title: Including health equity considerations in development of instruments for rheumatology research: an introduction to a novel OMERACT paradigm.
abstract: The Outcome Measures in Rheumatology (OMERACT) Equity Special Interest Group (SIG) was established in 2008 to create a preliminary core set of outcome measures for clinical trials that can assess equity gaps in healthcare and the effectiveness of interventions to close or narrow gaps between advantaged and disadvantaged populations with musculoskeletal (MSK) conditions. At the OMERACT 11 meeting in 2012, the Equity SIG workshop focused on health assessment scales and their applicability for disadvantaged patients with MSK conditions. The intent was to determine whether the items and domains in 2 common questionnaires, the Health Assessment Questionnaire and the Medical Outcome Study Short Form-36 Survey, are appropriate for the activities and life experiences of certain disadvantaged populations, and whether completion of any of the scales would present a challenge to disadvantaged persons. To generate discussion, we considered the reading level of items in these questionnaires and whether they would be accessible to people with different levels of literacy. The group concluded that the choice of measurement instrument may contribute to "outcome measure-generated inequalities" because disadvantaged groups might have difficulty understanding some of the questions. The future work of the Equity SIG will explore the appropriateness of different measurement scales as they relate to inequities in arthritis as well as the risk of exacerbating disadvantages for patients with low literacy.
authors.affiliation: From the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Université de Lorraine, Nancy, France; Maastricht University Medical Centre, Maastricht, Netherlands; The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Copenhagen, Denmark; Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA; University of Ottawa, Department of Medicine, Department of Epidemiology and Community Medicine Faculty of Medicine, Ottawa Hospital Research Institute, Clinical Epidemiology Program, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: O'Neill
authors.forename: Tamara
authors.initials: T
authors.lastname: Rader
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.forename: Annelies
authors.initials: A
authors.lastname: Boonen
authors.forename: Robin
authors.initials: R
authors.lastname: Christensen
authors.forename: Anne
authors.initials: A
authors.lastname: Lyddiatt
authors.forename: Jordi Pardo
authors.initials: JP
authors.lastname: Pardo
authors.forename: Vivian
authors.initials: V
authors.lastname: Welch
authors.forename: Jasvinder A
authors.initials: JA
authors.lastname: Singh
authors.forename: Peter
authors.initials: P
authors.lastname: Tugwell
mesh_terms: D057220:Health Literacy; D006297:Health Services Accessibility; D006801:Humans; D017063:Outcome Assessment, Health Care; D012106:Research; D012216:Rheumatic Diseases; D012219:Rheumatology; D012959:Socioeconomic Factors; D016896:Treatment Outcome
keywords: HEALTH EQUITY; MUSCULOSKELETAL CONDITIONS; RHEUMATOLOGY