate effects of the prototypic glucocorticoid dexamethasone on IL-22 production in the context of bacterial infection. Enhanced IL-22 plasma levels were detectable in rat sepsis. Moreover, heat-inactivated Staphylococcus epidermidis, used as a prototypic activator of innate immunity, induced robust production of IL-22 by human peripheral blood mononuclear cells (PBMC). Here, we report for the first time that dexamethasone mediates remarkable suppression of IL-22 as detected in S. epidermidis-activated PBMC and rat sepsis, respectively. The data presented herein suggest that insufficient IL-22 function may contribute to impaired intestinal host defence in the context of corticosteroid therapy.
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Affiliation(s)
- E Ziesché
- Pharmazentrum Frankfurt/ZAFES, Intensive Care Medicine and Pain Therapy, University Hospital Goethe University, 60590 Frankfurt am Main, Germany
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Howard BM, Hofstetter C, Wagner PL, Muskin ET, Lavi E, Boockvar JA. Transformation of a low-grade pineal parenchymal tumour to secondary pineoblastoma. Neuropathol Appl Neurobiol 2009; 35:214-7. [PMID: 19284482 DOI: 10.1111/j.1365-2990.2008.00985.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Byhahn C, Zgoda M, Birkelbach O, Hofstetter C, Gromann T. Ciaglia Blue Dolphin: a new technique for percutaneous tracheostomy using balloon dilation. Crit Care 2008. [PMCID: PMC4088704 DOI: 10.1186/cc6554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Flondor M, Hofstetter C, Boost KA, Betz C, Homann M, Zwissler B. Isoflurane inhalation after induction of endotoxemia in rats attenuates the systemic cytokine response. Eur Surg Res 2007; 40:1-6. [PMID: 17717418 DOI: 10.1159/000107614] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2006] [Accepted: 04/19/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Volatile anesthetics are frequently utilized in clinical routine. Isoflurane has been shown to attenuate the response to inflammatory stimuli such as lipopolysaccharide (LPS) when administered before induction of endotoxemia. We aimed therefore to evaluate the effect of isoflurane after administration of LPS on the cytokine release as a therapeutic option. MATERIALS AND METHODS 21 male Sprague-Dawley rats were randomly assigned to the following groups: animals that received LPS (5 mg/kg, i.v.) without further intervention (LPS group), animals that received continuous inhalation of 1 minimum alveolar concentration (MAC) isoflurane 15 min after administration of LPS (Iso group) and no specific intervention (sham group). Four hours following LPS injection, plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), IL-6 and IL-10 were determined. Furthermore, nitrite release from cultured alveolar macrophages was analyzed. RESULTS Inhalation of isoflurane after induction of endotoxemia attenuated the release of TNF-alpha (-52%, p < 0.05) and IL-1 beta (-39%, p < 0.05) as compared to the LPS group, while IL-6 and IL-10 levels were not significantly altered. Nitrite release was significantly increased in the Iso group as compared to the LPS group (+115%, p < 0.05). CONCLUSION Inhalation of 1 MAC isoflurane after induction of endotoxemia in rats attenuates the systemic release of proinflammatory cytokines and concurrently enhances the production of nitrite in cultured alveolar macrophages.
