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Research ArticleArticle

Feasibility and Face Validity of Outcome Measures for Use in Future Studies of Polymyalgia Rheumatica: An OMERACT Study

Max Yates, Claire E. Owen, Sara Muller, Karly Graham, Lorna Neill, Helen Twohig, Maarten Boers, Mar Pujades Rodriguez, Susan Goodman, Jonathan Cheah, Christian Dejaco, Chetan Mukhtyar, Berit Dalsgaard Nielsen, Joanna Robson, Lee S. Simon, Beverley Shea, Sarah L. Mackie and Catherine L. Hill for the OMERACT PMR Working Group
The Journal of Rheumatology February 2020, jrheum.190575; DOI: https://doi.org/10.3899/jrheum.190575
Max Yates
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Claire E. Owen
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Sara Muller
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Karly Graham
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Lorna Neill
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Helen Twohig
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Maarten Boers
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Mar Pujades Rodriguez
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Susan Goodman
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Jonathan Cheah
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Christian Dejaco
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Chetan Mukhtyar
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Berit Dalsgaard Nielsen
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Joanna Robson
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Lee S. Simon
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Beverley Shea
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Sarah L. Mackie
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Catherine L. Hill
From the Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, Norwich, UK; Department of Rheumatology, East Suffolk and North Essex Foundation Trust, Ipswich, UK; Department of Rheumatology, Austin Health; Department of Medicine, University of Melbourne, Melbourne, Australia; Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University, Keele; PMRGCA Scotland, Scotland, UK; Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands; Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Rheumatology, and Department of Medicine, Hospital for Special Surgery, New York, New York, USA; Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria; Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy; Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark; Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; SDG LLC, Cambridge, Massachusetts, USA; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Biomedical Research Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, UK; Discipline of Medicine, The University of Adelaide; the Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, Australia. M. Yates, BSc (Hons), MBBS, MSc, PhD, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia, and Department of Rheumatology, East Suffolk and North Essex Foundation Trust; C.E. Owen, MBBS (Hons), Department of Rheumatology, Austin Health, Department of Medicine, University of Melbourne; S. Muller, BSc (Hons), MSc, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; K. Graham, Epidemiology Centre Versus Arthritis, Norwich Medical School, University of East Anglia; L. Neill, BSc (Hons), Chair, PMRGCA Scotland; H. Twohig, MBChB, BMedSci, PhD, Primary Care Centre Versus Arthritis, Research Institute for Primary Care and Health Sciences, Keele University; M. Boers, MSc, MD, PhD, Department of Epidemiology and Biostatistics, and Amsterdam Rheumatology and Immunology Center, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam; M. Pujades Rodriguez, MSc, PhD, Leeds Institute of Health Sciences, University of Leeds; S.M. Goodman, MD, Department of Rheumatology, Hospital for Special Surgery; J. Cheah, MD, Department of Medicine, Hospital for Special Surgery; C. Dejaco, MD, PhD, MBA, Department of Rheumatology and Immunology, Medical University Graz, Department of Rheumatology, Hospital of Bruneck; C. Mukhtyar, MBBS, MSc, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; B. Dalsgaard Nielsen, MD, Department of Rheumatology, Norfolk and Norwich University Hospital; J. Robson, MBBS, PhD, Department of Rheumatology, Faculty of Health and Applied Sciences, University of the West of England; L.S. Simon, MD, SDG LLC; B. Shea, RN, BScN, MSc, PhD (epi), School of Epidemiology and Public Health, University of Ottawa; S.L. Mackie, BM, BCh, PhD, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust; C.L. Hill, MBBS, MD, MSc, Discipline of Medicine, The University of Adelaide, and Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals. Address correspondence to Dr. M. Yates, University of East Anglia, Norwich Medical School, BCRE Floor 2, Norwich NR4 7UQ, UK. E-mail: maxyates@doctors.org.uk. Accepted for publication January 24, 2020.
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Abstract

Objective To survey participants with polymyalgia rheumatica (PMR) to evaluate the face validity, acceptability, and domain match of proposed candidate outcome measures.

Methods A structured, online, anonymous survey was disseminated by patient support groups through their networks and online forums. The candidate outcome measures comprised (1) visual analog scale (VAS) and numerical rating score (NRS) to assess pain; (2) VAS, NRS, and duration to assess stiffness; (3) the modified Health Assessment Questionnaire and Health Assessment Questionnaire Disability Index to assess physical function; and (4) C-reactive protein and erythrocyte sedimentation rate to assess inflammation. Free-text answers were analyzed using descriptive thematic analysis to determine respondents’ views of the candidate instruments.

Results Seventy-eight people with PMR from 6 countries (UK, France, USA, Canada, Australia, and New Zealand) participated in the survey. Most respondents agreed candidate instruments were acceptable or “good to go.” Free-text analysis identified 5 themes that participants considered inadequately covered by the proposed instruments. These related to (1) the variability, context, and location of pain; (2) the variability of stiffness; (3) fatigue; (4) disability; and (5) the correlation of inflammatory marker levels and severity of symptoms, sometimes reflecting disease activity and other times not.

Conclusion Participants reported additional aspects of their experience that are not covered by the proposed instruments, particularly for the experience of stiffness and effect of fatigue. New patient-reported outcome measures are required to increase the relevance of results from clinical trials to patients with PMR.

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The Journal of Rheumatology
Vol. 48, Issue 1
1 Jan 2021
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Feasibility and Face Validity of Outcome Measures for Use in Future Studies of Polymyalgia Rheumatica: An OMERACT Study
Max Yates, Claire E. Owen, Sara Muller, Karly Graham, Lorna Neill, Helen Twohig, Maarten Boers, Mar Pujades Rodriguez, Susan Goodman, Jonathan Cheah, Christian Dejaco, Chetan Mukhtyar, Berit Dalsgaard Nielsen, Joanna Robson, Lee S. Simon, Beverley Shea, Sarah L. Mackie, Catherine L. Hill
The Journal of Rheumatology Feb 2020, jrheum.190575; DOI: 10.3899/jrheum.190575

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Feasibility and Face Validity of Outcome Measures for Use in Future Studies of Polymyalgia Rheumatica: An OMERACT Study
Max Yates, Claire E. Owen, Sara Muller, Karly Graham, Lorna Neill, Helen Twohig, Maarten Boers, Mar Pujades Rodriguez, Susan Goodman, Jonathan Cheah, Christian Dejaco, Chetan Mukhtyar, Berit Dalsgaard Nielsen, Joanna Robson, Lee S. Simon, Beverley Shea, Sarah L. Mackie, Catherine L. Hill
The Journal of Rheumatology Feb 2020, jrheum.190575; DOI: 10.3899/jrheum.190575
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