title: Development of System-level Performance Measures for Evaluation of Models of Care for Inflammatory Arthritis in Canada.
abstract: OBJECTIVE
  To develop system-level performance measures for evaluating the care of patients with inflammatory arthritis (IA), including rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis, and juvenile idiopathic arthritis.
  
  
  METHODS
  This study involved several methodological phases. Over multiple rounds, various participants were asked to help define a set of candidate measurement themes. A systematic search was conducted of existing guidelines and measures. A set of 6 performance measures was defined and presented to 50 people, including patients with IA, rheumatologists, allied health professionals, and researchers using a 3-round, online, modified Delphi process. Participants rated the validity, feasibility, relevance, and likelihood of use of the measures. Measures with median ratings ≥ 7 for validity and relevance were included in the final set.
  
  
  RESULTS
  Six performance measures were developed evaluating the following aspects of care, with each measure being applied separately for each type of IA except where specified: waiting times for rheumatology consultation for patients with new onset IA, percentage of patients with IA seen by a rheumatologist, percentage of patients with IA seen in yearly followup by a rheumatologist, percentage of patients with RA treated with a disease-modifying antirheumatic drug (DMARD), time to DMARD therapy in RA, and number of rheumatologists per capita.
  
  
  CONCLUSIONS
  The first set of system-level performance measures for IA care in Canada has been developed with broad input. The measures focus on timely access to care and initiation of appropriate treatment for patients with IA, and are likely to be of interest to other arthritis care systems internationally.
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Claire E H
authors.initials: CE
authors.lastname: Barber
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Marshall
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Dianne P
authors.initials: DP
authors.lastname: Mosher
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Pooneh
authors.initials: P
authors.lastname: Akhavan
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Lori
authors.initials: L
authors.lastname: Tucker
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Kristin
authors.initials: K
authors.lastname: Houghton
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Michelle
authors.initials: M
authors.lastname: Batthish
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Levy
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Heinrike
authors.initials: H
authors.lastname: Schmeling
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Janet
authors.initials: J
authors.lastname: Ellsworth
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Heidi
authors.initials: H
authors.lastname: Tibollo
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Sean
authors.initials: S
authors.lastname: Grant
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Dmitry
authors.initials: D
authors.lastname: Khodyakov
authors.affiliation: From the Division of Rheumatology, Department of Medicine, and Section of Rheumatology, Department of Pediatrics, University of Calgary; Department of Community Health Sciences, Canada Research Chair in Health Systems, Calgary; Division of Pediatric Rheumatology, University of Alberta/Stollery Children's Hospital, Edmonton, Alberta; Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; Hospital for Sick Children, University of Toronto, Toronto; Division of Rheumatology, McMaster Children's Hospital, Department of Pediatrics, McMaster University, Hamilton, Ontario; Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver; Arthritis Research Centre of Canada, Richmond, British Columbia, Canada; Doctor Evidence LLC; the RAND Corporation, Santa Monica, California, USA.C.E. Barber, MD, FRCPC, PhD Candidate, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary; D.A. Marshall, BSc, MHSA, PhD, Associate Professor, Department of Community Health Sciences, Canada Research Chair in Health Systems, and Services Arthur JE Child Chair in Rheumatology Research, University of Calgary; D.P. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; P. Akhavan, MD, MSc, FRCPC, Division of Rheumatology, Department of Medicine, University of Toronto, Mount Sinai Hospital; L. Tucker, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia; K. Houghton, MD, FRCPC, Clinical Associate Professor, Division of Rheumatology, Department of Pediatrics, University of British Columbia, BC Children's Hospital; M. Batthish, MSc, MD, FRCPC, Staff Physician, Division of Rheumatology, McMaster Children's Hospital, Assistant Professor, Department of Pediatrics, McMaster Univers
authors.forename: Diane
authors.initials: D
authors.lastname: Lacaille
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy*; D002170:Canada; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D012219:Rheumatology / Q000592:standards*
chemical_list: D018501:Antirheumatic Agents
keywords: ANKYLOSING SPONDYLITIS; JUVENILE IDIOPATHIC ARTHRITIS; PSORIATIC ARTHRITIS; QUALITY INDICATORS; RHEUMATOID ARTHRITIS