title: Clinicians' perspective on key domains in ANCA-associated vasculitis: a Delphi exercise.
abstract: OBJECTIVE
  The existing set of outcomes for anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) needs to incorporate views of outcome measure stakeholders to meet the current standards of outcome measurement proposed by the Outcome Measures in Rheumatology (OMERACT) initiative. This study identifies domains that clinical experts (one group of stakeholders) consider to be important to determining the impact of AAV using the International Classification of Functioning, Disability and Health (ICF), a framework that describes health along four components: body functions, body structures, activities and participation, and contextual factors.
  
  
  METHODS
  An international group of clinicians with expertise in the clinical care of patients with vasculitis were identified through consultation with three major vasculitis societies. The relevant domains were determined using a three-round e-mail-based Delphi questionnaire.
  
  
  RESULTS
  Eighty-two clinicians were invited to participate in this study and 41 responded. Nineteen domains were identified as important by > 80% of participants: six body functions (energy, seeing, hearing, pain, respiratory, and renal function), seven body structures (peripheral nerves, eye, ear, nose, sinuses, lungs (and airways), and kidneys), three activities and participation (carrying out daily routine, remunerative employment, and recreation and leisure), and three environmental factors (medications, support and relationships, and health services, systems, and policies).
  
  
  CONCLUSIONS
  Clinical experts focus on the physiological effects of AAV with less importance given to the effect of AAV on patients' activities and participation in life situations and the role of contextual factors. This study represents a step towards incorporating views of a range of stakeholders into disease assessment in AAV.
authors.affiliation: a Division of Rheumatology , Ottawa Hospital , Ottawa , Canada.|b Department of Medicine , University of Ottawa , Ottawa , Canada.|c Ottawa Hospital Research Institute , Ottawa , Canada.
authors.forename: N
authors.initials: N
authors.lastname: Milman
authors.affiliation: d Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Centre and Primary Care and Public Health Research Institute (CAPHRI) , Maastricht University , Maastricht , The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Boonen
authors.affiliation: a Division of Rheumatology , Ottawa Hospital , Ottawa , Canada.|c Ottawa Hospital Research Institute , Ottawa , Canada.|e Department of Epidemiology and Community Medicine , University of Ottawa , Ottawa , Canada.
authors.forename: P
authors.initials: P
authors.lastname: Tugwell
authors.affiliation: f Division of Rheumatology, Medicine and Epidemiology , University of Pennsylvania , Philadelphia , PA , USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Merkel
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000503:physiopathology / Q000628:therapy*; D003697:Delphi Technique; D006801:Humans; D017063:Outcome Assessment, Health Care