Quantitative rheumatology: a survey of outcome measurement procedures in routine rheumatology outpatient practice in Canada.
OBJECTIVE
To assess the extent to which quantitative clinical measurement is performed by rheumatologists in the longitudinal followup of patients with rheumatoid arthritis (RA), osteoarthritis (OA), ankylosing spondylitis (AS), and fibromyalgia (FM) in routine outpatient practice in Canada.


METHODS
A cross sectional postal survey was conducted using an 18 item self-administered questionnaire sent to Canadian Rheumatology Association members.


RESULTS
Rheumatologists (response rate 85%) were more likely to longitudinally follow patients with RA and AS than those with OA or FM. There was a high degree of variability in the methods used to monitor patients longitudinally. Many measures used in clinical research were used infrequently in routine clinical practice. In general, the major health status measures surveyed were not used in clinical monitoring. There was a high level of agreement (>80%) that the characteristics required of an outcome measure for use in clinical practice should include simplicity, brevity, ease of scoring, reliability, validity, and sensitivity to change.


CONCLUSIONS
The majority of Canadian rheumatologists perform outcome measurement during the longitudinal followup of their outpatients with RA, AS, OA, and FM. However, the process lacks standardization. High performance health status measures, developed for clinical research, have not been widely adopted in rheumatology practices. There is agreement on the characteristics required by Canadian rheumatologists for measurement procedures used in routine clinical care. Quantitative measurement in clinical practice using standardized procedures is an attainable, but as yet, unrealized opportunity.
Bellamy
N
N
Department of Medicine, University of Western Ontario, London, Canada.
Kaloni
S
S
Pope
J
J
Coulter
K
K
Campbell
J
J
D000553:Ambulatory Care / Q000592:standards*; D002170:Canada; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008137:Longitudinal Studies; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012216:Rheumatic Diseases / Q000188:drug therapy; D012219:Rheumatology / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires