J Rheumatol
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The usefulness of randomized control trials to advance clinical care depends upon the outcomes reported, but disagreement on the choice of outcome measures has resulted in inconsistency and the potential for reporting bias. One solution to this problem is the development of a core outcome set: a minimum set of outcome measures deemed critical for clinical decision making. Within rheumatology the Outcome Measures in Rheumatology (OMERACT) initiative has pioneered the development of core outcome sets since 1992. As the number of diseases addressed by OMERACT has increased and its experience in formulating core sets has grown, clarification and update of the conceptual framework and formulation of a more explicit process of area/domain core set development has become necessary. As part of the update process of the OMERACT Filter criteria to version 2, a literature review was undertaken to compare and contrast the OMERACT conceptual framework with others within and outside rheumatology. ⋯ This scoping review reinforced the need for clear methods and standards for core set development. Based on these findings, OMERACT will make its own conceptual framework and working process more explicit. Proposals for how to achieve this were discussed at the OMERACT 11 conference.
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The Outcome Measures in Rheumatology (OMERACT) community strives to develop core outcome sets for rheumatologic conditions to specify, for each condition, the minimum set of outcomes necessary to provide consistent estimates of the benefits of an intervention. The original and successful OMERACT filter of "truth, discrimination, and feasibility" requires development and updating because of application to a widening range of conditions by an expanding group, particularly patients. It should more explicitly identify the relevant core outcomes that might be universal to all randomized controlled trials within rheumatology. Working from first principles, comparing proposals against actual procedures adopted by OMERACT working groups, and seeking a broad consensus over several major sessions at the OMERACT 11 meeting, a new version has emerged, OMERACT Filter 2.0, which will form the central theme of the intended OMERACT handbook and offers an approach to core outcome set development in many areas of healthcare.
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To describe the longterm safety and efficacy profile of tofacitinib in patients with moderate to severe active rheumatoid arthritis (RA). ⋯ Tofacitinib demonstrated consistent safety and persistent efficacy over 48 months in patients with RA.
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Observational Study
Effect of urate-lowering therapies on renal disease progression in patients with hyperuricemia.
To evaluate the association between hyperuricemia and renal disease progression in a real-world, large observational database study. ⋯ Hyperuricemia is an independent risk factor for renal function decline. Patients treated with ULT who achieved sUA < 6 mg/dl on ULT showed a 37% reduction in outcome events.
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At a previous Outcome Measures in Rheumatology (OMERACT) meeting, participants reflected on the underlying methods of patient-reported outcome (PRO) instrument development. The participants requested proposals for more explicit instrument development protocols that would contribute to an enhanced version of the "Truth" statement in the OMERACT Filter, a widely used guide for outcome validation. In the present OMERACT session, we explored to what extent these new Filter 2.0 proposals were practicable, feasible, and already being applied. ⋯ Participants recognized, endorsed, and were generally already putting into practice the principles of PRO development presented in the plenary session. Further work is needed on some existing instruments and on establishing widespread good practice for working in close collaboration with patients.