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/></a></div><div class="bkr_bib"><h1 id="_NBK577120_"><span itemprop="name">Target for monitoring</span></h1><div class="subtitle">Rheumatoid arthritis in adults: diagnosis and management</div><p><b>Evidence review D</b></p><p><i>NICE Guideline, No. 100</i></p><p class="contrib-group"><h4>Authors</h4><span itemprop="author">National Guideline Centre (UK)</span>.</p><div class="half_rhythm">London: <a href="https://www.nice.org.uk" ref="pagearea=meta&amp;targetsite=external&amp;targetcat=link&amp;targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Excellence (NICE)</span></a>; <span itemprop="datePublished">2018 Jul</span>.<div class="small">ISBN-13: <span itemprop="isbn">978-1-4731-3003-6</span></div></div><div><a href="/books/about/copyright/">Copyright</a> &#x000a9; NICE 2018.</div></div><div class="bkr_clear"></div></div><div id="chd1"><h2 id="_chd1_">1. Target for monitoring</h2><div id="chd1.s1"><h3>1.1. Review question: In adults with rheumatoid arthritis, what is the
best target to use when monitoring disease activity (remission or low
disease activity)?</h3></div><div id="chd1.s2"><h3>1.2. Introduction</h3><p>Current consensus amongst the rheumatology community is that a
treat-to-target strategy should be used when treating people with
rheumatoid arthritis (RA) with DMARDs. A treat-to-target strategy is a
strategy that defines a treatment target (such as remission or low
disease activity) and applies tight control (for example, monthly visits
and respective treatment adjustment) to reach this target. The treatment
strategy often follows a protocol for treatment adaptions depending on
the disease activity level and degree of response to treatment.</p><p>The 2009 NICE guideline: Rheumatoid arthritis in adults: management<a class="bibr" href="#ptd.ref9" rid="ptd.ref9"><sup>9</sup></a> suggested a
treat-to-target approach in the recommendations that said to measure
inflammatory markers and disease activity monthly &#x0201c;until
treatment has controlled the disease to a level previously agreed with
the person with RA&#x0201d;. However, the committee agreed that the
evidence for a treat-to-target strategy should be reviewed, to make this
recommendation clearer and more direct if supported by the evidence.</p><p>The committee also agreed that greater clarity was needed on how
frequently people with rheumatoid arthritis should be monitored, as
there was currently variation in practice and some uncertainty about how
frequent monitoring should be in different groups of people with
rheumatoid arthritis with varying degrees of disease activity. However,
the frequency of monitoring review excluded an update of the annual
review recommended in the previous guideline, as it is an essential and
well-established practice and therefore was not included within the
scope of this update.</p><p>Three interrelated evidence reviews were conducted to answer the
following key questions in this area: <ol id="l73"><li id="lt217" class="half_rhythm"><div>Is treat-to-target more effective than usual care?</div></li><li id="lt218" class="half_rhythm"><div>If so, should the treatment target be low disease activity or
remission?</div></li><li id="lt219" class="half_rhythm"><div>How often should people be monitored, outside of the annual
review?</div></li></ol></p></div><div id="chd1.s3"><h3>1.3. PICO table</h3><p>For full details, see the review protocol in <a href="#ptd.appa">appendix A</a>.</p><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figchd1tab1"><a href="/books/NBK577120/table/chd1.tab1/?report=objectonly" target="object" title="Table 1" class="img_link icnblk_img figpopup" rid-figpopup="figchd1tab1" rid-ob="figobchd1tab1"><img class="small-thumb" src="/books/NBK577120/table/chd1.tab1/?report=thumb" src-large="/books/NBK577120/table/chd1.tab1/?report=previmg" alt="Table 1. PICO characteristics of review question." /></a><div class="icnblk_cntnt"><h4 id="chd1.tab1"><a href="/books/NBK577120/table/chd1.tab1/?report=objectonly" target="object" rid-ob="figobchd1tab1">Table 1</a></h4><p class="float-caption no_bottom_margin">PICO characteristics of review question. </p></div></div></div><div id="chd1.s4"><h3>1.4. Methods and process</h3><p>This evidence review was developed using the methods and process
described in Developing NICE guidelines: the manual.<a class="bibr" href="#ptd.ref1" rid="ptd.ref1"><sup>1</sup></a> Methods specific
to this review question are described in the review protocol in <a href="#ptd.appa">appendix A</a>.</p><p>Declarations of interest were recorded according to NICE&#x02019;s 2014
conflicts of interest policy.</p></div><div id="chd1.s5"><h3>1.5. Clinical evidence</h3><div id="chd1.s5.1"><h4>1.5.1. Included studies</h4><p>A search was conducted for randomised controlled trials and
systematic reviews of randomised controlled trials comparing
remission with low disease activity as targets in monitoring RA.</p><p>No relevant clinical studies were identified.</p><p>See also the study selection flow chart in <a href="#ptd.appc">appendix C</a>.</p></div><div id="chd1.s5.2"><h4>1.5.2. Excluded studies</h4><p>See the excluded studies list in <a href="#ptd.appi">appendix I</a>.</p></div><div id="chd1.s5.3"><h4>1.5.3. Summary of clinical studies included in the evidence
review</h4><p>No relevant clinical studies were identified.</p></div><div id="chd1.s5.4"><h4>1.5.4. Quality assessment of clinical studies included in the evidence
review</h4><p>No relevant clinical studies were identified.</p></div></div><div id="chd1.s6"><h3>1.6. Economic evidence</h3><div id="chd1.s6.1"><h4>1.6.1. Included studies</h4><p>No relevant health economic studies were identified.</p></div><div id="chd1.s6.2"><h4>1.6.2. Excluded studies</h4><p>No health economic studies that were relevant to this question were
excluded due to assessment of limited applicability or
methodological limitations.</p><p>See also the health economic study selection flow chart in <a href="#ptd.appg">appendix G</a>.</p></div><div id="chd1.s6.3"><h4>1.6.3. Unit costs</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figchd1tab2"><a href="/books/NBK577120/table/chd1.tab2/?report=objectonly" target="object" title="Table 2" class="img_link icnblk_img figpopup" rid-figpopup="figchd1tab2" rid-ob="figobchd1tab2"><img class="small-thumb" src="/books/NBK577120/table/chd1.tab2/?report=thumb" src-large="/books/NBK577120/table/chd1.tab2/?report=previmg" alt="Table 2. UK costs of healthcare professional visits." /></a><div class="icnblk_cntnt"><h4 id="chd1.tab2"><a href="/books/NBK577120/table/chd1.tab2/?report=objectonly" target="object" rid-ob="figobchd1tab2">Table 2</a></h4><p class="float-caption no_bottom_margin">UK costs of healthcare professional visits. </p></div></div></div></div><div id="chd1.s7"><h3>1.7. Resource costs</h3><p>The recommendations made in this review are not expected to have a
substantial impact on resources.</p></div><div id="chd1.s8"><h3>1.8. Evidence statements</h3><div id="chd1.s8.1"><h4>1.8.1. Clinical evidence statements</h4><p>No relevant clinical studies were identified.</p></div><div id="chd1.s8.2"><h4>1.8.2. Health economic evidence statements</h4><ul id="l78"><li id="lt233" class="half_rhythm"><div>No relevant economic evaluations were identified.</div></li></ul></div></div><div id="chd1.s9"><h3>1.9. The committee&#x02019;s discussion of the evidence</h3><div id="chd1.s9.1"><h4>1.9.1. Interpreting the evidence</h4><div id="chd1.s9.1.1"><h5>1.9.1.1. The outcomes that matter most</h5><p>The critical outcomes were agreed to be the Disease Activity
Score (DAS), quality of life and function for all 3 reviews.</p><p>Pain, radiographic progression, fatigue and the number of people
who withdrew from the trial were agreed to be important outcomes
for all 3 reviews. The treat-to-target review and the frequency
of monitoring review also specified the number of people
achieving remission and low disease activity, using DAS
thresholds, as important outcomes. The committee agreed that
data reported in this format are not as informative as
continuous DAS data but still give an indication of symptom
relief and disease activity improvement. Disease activity data
in this dichotomous format were not considered informative for
the review of whether low disease activity or remission was the
better target given the question posed by the review.</p><p>In the treat-to-target review, no data were available for the
outcome of fatigue. For the frequency of monitoring review, no
data were available for any of the disease activity outcomes,
quality of life or fatigue.</p><p>No studies were identified for the review of remission compared
with low disease activity as a treatment target.</p></div><div id="chd1.s9.1.2"><h5>1.9.1.2. The quality of the evidence</h5><div id="chd1.s9.1.2.1"><h5>Treat-to-target versus usual care</h5><p>Five studies were included in the review of treat-to-target
versus usual care. The quality of the evidence was varied,
ranging from moderate to very low quality, with the majority
of the outcomes graded either low or very low quality. A
lack of blinding was a source of risk of bias in all of the
included studies. Some studies also poorly reported aspects
of their design such as how they randomised participants,
concealed allocation, and dealt with missing data, which
affected the quality rating. For those outcomes where the
data was reported by only 1 or 2 trials, the confidence
intervals tended to be wide which meant there was some
uncertainty about whether the treat-to-target strategy was
more effective than usual care.</p><p>Importantly, there was substantial inconsistency in the
magnitude of the benefit of treat-to-target across the
studies and between different treat-to-target arms within
studies, which also affected the quality of the evidence for
most outcomes (DAS, HAQ, remission, low disease activity,
pain, and study discontinuation). It was not possible to
conduct formal subgroup analysis to see if this explained
the heterogeneity, as there were too few studies in each
subgroup category. However, the committee discussed the
possible reasons for these differing results. The committee
noted the great variation in the design of the studies,
particularly around the disease duration of participants
(which ranged from less than 1 year in 1 study, to a median
of 6-7 years in another study), the nature of the target
used in the intervention arm (whether a DAS-based target was
