A method for achieving consensus on rheumatoid arthritis outcome measures: the OMERACT conference process

We describe the process used during the international Conference on Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The objectives of the conference were (1) to broaden consensus on the minimum number of outcome measures to be included in all RA clinical trials in rheumatoid arthritis (RA); (2) to achieve consensus on criteria for (a) minimum clinically important improvement in patients with RA and (b) minimum important differences between treatment groups in RA clinical trials; and (3) to decide whether aggregate outcome measures (indices) are useful in the assessment of patients and trials. A combination of plenary sessions and structured nominal groups were employed during the conference. Simulated patient profiles and clinical trial profiles were used to generate discussion. The objective of the nominal group exercises was to capture each participant's judgments of the relative importance of each outcome measure and the degree of change required to indicate clinical improvement. Considerable discussion ensued on the content of the core set of outcome measures. An electronic interactive voting machine was used to obtain participants' views on a core set of outcome measures and methodological issues. To permit further discussion of outcome measures, the group explored the use of aggregate outcome measures (indices) in patient care and trials only in a preliminary way. A final plenary session dealt with patient perceptions of minimum important differences, a new classification of antirheumatic drugs, and a repeat of part of the preconference questionnaire. Concluding statements and future plans were developed at the conclusion of the meeting. [References: 13]

Aim

The objectives of the conference were (1) to broaden consensus on the minimum number of outcome measures to be included in all RA clinical trials in rheumatoid arthritis (RA); (2) to achieve consensus on criteria for (a) minimum clinically important improvement in patients with RA and (b) minimum important differences between treatment groups in RA clinical trials; and (3) to decide whether aggregate outcome measures (indices) are useful in the assessment of patients and trials.

Contributors

Fried, B. J. Boers, M. Baker, P. R.

Publication

Journal: Journal of Rheumatology
Volume: 20
Issue: 3
Pages: 548 - 51
Year: 1993
DOI:

Further Study Information

Current Stage: Not Applicable
Date: 2002
Funding source(s):


Health Area

Disease Category: Rheumatology

Disease Name: Rheumatoid arthritis

Target Population

Age Range: Unknown

Sex: Either

Nature of Intervention: Not specified

Stakeholders Involved

Study Type

- COS for clinical trials or clinical research

Method(s)

- Consensus meeting
- Nominal group technique (NGT)
- Semi structured discussion

See also: Tugwell, P. and M. Boers (1993). "OMERACT conference on outcome measures in rheumatoid arthritis clinical trials: introduction." Journal of Rheumatology 20(3): 528-30.

Stakeholders detailed in: Boers, M., P. Tugwell, et al. (1994). "World Health Organization and International League of Associations for Rheumatology core endpoints for symptom modifying antirheumatic drugs in rheumatoid arthritis clinical trials." Journal of Rheumatology - Supplement 41: 86-9.