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Affiliation(s)
- M Flondor
- Department of Anesthesiology, Intensive Care and Pain Therapy, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
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Hofstetter C, Boost KA, Flondor M, Basagan-Mogol E, Betz C, Homann M, Muhl H, Pfeilschifter J, Zwissler B. Anti-inflammatory effects of sevoflurane and mild hypothermia in endotoxemic rats. Acta Anaesthesiol Scand 2007; 51:893-9. [PMID: 17635397 DOI: 10.1111/j.1399-6576.2007.01353.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Volatile anesthetics and hypothermia attenuate the inflammatory response. We aimed to compare the anti-inflammatory effects of sevoflurane and mild hypothermia during experimental endotoxemia in the rat. METHODS Anesthetized, ventilated Sprague-Dawley (SD) rats were randomly treated as follows (n = 6 per group): lipopolysaccharide (LPS) only, animals received LPS [LPS 5 mg/kg, intravenously (i.v.)] with no further treatment. In the LPS-hypothermia group, rats were cooled down to a temperature of 33 degrees C 15 min after LPS-injection (LPS 5 mg/kg i.v.). In animals of the LPS-sevoflurane group, sevoflurane inhalation (1 MAC) was initiated 15 min after induction of endotoxemia. The LPS-sevoflurane-hypothermia group received combined sevoflurane and hypothermia 15 min after induction of endotoxemia. A Sham group served as control without endotoxemia or treatment. After 4 h of endotoxemia, plasma levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and IL-10 were measured. Alveolar macrophages (AM) were ex vivo cultured for nitrite assay. RESULTS Inhalation of sevoflurane significantly attenuated plasma levels of TNF-alpha (-60%, P < 0.05) and IL-1beta (-68%, P < 0.05) as compared with the LPS-only group. Hypothermia and its combination with sevoflurane significantly reduced TNF-alpha levels (-46% and -58%, each P < 0.05), but not IL-1beta. Application of mild hypothermia and also its combination with sevoflurane resulted in a significant increase in plasma IL-10 as compared with endotoxemic controls. Nitrite release from AM was found to be significantly suppressed by sevoflurane (-83%), hypothermia (-73%) and by the combination of both (-67%) (P < 0.05, each). CONCLUSION Our data suggest that sevoflurane and mild hypothermia attenuate the inflammatory response during endotoxemia in vivo thus contributing to their beneficial role in clinical organ protection.
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Affiliation(s)
- C Hofstetter
- Clinic for Anesthesiology, Intensive Care Medicine and Pain Therapy, Johann Wolfgang Goethe-University of Frankfurt, Frankfurt, Germany.
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Boost KA, Flondor M, Hofstetter C, Platacis I, Stegewerth K, Hoegl S, Nguyen T, Muhl H, Zwissler B. The beta-adrenoceptor antagonist propranolol counteracts anti-inflammatory effects of isoflurane in rat endotoxemia. Acta Anaesthesiol Scand 2007; 51:900-8. [PMID: 17635398 DOI: 10.1111/j.1399-6576.2007.01363.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Recent studies suggest that volatile anaesthetics have anti-inflammatory and preconditioning properties and that beta-adrenoceptors are involved in the signalling pathways for these effects. Concurrently, the blockade of beta-adrenoceptors has been shown to augment the release of inflammatory mediators in response to pro-inflammatory stimuli. We therefore aimed to investigate whether the beta-adrenoceptor antagonist propranolol might modulate the anti-inflammatory effects of isoflurane on the systemic and pulmonary release of pro-inflammatory cytokines in endotoxemic rats. METHODS Forty anaesthetized and ventilated Sprague-Dawley rats were randomly treated as follows. Lipopolysaccharide (LPS) only (n = 8), endotoxemia with LPS [5 mg/kg, intravenously (i.v.)]. LPS-isoflurane (n = 8): endotoxemia and continuous inhalation of 1 minimum alveolar concentration (MAC) of isoflurane. LPS-isoflurane-propranolol (n = 8): administration of propranolol (3 mg/kg) before continuous inhalation of isoflurane and induction of endotoxemia. LPS-propranolol (n = 8): administration of propranolol (3 mg/kg) before endotoxemia without inhalation of isoflurane. Sham (n = 8): control-group only with surgical preparation. After 4 h of endotoxemia, levels of tumour necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta) and interleukin-10 (IL-10) in plasma and bronchoalveolar fluid (BALF) were analysed. Release of nitric oxide (NO) and amount of inducible nitric oxide synthase (iNOS) protein in alveolar macrophages was measured by Griess assay or determined by Western Blotting, respectively. RESULTS Inhalation of isoflurane reduced the release of TNF-alpha (P < 0.05) and IL-1beta (P < 0.05) in plasma and IL-1beta (P < 0.05) in BALF. Co-administration of propranolol significantly inhibited these effects. During inhalation of isoflurane, the increased release of NO and iNOS protein from alveolar macrophages was also completely inhibited by propranolol. CONCLUSION Our results indicate for the first time, that blockade of beta-adrenoceptors counteracts the anti-inflammatory effects of isoflurane in endotoxemic rats.
