Standard Set of Outcomes Developed for Value-Based Health Care in Inflammatory Arthritis

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The International Consortium for Health Outcome Measurement released a set of outcomes to enable the implementation of value-based health care for patients with inflammatory arthritis.

The International Consortium for Health Outcome Measurement (ICHOM) has released a set of outcomes to help enable clinicians to implement value-based health care for patients with inflammatory arthritis, according to results published in Arthritis Care & Research.

The outcome measurements, called the ICHOM IA Standard Set, applies to patients with rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, and juvenile idiopathic arthritis.

To construct these outcomes, ICHOM assembled a multidisciplinary working group of 24 experts from 6 continents, including 6 patient representatives. The group used a modified Delphi process to reach consensus on conditions covered by the set, outcome domains, outcome measures, and risk-adjustment variables.

After the Delphi process was complete, the preliminary Standard Set was validated by health professionals and patient experts. Using a survey, patients rated the importance of each outcome using a 9-point Likert scale. Health professionals rated the relevance of each domain, provided feedback on the feasibility of implementing the Standard Set in clinical settings, and rated the appropriateness of risk-adjustment variables and time points for assessment.

ICHOM recommends that certain outcomes should be collected at least once a year, including pain, fatigue, activity limitations, overall physical and mental health impact, work/school/housework ability and productivity, disease activity, and serious adverse events.

For each domain, ICHOM recommends using validated patient-reported outcome measures.

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ICHOM also recommends that age, sex at birth, educational level, smoking status, comorbidities, time since diagnosis, rheumatoid factor, and anticitrullinated protein antibody laboratory testing for rheumatoid arthritis and juvenile idiopathic arthritis should be collected as risk-adjustment variables.

“We propose a Standard Set of outcomes for patients with [inflammatory arthritis] that providers of care for patients with [inflammatory arthritis] can track to facilitate the global reporting of outcome data and shared learning,” the researchers wrote.

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Voshaar MAHO, Gupta ZD, Bijlsma JWJ, et al. The International Consortium for Health Outcome Measurement (ICHOM) set of outcomes that matter to people living with inflammatory arthritis: consensus from an international working group [published online October 24, 2018].  Arthritis Care Res (Hoboken). doi:10.1002/acr.23799