The OMERACT Core Domain Set for Clinical Trials of Shoulder Disorders

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.

From the Department of Rheumatology, Leiden University Medical Center, Leiden; Zuyderland Medical Center, Heerlen; Department of Psychology, Health and Technology, University of Twente, Enschede; Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands; School of Public Health and Preventive Medicine, Monash University; Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Monash Department of Clinical Epidemiology, Cabrini Institute; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne; Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; Adelaide Medical School, The University of Adelaide, Adelaide; University of Technology; Royal Prince Alfred Hospital, Camperdown NSW; University of Sydney, Sydney, Australia; Department of Orthopaedic Surgery, University of Michigan; Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan; Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center, Nashville, Tennessee, USA; Institute for Work & Health; University of Toronto, Toronto; Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; University of Bristol, Bristol; Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University, Keele; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals UK National Health Service (NHS) Trust, Leeds; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK; Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences), Bochum, Germany; Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Physiotherapy, OsloMet — Oslo Metropolitan University, Oslo, Norway. RB is supported by an Australian National Health and Medical Research Council Senior Principal Research Fellowship. NEF is an NIHR Senior Investigator and was supported through an NIHR Research Professorship (NIHR-RP-011-015). TS and PGC are supported by the NIHR Biomedical Research Centre, Oxford and the NIHR Leeds Biomedical Research Centre, respectively. The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the UK Department of Health. S. Ramiro, MD, MSc, PhD, Department of Rheumatology, Leiden University Medical Center, and Zuyderland Medical Center, Heerlen; M.J. Page, PhD, School of Public Health and Preventive Medicine, Monash University; S.L. Whittle, MBBS(Hons), MClinEpi, FRACP, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; H. Huang, MPH, Department of Orthopaedic Surgery, University of Michigan; A.P. Verhagen, MSc, PhD, University of Technology; D.E. Beaton, BScOT, PhD, Institute for Work & Health, Institute of Health Policy Management and Evaluation, and the University of Toronto; P. Richards, Patient Research Partner, University of Bristol; M. Voshaar, MSc, PhD Student, Department of Psychology, Health and Technology, University of Twente, and Patient Research Partner, OMERACT; B. Shea, PhD, Clinical Investigator and Adjunct Professor, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa; D.A. van der Windt, PhD, Professor of Primary Care Epidemiology, Arthritis Research UK Primary Care Centre, Institute for Primary Care and Health Sciences, Keele University; C. Kopkow, BScPT, MPH, PhD, Department of Applied Health Sciences, Hochschule für Gesundheit Bochum (University of Applied Sciences); M. Lenza, MD, PhD, Professor, Hospital Israelita Albert Einstein; N.B. Jain, MD, MSPH, Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Epidemiology (Medicine), Vanderbilt University Medical Center; B. Richards, MBBS(Hons), MClinEpi, MSportsMed, FRACP, Royal Prince Alfred Hospital, Camperdown NSW, and University of Sydney; C. Hill, MBBS, MD, MSc, Department of Rheumatology, The Queen Elizabeth Hospital and the University of Adelaide; T.K. Gill, MBA, PhD, Adelaide Medical School, University of Adelaide; B. Koes, MSc, PhD, Department of General Practice, Erasmus University Medical Center; N.E. Foster, DPhil, BSc(Hons), FCSP, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University; P.G. Conaghan, MBBS, PhD, FRACP, FRCP, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; T. Smith, BSc (Hons), MSc, MA, PhD, MCSP, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford; P. Malliaras, PhD, Monash Department of Physiotherapy, School of Primary and Allied Health Care, Monash University; Y. Roe, MSc, PhD, Department of Physiotherapy, OsloMet — Oslo Metropolitan University; J.J. Gagnier, ND, MSc, PhD, Department of Epidemiology, School of Public Health, Department of Orthopaedic Surgery, University of Michigan; R. Buchbinder, MBBS (Hons), MSc, PhD, FRACP, FAHMS, Monash Department of Clinical Epidemiology, Cabrini Institute, and Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University. J.J. Gagnier and R. Buchbinder contributed equally to this work as senior authors. Address correspondence to Dr. S. Ramiro, Department of Rheumatology, Leiden University Medical Center, P.O. Box 9600, 2300RC Leiden, the Netherlands. E-mail: sofiaramiro@gmail.com. Accepted for publication January 17, 2019.