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Affiliation(s)
- K A Boost
- Department of Anaesthesiology, Intensive Care and Pain Therapy, University Hospital of Johann Wolfgang Goethe-University Frankfurt am Main, Germany.
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Abstract
Polyomaviruses, as their name indicates, are viruses capable of inducing a variety of tumors in vivo. Members of this family, including the human JC and BK viruses (JCV, BKV), and the better characterized mouse polyomavirus and simian virus 40 (SV40), are small DNA viruses that commandeer a cell's molecular machinery to reproduce themselves. Studies of these virus-host interactions have greatly enhanced our understanding of a wide range of phenomena from cellular processes (e.g., DNA replication and transcription) to viral oncogenesis. The current chapter will focus upon the five known JCV early proteins and the contributions each makes to the oncogenic process (transformation) when expressed in cultured cells. Where appropriate, gaps in our understanding of JCV protein function will be supplanted with information obtained from the study of SV40 and BKV.
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Flondor M, Merkel M, Hofstetter C, Irlbeck M, Frey L, Zwissler B. The effect of inhaled nitric oxide and inhaled iloprost on hypoxaemia in a patient with pulmonary hypertension after pulmonary thrombarterectomy. Anaesthesia 2007; 61:1200-3. [PMID: 17090242 DOI: 10.1111/j.1365-2044.2006.04861.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Acute pulmonary hypertension with life-threatening right heart failure may complicate the postoperative course following cardiothoracic surgery. Both inhaled nitric oxide and inhaled iloprost, a stable analogue of prostacyclin, have been used frequently for this purpose in acute pulmonary hypertension of various origins. We present a case of a patient with acute pulmonary hypertension and severely impaired gas exchange following pulmonary thrombo-endarterectomy. Therapy with one inhaled vasodilator alone did not satisfactorily abort a postoperative pulmonary hypertensive crisis and low-output syndrome due to right heart failure. Combined inhaled nitric oxide and inhaled iloprost, however, showed additive effects. Hence, the combination of both drugs may be reasonable in cases where the standard therapy fails. The effect has been demonstrated by means of continuous blood gas monitoring.
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Affiliation(s)
- M Flondor
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Johann-Wolfgang-Goethe University Frankfurt, Frankfurt, Germany.
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Hofstetter C, Scheller B, Flondor M, Gerig HJ, Heidegger T, Brambrink A, Thierbach A, Wilhelm W, Wrobel M, Zwissler B. Videolaryngoskopie versus direkte Laryngoskopie zur elektiven endotrachealen Intubation. Anaesthesist 2006; 55:535-40. [PMID: 16688385 DOI: 10.1007/s00101-006-0998-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND We compared the ease of viewing the glottis under direct vision during conventional laryngoscopy with the quality of indirectly viewing on a monitor during laryngoscopy with a Macintosh videolaryngoscope in a multicenter study. PATIENTS AND METHODS After ethical approval and written informed consent of 300 patients with no anticipated difficult airway, conventional laryngoscopy with a Macintosh videolaryngoscopy blade was performed and the quality of the view of the glottis was assessed and documented according to the Cormack and Lehane scoring system as modified by Yentis and Lee. Subsequently, the indirect viewing conditions on the monitor were documented without changing the position of the blade. Differences between both distributions were analyzed using the Bland-Altman Test. RESULTS Videolaryngoscopy improved the laryngoscopy score by 1 grade in 72 cases, by 2 grades in 17 cases and by 3 grades in 2 cases. A relevant improvement (from grades III/IV to II) was found in 28 patients. Viewing conditions worsened in 3 cases by 1 grade, in 4 cases by 2 grades and in 3 cases by 3 grades. A statistical analysis of the data gave a bias of 0.31 and an SD bias of 0.77.The 95% confidence interval of the distribution ranged from -1.12 to 1.81. CONCLUSION Videolaryngoscopy can lead to better viewing conditions but in rare cases it may result in worse viewing conditions.
