title: The Canadian Rheumatology Association/ Spondyloarthritis Research Consortium of Canada treatment recommendations for the management of spondyloarthritis: a national multidisciplinary stakeholder project.
abstract: OBJECTIVE
  Development of treatment recommendations for arthritis has traditionally relied on the compilation of evidence-based data by experts in the field despite recommendations by various bodies for broad stakeholder input. Our objectives were: (1) To develop evidence-based treatment recommendations for the management of spondyloarthritis (SpA) in Canada that also incorporate the perspective of multiple stakeholders. (2) To generate a procedural template for the multidisciplinary development of treatment recommendations.
  
  
  METHODS
  The process was directed by a steering committee comprising the SPARCC Executive, rheumatologists from academic and community-based practice, patient consumers, and a representative from the John Dossetor Health Ethics Centre. Guidelines established by EULAR and stipulated in the AGREE instrument were followed. First, a working document was drafted that included a referenced summary of the evidence-based data and the 12 national arthritis care standards developed by the Alliance for the Canadian Arthritis Program. Second, a Web-based survey was conducted among patient consumers to address the relevance to patients of 2 primary outcome instruments that assess the effectiveness of treatment. Third, a list of questions was generated for drafting propositions by the ethics consultant. A Delphi consensus exercise was then conducted.
  
  
  RESULTS
  Consensus was generated on a final list of 38 treatment recommendations categorized under the subject headings of general management principles, ethical considerations, target groups, definition of target disease, disease monitoring, and specific management recommendations.
  
  
  CONCLUSIONS
  Using broad stakeholder input, we provide treatment recommendations to guide clinical practice and access to care for patients with SpA in Canada.
authors: University of Alberta, Edmonton, Alberta, Canada.
authors: Walter P
authors: WP
authors: Maksymowych
authors: Dafna
authors: D
authors: Gladman
authors: Proton
authors: P
authors: Rahman
authors: Annelies
authors: A
authors: Boonen
authors: Vivien
authors: V
authors: Bykerk
authors: Denis
authors: D
authors: Choquette
authors: Sherry
authors: S
authors: Dimond
authors: Paul
authors: P
authors: Fortin
authors: Jacob
authors: J
authors: Karsh
authors: Alice V
authors: AV
authors: Klinkhoff
authors: Dianne
authors: D
authors: Mosher
authors: Ken
authors: K
authors: Mulholland
authors: Wojciech P
authors: WP
authors: Olszynski
authors: Anthony S
authors: AS
authors: Russell
authors: Laurie
authors: L
authors: Savage
authors: Laura
authors: L
authors: Shanner
authors: Kam
authors: K
authors: Shojania
authors: Michael
authors: M
authors: Starr
authors: Glen
authors: G
authors: Thomson
authors: Michel
authors: M
authors: Zummer
authors: Robert
authors: R
authors: Inman
mesh_terms: D002170:Canada; D004992:Ethics, Medical; D019317:Evidence-Based Medicine; D006801:Humans; D012955:Societies, Medical; D025242:Spondylarthropathies / Q000628:therapy*