Research ArticleArticle
Open Access
Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada
Claire E.H. Barber, Deborah A. Marshall, Dianne P. Mosher, Pooneh Akhavan, Lori Tucker, Kristin Houghton, Michelle Batthish, Deborah M. Levy, Heinrike Schmeling, Janet Ellsworth, Heidi Tibollo, Sean Grant, Dmitry Khodyakov, Diane Lacaille and and the Arthritis Alliance of Canada Performance Measurement Development Panel
The Journal of Rheumatology January 2016, jrheum.150839; DOI: https://doi.org/10.3899/jrheum.150839
Claire E.H. Barber
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Deborah A. Marshall
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Dianne P. Mosher
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Pooneh Akhavan
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Lori Tucker
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Kristin Houghton
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Michelle Batthish
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Deborah M. Levy
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Heinrike Schmeling
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Janet Ellsworth
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Heidi Tibollo
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Sean Grant
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Dmitry Khodyakov
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Diane Lacaille
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children’s Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA. Funding from a Canadian Institutes for Health Research Planning Grants 2013-10-15 (Funding reference number is 218913). Additional funding and in-kind resources provided by the Arthritis Alliance of Canada (AAC). Dr. Lacaille holds the Mary Pack Chair in Arthritis Research from the University of British Columbia and The Arthritis Society of Canada. C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children’s Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children’s Hospital, Assistant Professor, Department of Pediatrics, McMaster University; D.M. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, Assistant Professor of Pediatrics, University of Toronto; H. Schmeling, MD, PhD, Assistant Professor, Clinician Scientist, Section of Rheumatology, Department of Pediatrics, University of Calgary; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, University of Alberta/Stollery Children’s Hospital; H. Tibollo, MLS, BSN, Medical librarian, Doctor Evidence LLC; S. Grant, DPhil, Associate Behavioural/Social Scientist, the RAND Corporation; D. Khodyakov, PhD, MA, Social/Behavioral Scientist, the RAND Corporation; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Centre of Canada. Address correspondence to Dr. C.E. Barber, Division of Rheumatology, University of Calgary, HRIC Room 3AA20, 3280 Hospital Dr. NW, Calgary, Alberta T2N 4Z6, Canada. E-mail: cehbarbe@ucalgary.ca. Accepted for publication October 31, 2015.
Abstract
Objective To develop system-level performance measures for evaluating the care of patients with inflammatory arthritis (IA), including rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis.
Methods This study involved several methodological phases. Over multiple rounds, various participants were asked to help define a set of candidate measurement themes. A systematic search was conducted of existing guidelines and measures. A set of 6 performance measures was defined and presented to 50 people, including patients with IA, rheumatologists, allied health professionals, and researchers using a 3-round, online, modified Delphi process. Participants rated the validity, feasibility, relevance, and likelihood of use of the measures. Measures with median ratings ≥ 7 for validity and relevance were included in the final set.
Results Six performance measures were developed evaluating the following aspects of care, with each measure being applied separately for each type of IA except where specified: waiting times for rheumatology consultation for patients with new onset IA, percentage of patients with IA seen by a rheumatologist, percentage of patients with IA seen in yearly followup by a rheumatologist, percentage of patients with RA treated with a disease-modifying antirheumatic drug (DMARD), time to DMARD therapy in RA, and number of rheumatologists per capita.
Conclusion The first set of system-level performance measures for IA care in Canada has been developed with broad input. The measures focus on timely access to care and initiation of appropriate treatment for patients with IA, and are likely to be of interest to other arthritis care systems internationally.
In this issue
The Journal of Rheumatology
Vol. 48, Issue 4
1 Apr 2021
Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada
Claire E.H. Barber, Deborah A. Marshall, Dianne P. Mosher, Pooneh Akhavan, Lori Tucker, Kristin Houghton, Michelle Batthish, Deborah M. Levy, Heinrike Schmeling, Janet Ellsworth, Heidi Tibollo, Sean Grant, Dmitry Khodyakov, Diane Lacaille, and the Arthritis Alliance of Canada Performance Measurement Development Panel
The Journal of Rheumatology Jan 2016, jrheum.150839; DOI: 10.3899/jrheum.150839
Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada
Claire E.H. Barber, Deborah A. Marshall, Dianne P. Mosher, Pooneh Akhavan, Lori Tucker, Kristin Houghton, Michelle Batthish, Deborah M. Levy, Heinrike Schmeling, Janet Ellsworth, Heidi Tibollo, Sean Grant, Dmitry Khodyakov, Diane Lacaille, and the Arthritis Alliance of Canada Performance Measurement Development Panel
The Journal of Rheumatology Jan 2016, jrheum.150839; DOI: 10.3899/jrheum.150839