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Affiliation(s)
- C Hofstetter
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Klinikum der Johann-Wolfgang-Goethe-Universität, Theodor Stern Kai 7, 60590, Frankfurt a. M., Germany.
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Brumovsky P, Hofstetter C, Olson L, Ohning G, Villar M, Hökfelt T. The neuropeptide tyrosine Y1R is expressed in interneurons and projection neurons in the dorsal horn and area X of the rat spinal cord. Neuroscience 2006; 138:1361-76. [PMID: 16448775 DOI: 10.1016/j.neuroscience.2005.11.069] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2005] [Revised: 11/22/2005] [Accepted: 11/30/2005] [Indexed: 11/16/2022]
Abstract
The localization of the neuropeptide tyrosine Y1 receptor was studied with immunohistochemistry in parasagittal and transverse, free-floating sections of the rat lumbar spinal cord. At least seven distinct Y1 receptor-positive populations could tentatively be recognized: Type 1) abundant small, fusiform Y1 receptor-positive neurons in laminae I-II, producing a profuse neuropil; Type 2) Y1 receptor-positive projection neurons in lamina I; Type 3) small Y1 receptor-positive neurons in lamina III, similar to Type 1 neurons, but less densely packed; Type 4) a number of large, multipolar Y1 receptor-positive neurons in the border area between laminae III-IV, with dendrites projecting toward laminae I-II; Type 5) a considerable number of large, multipolar Y1 receptor-positive neurons in laminae V-VI; Type 6) many large Y1 receptor-positive neurons around the central canal (area X); and Type 7) a small number of large Y1 receptor-positive neurons in the medial aspect of the ventral horns (lamina VIII). Many of the neurons present in laminae V-VI and area X produce craniocaudal processes extending for several hundred micrometers. Retrograde tracing using cholera toxin B subunit injected at the 9th thoracic spinal cord level shows that several Type 5 neurons in laminae V-VI, and at least a few Type 2 in lamina I and Type 6 in area X have projections extending to the lower segments of the thoracic spinal cord (and perhaps to supraspinal levels). The present results define distinct subpopulations of neuropeptide tyrosine-sensitive neurons, localized in superficial and deep layers of the dorsal, in the ventral horns and in area X. The lamina II neurons express somatostatin [The neuropeptide Y Y1 receptor is a somatic receptor on dorsal root ganglion neurons and a postsynaptic receptor on somatostatin dorsal horn neurons. Eur J Neurosci 11:2211-2225] and are presumably glutamatergic [Todd AJ, Hughes DI, Polgar E, Nagy GG, Mackie M, Ottersen OP, Maxwell DJ (2003) The expression of vesicular glutamate transporters VGLUT1 and VGLUT2 in neurochemically defined axonal populations in the rat spinal cord with emphasis on the dorsal horn. Eur J Neurosci 17:13-27], that is they are excitatory interneurons under a Y1 receptor-mediated inhibitory influence. The remaining Y1 receptor-positive spinal neurons need to be phenotyped, for example if the large Y1 receptor-positive laminae III-IV neurons (Type 5) are identical to the neurokinin (NK)1R-positive neurons previously shown to receive neuropeptide tyrosine positive dendritic contacts [Polgár E, Shehab SA, Watt C, Todd AJ (1999) GABAergic neurons that contain neuropeptide Y selectively target cells with the NK1 receptor in laminae III and IV of the rat spinal cord. J Neurosci 19:2637-2646]. If so, neuropeptide tyrosine could have an antinociceptive action not only via Y1 receptor-positive interneurons (Type 1) but also projection neurons. The present results show neuropeptide tyrosine-sensitive neuron populations virtually in all parts of the lumbar spinal cord, suggesting a role for neuropeptide tyrosine signaling in many spinal functions, including pain.
