QUANTITATIVE RHEUMATOLOGY - A SURVEY OF OUTCOME MEASUREMENT PROCEDURES IN ROUTINE RHEUMATOLOGY OUTPATIENT PRACTICE IN CANADA

Objective. To assess the extent to which quantitative clinical measure ment is performed by rheumatologists in the longitudinal followup of p atients with rheumatoid arthritis (RA), osteoarthritis (OA), ankylosin g spondylitis (AS), and fibromyalgia (FM) in routine outpatient practi ce in Canada. Methods. A cross sectional postal survey was conducted u sing on 18 item self-administered questionnaire sent to Canadian Rheum atology Association members. Results, Rheumatologists (response rate 8 5%) were more likely to longitudinally follow patients with RA and AS than those with OA or FM. Then was a high degree of variability in the methods used to monitor patients longitudinally. Many measures used i n clinical research were used infrequently in routine clinical practic e. In general, the major health status measures surveyed were net used in clinical monitoring. There was a high level of agreement (>80%) th at the characteristics required of an outcome measure for use in clini cal practice should include simplicity, brevity, ease of scoring, reli ability, validity, and sensitivity to change. Conclusion. The majority of Canadian rheumatologists perform outcome measurement during the lo ngitudinal followup of their outpatients with RA, AS, OA, and FM. Howe ver, the process lacks standardization. High performance health status measures, developed for clinical research, have not been widely adopt ed in rheumatology practices, There is agreement on the characteristic s required by Canadian rheumatologists for measurement procedures used in routine clinical care, Quantitative measurement in clinical practi ce using standardized procedures is an attainable, but as yet, unreali zed opportunity.