Patient, Clinician Panels Develop Similar Rheumatoid Arthritis Recommendations

HealthDay News — A voting panel composed of patients with rheumatoid arthritis develops recommendations that are very similar to those of a physician-dominated panel when there is evidence warranting moderate or high confidence, according to research published in Arthritis Care & Research.

Liana Fraenkel, MD, MPH, from the Yale University School of Medicine in New Haven, Connecticut, and colleagues determined the feasibility and value of developing clinical practice guideline recommendations based on a voting panel composed of patients compared with recommendations developed by a physician-dominated voting panel. Ten patients completed 8 hours of training relating to evidence-based medicine and development of guidelines. The patients met at a face-to-face meeting to develop recommendations, with two American College of Rheumatology staff members with expertise in guideline development and a physician facilitator. The patients formulated recommendation on 18 questions for which there was evidence warranting moderate or high confidence.

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According to the researchers, the patient panel developed recommendations for 16 questions. The panel thought there was insufficient evidence to support a recommendation for the other 2 questions. 

The patient panel recommended the same course of action as the physician-dominated panel for 13 of the 16 questions. Differences were due to the assessment of the balance between benefits and harms by the two panels.

“Additional experiences are necessary to advance the evidence necessary to determine what panel composition is optimal to produce the best guidelines,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.


Fraenkel L, Miller A, Clayton K et al. When Patients Write the Guidelines: Patient Panel Recommendations for the Treatment of Rheumatoid Arthritis. Arthritis Care Res. 2015;68(1):26-35. doi:10.1002/acr.22758.