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Affiliation(s)
- P Brumovsky
- Department of Neuroscience, Karolinska Institutet, Retzius väg 8, B2:5, S-171 77 Stockholm, Sweden.
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Kemming G, Kisch-Wedel H, Flondor M, Hofstetter C, Kreyling W, Thein E, Meisner F, Bruhn S, Zwissler B. Improved Ventricular Function during Inhalation of PGI 2 Aerosol Partly Relies on Enhanced Myocardial Contractility. Eur Surg Res 2005; 37:9-17. [PMID: 15818036 DOI: 10.1159/000083142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2004] [Accepted: 09/08/2004] [Indexed: 11/19/2022]
Abstract
Inhaled prostacyclin (PGI(2)) aerosol induces selective pulmonary vasodilation. Further, it improves right ventricular (RV) function, which may largely rely on pulmonary vasodilation, but also on enhanced myocardial contractility. We investigated the effects of the inhaled PGI(2) analogs epoprostenol (EPO) and iloprost (ILO) on RV function and myocardial contractility in 9 anesthetized pigs receiving aerosolized EPO (25 and 50 ng.kg(-1).min(-1)) and, consecutively, ILO (60 ng.kg(-1).min(-1)) for 20 min each. We measured pulmonary artery pressure (PAP), RV ejection fraction (RVEF) and RV end-diastolic-volume (RV-EDV), and left ventricular end-systolic pressure-volume-relation (end-systolic elastance, E(es)). EPO and ILO reduced PAP, increased RVEF and reduced RVEDV. E(es) was enhanced during all doses tested, which reached statistical significance during EPO(25 ng) and ILO, but not during EPO(50 ng). PGI(2) aerosol enhances myocardial contractility in healthy pigs, contributing to improve RV function.
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Affiliation(s)
- G Kemming
- Institute for Surgical Research, Ludwig-Maximilians-University, Munich, Germany
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45
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Widenfalk J, Lipson A, Jubran M, Hofstetter C, Ebendal T, Cao Y, Olson L. Vascular endothelial growth factor improves functional outcome and decreases secondary degeneration in experimental spinal cord contusion injury. Neuroscience 2003; 120:951-60. [PMID: 12927201 DOI: 10.1016/s0306-4522(03)00399-3] [Citation(s) in RCA: 188] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Spinal cord injury leads to acute local ischemia, which may contribute to secondary degeneration. Hypoxia stimulates angiogenesis through a cascade of events, involving angiogenesis stimulatory substances, such as vascular endothelial growth factor (VEGF). To test the importance of angiogenesis for functional outcome and wound healing in spinal cord injury VEGF165 (proangiogenic), Ringer's (control) or angiostatin (antiangiogenic) were delivered locally immediately after a contusion injury produced using the NYU impactor and a 25 mm weight-drop. Rats treated with VEGF showed significantly improved behavior up to 6 weeks after injury compared with control animals, while angiostatin treatment lead to no statistically significant changes in behavior outcome. Furthermore, VEGF-treated animals had an increased amount of spared tissue in the lesion center and a higher blood vessel density in parts of the wound area compared with controls. These effects were unlikely to be due to increased cell proliferation as determined by bromo-deoxy-uridine-labeling. Moreover, VEGF treatment led to decreased levels of apoptosis, as revealed by TUNEL assays. In situ hybridization demonstrated presence of mRNA for VEGF receptors Flt-1, fetal liver kinase-1, neuropilin-1 and -2 in several important cellular compartments of the spinal cord. The different experiments indicate that beneficial effects seen by acute VEGF delivery was attributable to protection/repair of blood vessels, decreased apoptosis and possibly also by other additional effects on glial cells or certain neuron populations.
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Affiliation(s)
- J Widenfalk
- Department of Neuroscience, Karolinska Institutet, Retzius väg 8, B2,IV, S-171 77, Stockholm, Sweden.
