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Goh AMY, You E, Perin S, Lautenschlager NT, Clay FJ, Loi SM, Chong T, Ames D, Chiu E, Ellis KA. Alcohol Use, Mental Health, and Functional Capacity as Predictors of Workplace Disability in a Cohort With Manifest Huntington's Disease. J Neuropsychiatry Clin Neurosci 2021; 32:235-243. [PMID: 32102602 DOI: 10.1176/appi.neuropsych.19090199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Huntington's disease (HD) is an inherited neurodegenerative disease involving motor, cognitive, psychiatric, and behavioral impairments that eventually affect work-role functioning. There is limited research regarding predictors of workplace disability in HD. The authors examined predictors of work impairment and disability in a cross-sectional cohort of employed persons with symptomatic HD participating in the worldwide Enroll-HD study. METHODS The study sample (N=316) comprised individuals with manifest HD and a CAG repeat length range between 39 and 60 and were currently engaged in paid full- or part-time employment. Univariate and multivariate logistic regression analyses identified predictors and the effect of all predictors in a fully adjusted model. RESULTS Of the sample, 20.3% reported missing work due to HD, 60.1% reported experiencing impairment while working due to HD, 79.1% reported having work-related activity impairment due to HD, and 60.8% reported impairment in overall work productivity due to HD. Individuals had 25% higher odds of missing work time if they had a higher level of functional impairment (odds ratio=0.76, 95% CI=0.64, 0.91) and had three times greater odds of missing work if they were current alcohol drinkers, compared with nondrinkers (odds ratio=2.86, 95% CI=1.62, 5.03). Individuals with lower self-perceived mental health were also 5% more likely to experience impairment at work due to HD. Motor impairment was not a strong predictor of workplace disability. CONCLUSIONS These findings provide important new knowledge that can inform the development of strategies or targeted intervention trials to support persons with symptomatic HD to maintain their work roles.
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Affiliation(s)
- Anita M Y Goh
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Emily You
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Stephanie Perin
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Nicola T Lautenschlager
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Fiona J Clay
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Samantha M Loi
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Terence Chong
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - David Ames
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Edmond Chiu
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
| | - Kathryn A Ellis
- Department of Psychiatry, Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne (Goh, You, Perin, Lautenschlager, Chong, Ames, Chiu, Ellis); Neuropsychiatry Unit, Melbourne Neuropsychiatry Centre, Royal Melbourne Hospital, Melbourne (Goh, Loi); Department of Psychiatry, University of Melbourne, Melbourne (Goh, Lautenschlager, Clay, Ellis); NorthWestern Mental Health, Melbourne Health, Melbourne (Goh, Lautenschlager, Ellis); National Ageing Research Institute, Parkville, Australia (Goh); Department of Psychiatry, St. Vincent's Hospital, University of Melbourne, Melbourne (Chong); School of Psychological Sciences, University of Melbourne, Melbourne (Ellis); Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne (Ellis)
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Leggett S, van der Zee-Neuen A, Boonen A, Beaton DE, Bojinca M, Bosworth A, Dadoun S, Fautrel B, Hagel S, Hofstetter C, Lacaille D, Linton D, Mihai C, Petersson IF, Rogers P, Sergeant JC, Sciré C, Verstappen SMM. Test-retest Reliability and Correlations of 5 Global Measures Addressing At-work Productivity Loss in Patients with Rheumatic Diseases. J Rheumatol 2015; 43:433-9. [PMID: 26628608 DOI: 10.3899/jrheum.141605] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Several global measures to assess at-work productivity loss or presenteeism in patients with rheumatic diseases have been proposed, but the comparative validity is hampered by the lack of data on test-retest reliability and comparative concurrent and construct validity. Our objective was to test-retest 5 global measures of presenteeism and to compare the association between these scales and health-related well-being. METHODS Sixty-five participants with inflammatory arthritis or osteoarthritis in paid employment were recruited from 7 countries (UK, Canada, Netherlands, France, Sweden, Romania, and Italy). At baseline and 2 weeks later, 5 global measures of presenteeism were evaluated: the Work Productivity Scale-Rheumatoid Arthritis (WPS-RA), Work Productivity and Activity Impairment Questionnaire (WPAI), Work Ability Index (WAI), Quality and Quantity questionnaire (QQ), and the WHO Health and Performance Questionnaire (HPQ). Agreement between the 2 timepoints was assessed using single-measure intraclass correlations (ICC) and correlated between each other and with visual analog scale general well-being scores at followup by Spearman correlation. RESULTS ICC between measures ranged from fair (HPQ 0.59) to excellent (WPS-RA 0.78). Spearman correlations between measures were moderate (Qquality vs WAI, r = 0.51) to strong (WPS-RA vs WPAI, r = 0.88). Correlations between measures and general well-being were low to moderate, ranging from -0.44 ≤ r ≤ 0.66. CONCLUSION Test-retest results of 4 out of 5 global measures were good, and the correlations between these were moderate. The latter probably reflect differences in the concepts, recall periods, and references used in the measures, which implies that some measures are probably not interchangeable.
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Affiliation(s)
- Sarah Leggett
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Antje van der Zee-Neuen
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Annelies Boonen
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Dorcas E Beaton
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Mihai Bojinca
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Ailsa Bosworth
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Sabrina Dadoun
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Bruno Fautrel
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Sofia Hagel
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Catherine Hofstetter
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Diane Lacaille
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Denise Linton
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Carina Mihai
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Ingemar F Petersson
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Pam Rogers
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Jamie C Sergeant
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Carlo Sciré
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
| | - Suzanne M M Verstappen
- From the Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute, Maastricht University, The Netherlands; Mobility Program Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario, Canada; Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; National Rheumatoid Arthritis Society, Maidenhead, UK; Department of Rheumatology, Université Pierre et Marie Curie, Paris, France; Department of Clinical Sciences Lund, Section of Rheumatology, Lund University and Skane University Hospital, Lund, Sweden; Canadian Arthritis Patient Alliance, Toronto, Ontario, Canada; Arthritis Research Centre of Canada, Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada; Orthopaedics, Clinical Sciences Lund, Lund University, Lund, Sweden; NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK; Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; and the Arthritis Research UK/MRC Centre for Musculoskeletal Health and Research, University of Southampton, Southampton, UK.S. Leggett, MSc, Arthritis Research UK Centre for Epidemiology; A. van der Zee-Neuen, PhD, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; A. Boonen, MD, PhD, Professor of Rheumatology, Department of Rheumatology, Maastricht University Medical Centre, and Caphri Research Institute; D.E. Beaton, PhD, Mobility Program Clinical Research Unit, St. Michael's Hospital; M. Bojinca, MD, PhD, Internal Medicine and Rheumatology Clinic, Dr. Ion Cantacuzino Hospital, Carol Davila University of Medicine and Pharmacy; A. Bosworth, Patient Partner, National Rheumatoid A
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