@article {POPE2247, author = {JANET POPE and CARTER THORNE and ALFRED CIVIDINO and KURT LUCAS}, title = {Effect of Rheumatologist Education on Systematic Measurements and Treatment Decisions in Rheumatoid Arthritis: The Metrix Study}, volume = {39}, number = {12}, pages = {2247--2252}, year = {2012}, doi = {10.3899/jrheum.120597}, publisher = {The Journal of Rheumatology}, abstract = {Objective. To determine whether an educational intervention could result in changes in physicians{\textquoteright} practice behavior. Methods. Twenty rheumatologists performed a prospective chart audit of 50 consecutive patients with rheumatoid arthritis (RA) and again after 6 months. Ten were randomized to the educational intervention: monthly Web-based conferences on the value of systematic assessments in RA, recent evidence-based information, practice efficiency, and other topics; this group also read articles on targeting care in RA. The others were randomized to no intervention. Results. One thousand serial RA charts were audited at baseline and 1000 at 6 months, with no between-group differences in patient characteristics: mean disease duration of 10 years; 77\% women; 74\% rheumatoid factor{\textendash} positive; mean Disease Activity Score (DAS) 3.7; and 68\% taking methotrexate, 14\% taking steroids, and 27\% taking biologics. At 6 months the intervention group collected more global assessments (patient global 53\% preintervention vs 66\% postintervention, and MD global 51\% vs 60\%; p \< 0.05) and Health Assessment Questionnaires (37\% vs 42\%; p \> 0.05; p = nonsignificant), whereas controls had no change in outcomes collected. For the intervention group there was a 32\% increase in calculable composite scores [such as DAS, Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index; p \< 0.05] but no change in the controls. There was more targeting to a low disease state. For those with SDAI between 3.3 and 11, the percentage of patients receiving a change in therapy was 66\% in the intervention group and 36\% in controls (p \< 0.05). When DAS was between 2.4 and 3.6, 57\% of the intervention group and 38\% of controls made changes to treatment (p \< 0.05). Conclusion. Small-group learning with feedback from practice audits is an inexpensive way to improve outcomes in RA.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/39/12/2247}, eprint = {https://www.jrheum.org/content/39/12/2247.full.pdf}, journal = {The Journal of Rheumatology} }