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Bowers PG, Hofstetter C, Ngo HL, Toomey RT. Temperature Dependence of Bubble Nucleation Limits for Aqueous Solutions of Carbon Dioxide, Hydrogen, and Oxygen. J Colloid Interface Sci 1999; 215:441-442. [PMID: 10419679 DOI: 10.1006/jcis.1999.6261] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report the temperature variation of critical supersaturation for carbon dioxide, hydrogen, and oxygen in water at 1 atm pressure. The measurements were made by generating solutions of the gases chemically. Between 273 and 323 K, the bubble nucleation limit for carbon dioxide decreases from 0.4 to 0.2 M. For oxygen the limit decreases from 0.15 to 0.10 M in the range 283-298 K. The limit for hydrogen increases from 0.03 M at 290 K to 0.08 M at 308 K. The trends correlate with the Lennard-Jones interaction energies of the molecules, in agreement with recently published bubble nucleation models based on density functional calculations. Copyright 1999 Academic Press.
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Affiliation(s)
- PG Bowers
- Department of Chemistry, Simmons College, Boston, Massachusetts, 02115
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47
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Haffner D, Hofstetter C, Mehls O, Schaefer F. Peritoneal loss of growth hormone in children on automated peritoneal dialysis. Perit Dial Int 1999; 19:343-9. [PMID: 10507815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
OBJECTIVE To provide quantitative data regarding the daily dialytic loss of growth hormone (GH) in children on peritoneal dialysis (PD). DESIGN Prospective study involving 24-hour dialysate collections on 3 consecutive days in patients with and without recombinant human GH (rhGH) treatment. SETTING Single-center outpatient PD program. PATIENTS Twenty-six children undergoing automated PD (APD): 6 with and 20 without daily rhGH. MAIN OUTCOME MEASURES Daily peritoneal losses of GH, alpha1-, beta2-microglobulin, transferrin, and albumin. RESULTS The mean (+/-SEM) daily dialytic GH loss was 2.18+/-0.62 microg/1.73 m2 per day in rhGH-treated patients and 0.42+/-0.28 microg/1.73 m2 per day in untreated patients, (p < 0.05). The intraindividual coefficient of variation of daily GH loss was 65%. The peritoneal loss of GH was positively correlated with that of beta2-microglobulin (r = 0.77, p < 0.001) and alpha1-microglobulin (r = 0.51, p < 0.01). The variability in beta2-microglobulin and alpha1-microglobulin elimination, together with the use of rhGH, explained 66% of the total variability of daily GH excretion. In patients without rhGH therapy, the daily peritoneal GH loss was approximately 0.05% of the estimated daily endogenous production rate based on previous estimates in children with end-stage renal failure. In patients on rhGH therapy, less than 0.1% of the injected rhGH dose was eliminated by dialysis. CONCLUSION Peritoneal losses of GH in children on APD account only for a minute fraction of endogenous metabolic clearance, and do not explain the variability of the rhGH treatment response. The assessment of dialytic GH elimination may be used to estimate time-integrated mean plasma GH concentrations, and to monitor rhGH treatment compliance.
