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Petkovic J, Epstein J, Buchbinder R, Welch V, Rader T, Lyddiatt A, Clerehan R, Christensen R, Boonen A, Goel N, Maxwell LJ, Toupin-April K, De Wit M, Barton J, Flurey C, Jull J, Barnabe C, Sreih AG, Campbell W, Pohl C, Duruöz MT, Singh JA, Tugwell PS, Guillemin F. Toward Ensuring Health Equity: Readability and Cultural Equivalence of OMERACT Patient-reported Outcome Measures. J Rheumatol 2015; 42:2448-59. [PMID: 26077410 DOI: 10.3899/jrheum.141168] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. METHODS The English, Dutch, French, and Turkish Health Assessment Questionnaires and English and French Osteoarthritis Knee and Hip Quality of Life questionnaires were evaluated by applying 3 readability formulas: Flesch Reading Ease, Flesch-Kincaid grade level, and Simple Measure of Gobbledygook; and a new tool, the Evaluative Linguistic Framework for Questionnaires, developed to assess text quality of questionnaires. We also considered a study assessing cross-cultural adaptation with/without back-translation and/or expert committee. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM. RESULTS Thirty-one OMERACT delegates attended the equity session. Twenty-six participants agreed that PROM should be assessed for comprehensibility and for use of suitable methods (4 abstained, 1 no). Twenty-two participants agreed that cultural equivalency of PROM should be assessed and suitable methods used (7 abstained, 2 no). Special interest group participants identified challenges with cross-cultural adaptation including resources required, and suggested patient involvement for improving translation and adaptation. CONCLUSION Future work will include consensus exercises on what methods are required to ensure PROM are appropriate for people with low literacy and different cultures.
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Affiliation(s)
- Jennifer Petkovic
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Jonathan Epstein
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Rachelle Buchbinder
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Vivian Welch
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Tamara Rader
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Anne Lyddiatt
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Rosemary Clerehan
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Robin Christensen
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Annelies Boonen
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Niti Goel
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Lara J Maxwell
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Karine Toupin-April
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Maarten De Wit
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Jennifer Barton
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Caroline Flurey
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Janet Jull
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Cheryl Barnabe
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Antoine G Sreih
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Willemina Campbell
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Christoph Pohl
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Mehmet Tuncay Duruöz
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Jasvinder A Singh
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Peter S Tugwell
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Francis Guillemin
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
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