Research ArticleArticle
Including Health Equity Considerations in Development of Instruments for Rheumatology Research: An Introduction to a Novel OMERACT Paradigm
Jennifer O'Neill, Tamara Rader, Francis Guillemin, Annelies Boonen, Robin Christensen, Anne Lyddiatt, Jordi Pardo Pardo, Vivian Welch, Jasvinder A. Singh and Peter Tugwell
The Journal of Rheumatology October 2013, jrheum.130812; DOI: https://doi.org/10.3899/jrheum.130812
Jennifer O'Neill
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Tamara Rader
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Francis Guillemin
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Annelies Boonen
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Robin Christensen
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Anne Lyddiatt
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Jordi Pardo Pardo
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Vivian Welch
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Jasvinder A. Singh
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Peter Tugwell
From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada. P. Tugwell is supported in part by the Canadian Institutes of Health Research. J. Singh has received consultant fees, speaking fees, and/or honoraria (less than $10,000 each) from Allergan, Ardea, Savient, and Novartis; and (more than $10,000) from Takeda; and an investigator-initiated grant from Savient and Takeda. J. O’Neill, MSc, Coordinator, Campbell and Cochrane Equity Methods Group; T. Rader, MLIS, Knowledge Translation Specialist and Trials Search Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; F. Guillemin, MD, PhD, Ecole de santé publique, Faculté de Médecine, Université de Lorraine; A. Boonen, MD, PhD, Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; R. Christensen, MSc, PhD, Head of Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg; A. Lyddiatt, BA, Consumer Coordinator, Cochrane Musculoskeletal Group, University of Ottawa; J. Pardo Pardo, LDO, Cochrane Musculoskeletal Group, University of Ottawa; V. Welch, PhD, Deputy Director, Centre for Global Health, University of Ottawa; J. Singh, MBBS, MPH, University of Alabama at Birmingham; P. Tugwell, MD, MSc, Canada Research Chair in Health Equity, Professor of Medicine and Epidemiology, Department of Medicine, University of Ottawa. Address correspondence to J. O’Neill, University of Ottawa, Institute of Population Health, 1 Stewart St., Ottawa, Ontario K1N6N5, Canada. E-mail: Jennifer.ONeill@uottawa.ca.
Abstract
The Outcome Measures in Rheumatology (OMERACT) Equity Special Interest Group (SIG) was established in 2008 to create a preliminary core set of outcome measures for clinical trials that can assess equity gaps in healthcare and the effectiveness of interventions to close or narrow gaps between advantaged and disadvantaged populations with musculoskeletal (MSK) conditions. At the OMERACT 11 meeting in 2012, the Equity SIG workshop focused on health assessment scales and their applicability for disadvantaged patients with MSK conditions. The intent was to determine whether the items and domains in 2 common questionnaires, the Health Assessment Questionnaire and the Medical Outcome Study Short Form-36 Survey, are appropriate for the activities and life experiences of certain disadvantaged populations, and whether completion of any of the scales would present a challenge to disadvantaged persons. To generate discussion, we considered the reading level of items in these questionnaires and whether they would be accessible to people with different levels of literacy. The group concluded that the choice of measurement instrument may contribute to “outcome measure–generated inequalities” because disadvantaged groups might have difficulty understanding some of the questions. The future work of the Equity SIG will explore the appropriateness of different measurement scales as they relate to inequities in arthritis as well as the risk of exacerbating disadvantages for patients with low literacy.
In this issue
The Journal of Rheumatology
Vol. 50, Issue 3
1 Mar 2023
Including Health Equity Considerations in Development of Instruments for Rheumatology Research: An Introduction to a Novel OMERACT Paradigm
Jennifer O'Neill, Tamara Rader, Francis Guillemin, Annelies Boonen, Robin Christensen, Anne Lyddiatt, Jordi Pardo Pardo, Vivian Welch, Jasvinder A. Singh, Peter Tugwell
The Journal of Rheumatology Oct 2013, jrheum.130812; DOI: 10.3899/jrheum.130812
Including Health Equity Considerations in Development of Instruments for Rheumatology Research: An Introduction to a Novel OMERACT Paradigm
Jennifer O'Neill, Tamara Rader, Francis Guillemin, Annelies Boonen, Robin Christensen, Anne Lyddiatt, Jordi Pardo Pardo, Vivian Welch, Jasvinder A. Singh, Peter Tugwell
The Journal of Rheumatology Oct 2013, jrheum.130812; DOI: 10.3899/jrheum.130812