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Affiliation(s)
- D Haffner
- Pediatric Nephrology Division, University Children's Hospital, Heidelberg, Germany
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Hofstetter C, Kleen M, Habler O, Allmeling AM, Krombach F, Zwissler B. Recombinant human interleukin-10 attenuates TNFalpha production by porcine monocytes. Eur J Med Res 1998; 3:299-303. [PMID: 9620892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Human recombinant interleukin-10 (rhIL-10) has been found to inhibit endotoxin-induced production of several proinflammatory cytokines including tumor necrosis factor alpha (TNFalpha) from human monocytes. The exogenous therapeutic administration of rhIL-10 in acute and chronic hyperinflammatory conditions has been discussed. For none of the large animal species that have been used to study the role and effects of various mediators during septicemia, crossreactivity of rhIL-10 has been shown so far. Therefore, the aim of the present investigation was to evaluate the crossreactivity of rhIL-10 in a porcine model. METHODS To determine the effects of rhIL-10 on endotoxin-challenged porcine monocytes, we incubated porcine peripheral blood monocytes from five donors with three different concentrations of rhIL-10 (500 ng/ml, 1000 ng/ml and 2000 ng/ml, respectively) either simultaneously with, or two hours prior to lipopolysaccharide (LPS) administration. RESULTS As compared to incubation with LPS (1 microg/ml) alone, coincubation with LPS and rhIL-10 (500 ng/ml, 1000 ng/ml and 2000 ng/ml) (n = 5) for four hours resulted in a marked and uniform reduction of immunoreactive TNFalpha. For preincubation (n = 5), only the addition of 500 ng/ml rhIL-10 led to a homogeneous decrease of TNFalpha levels in each sample. There was no consistent reduction in TNFalpha after preincubation with 1000 and 2000 ng/ml rhIL-10. Our results indicate crossreactivity of recombinant human interleukin-10 in porcine peripheral blood monocytes. Further investigations on the potential therapeutical role of exogenously administered rhIL-10 are thus possible in porcine models.
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Affiliation(s)
- C Hofstetter
- Institute of Anesthesiology, Klinikum Grosshadern, University of Munich, Marchioninistr. 15, D-81366 Munich, Germany
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Abstract
OBJECTIVES To evaluate the effects of inhaled prostacyclin (PGI2) and inhaled as well as intravenous prostaglandin E1 (PGE1) on thromboxane A2 mimetic-induced pulmonary vasoconstriction. Active pulmonary vasoconstriction was to be distinguished from passive resistance to blood flow. DESIGN Prospective, randomized, crossover study. SETTING Experimental animal laboratory. SUBJECTS Eight anesthetized and paralyzed sheep. INTERVENTIONS The stable thromboxane A2 mimetic, U46619, was infused in increasing dosage to obtain a stable pulmonary hypertension of approximately 30 mm Hg. Subsequently, PGE1 aerosol (0.6, 6, 58, 259 ng/kg/min), intravenous PGE, (0.5 microg/kg/min), or PGI2 aerosol (27 ng/kg/min) were administered in randomized order. MEASUREMENTS AND MAIN RESULTS Active pulmonary vasoconstriction was assessed by determining the pulmonary pressure-flow relationship (PPFR). For measurement of pulmonary artery flow, an ultrasound flow probe was placed around the pulmonary artery after a sternotomy. Pulmonary arterial pressure was measured with a pulmonary artery flotation catheter. Flow was varied by partial occlusion of the inferior vena cava or incremental opening of an arterio-venous fistula between the large neck vessels. The primary end points were the slope of the resulting linear pressure-flow relationship, and pulmonary vascular resistance (PVR). Infusion of U46619 increased the slope of the PPFR (2.9+/-0.7 vs. 4.2+/-1.2 mm Hg/L/min [median+/-semi-interquartile range]; p < or = .05), and PVR (221+/-20 vs. 424+/-57 dyne x sec/cm5) (p < .05). Neither dose of PGE1 aerosol induced changes of the slope of PPFR or PVR. In contrast, intravenous administration of the same drug reduced the slope of the PPFR (4.0+/-1.0 vs. 3.1+/-0.4) (p < .05) but left PVR unchanged. Inhalation of PGI2 reduced both the slope of the PPFR, slightly but significantly, and PVR (424+/-98 vs. 323+/-26 dyne x sec/cm5) (p < .05). CONCLUSIONS This study is the first to show reduction of active pulmonary vasoconstriction by PGI2 aerosol. Neither inhalation nor intravenous administration of PGE1 reduced PVR but the latter reduced the slope of PPFR. We conclude that PGE1 has potential for pulmonary vasodilation, but that it is ineffective as an aerosol, even in high doses, in sheep. PVR may fail to reflect drug-induced pulmonary vasodilation.
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Affiliation(s)
- M Kleen
- Institute for Surgical Research, Ludwig-Maximilians-University of Munich, Germany
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