Expert panel members used a standardized template (Supplementary Figure 1, available in the online version of this article at http://www3.interscience.wiley.com/journal/76509746/home ) to submit 3–5 real-life case scenarios representing patients with early (within 1 year of symptom onset) undifferentiated inflammatory arthritis. These scenarios included all patient information that the experts considered relevant to rule in (positive factors) or out (negative factors) an eventual diagnosis of RA.
Each scenario captured the following patient elements: age and sex, duration of joint pain, duration of joint swelling, average duration of morning stiffness, and distribution of affected joints (swollen and tender joints, indicated on joint homunculi). The expert also provided information on the subsequent disease course, whether or not treatment with methotrexate (MTX) had been initiated at that assessment time point, and the expert’s opinion, using a 5-point Likert scale from 1 (very low probability) to 5 (very high probability), of the probability that the patient would, if untreated, “develop RA.”
Each completed case scenario was assigned a unique name. Two members of the steering committee (TN and GH) selected a subset of 30 case scenarios that best represented the spectrum of probability of RA development. Most of the cases were in the middle 3 probability categories. These 30 scenarios were then simplified and standardized. The submitting expert’s identity, opinion regarding the probability of RA, and information on the subsequent disease course were removed.
Each scenario captured the following patient elements: age and sex, duration of joint pain, duration of joint swelling, average duration of morning stiffness, and distribution of affected joints (swollen and tender joints, indicated on joint homunculi). The expert also provided information on the subsequent disease course, whether or not treatment with methotrexate (MTX) had been initiated at that assessment time point, and the expert’s opinion, using a 5-point Likert scale from 1 (very low probability) to 5 (very high probability), of the probability that the patient would, if untreated, “develop RA.”
Each completed case scenario was assigned a unique name. Two members of the steering committee (TN and GH) selected a subset of 30 case scenarios that best represented the spectrum of probability of RA development. Most of the cases were in the middle 3 probability categories. These 30 scenarios were then simplified and standardized. The submitting expert’s identity, opinion regarding the probability of RA, and information on the subsequent disease course were removed.
