Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada

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.

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.

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.

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.

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.

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.

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.

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.