used), and whether or not either or both study arms used a
protocol-driven treatment strategy (some studies did not use
a protocol in either arm, other studies used a protocol in
both arms and some studies compared a protocol in the
intervention arm to usual care without a protocol).</p><p>The committee agreed that it was not possible to establish
definitively which of these factors (if any) might explain
the differences in the magnitude of the effect between the
studies. However, the committee noted that while there was
some inconsistency in the magnitude of the benefit of
treat-to-target in improving disease activity, function and
pain, in general the majority of evidence across outcomes
favoured treat-to-target over usual care. The few results
that did suggest a benefit of usual care were generally from
the non- DAS-based target arms of 2 studies (which used
targets of zero swollen joint count and matrix
metalloproteinase 3 levels). The results of the DAS-based
target arms of those studies favoured the intervention arm,
consistent with the other study results.</p></div><div id="chd1.s9.1.2.2"><h5>Remission or low disease activity as the target</h5><p>No evidence was identified comparing the targets of remission
or low disease activity. Recommendations were therefore
informed by GC consensus opinion.</p></div><div id="chd1.s9.1.2.3"><h5>Frequency of monitoring</h5><p>One study was included in the review of different monitoring
frequencies. This study compared patient-initiated rapid
access with traditionally scheduled reviews every 3 to 6
months. All of the evidence was assessed to be very low
quality. Lack of blinding, along with relatively high rates
of missing data and limited information about how this was
dealt with in the analysis contributed to the risk of bias.
It was also unclear what was measured at each review and
whether the minimum requirements as specified in the review
protocol were satisfied (assessment of the joints for
swelling and measurement of inflammatory markers), which
further weakened the evidence. The evidence was also
assessed to be indirect to that specified in the protocol
due to the variation in the frequency of reviews in the
control group, and the population being a mix of people with
stable and unstable disease.</p><p>No studies were found comparing any other frequencies of
monitoring.</p><div id="chd1.s9.1.2.3.1"><h5>People at risk of poor outcomes</h5><p>People with a poor prognosis were pre-specified as a
separate stratum in the protocols for the review of
remission versus low disease activity as a target and
the review of frequency of monitoring. People with a
poor prognosis were considered to be those with one or
more of the key prognostic factors identified in a
separate review, which were anti-CCP positive status and
the presence of erosions at baseline. No evidence was
found in this subgroup of people for either
question.</p></div></div></div><div id="chd1.s9.1.3"><h5>1.9.1.3. Benefits and harms</h5><div id="chd1.s9.1.3.1"><h5>Treat-to-target versus usual care</h5><p>The committee agreed that the evidence for the
treat-to-target versus usual care review suggested that a
treat-to-target approach was more effective than usual care.
The committee acknowledged the limitations of the evidence
base described above, but were persuaded by the consistency
of the overall findings of a clinically important benefit in
favour of treat-to-target across almost all of the outcomes.
The committee acknowledged that the more frequent
appointments usually required with treat-to-target
management could, for some people, be difficult to combine
with full time work, although this would depend on the
individual. The committee were reassured by the evidence
that not only did treat-to-target appear to be more
clinically effective than usual care, study discontinuation
rates tended to be lower in people receiving treat-to-target
care, even though the frequency of monitoring in the
treat-to-target groups was often higher and so the burden on
people attending the appointments greater.</p><p>In further support of treat-to-target despite the differences
in the included studies, the committee agreed that one
included study most closely reflected the treat-to-target
and usual care approaches used in clinical practice in
England, whereas some of the other included studies used
more unusual designs. This study was the only study that
utilised more frequent monitoring and a protocol-driven
treatment strategy in the intervention group, compared with
less frequent visits and treatment at the discretion of
treating doctor in the usual care group. The committee noted
that this trial found consistent and substantial benefits of
treat-to-target approach over usual care, which further
reinforced their view that treat-to-target was more
effective than usual care. In addition, the committee noted
that many of the included studies in the separate evidence
review of DMARD treatment, which reported positive outcomes
for people with rheumatoid arthritis, were strategy trials
that employed a treat-to-target approach. This provided
further indirect evidence of the importance of
treating-to-target to achieve good outcomes for people with
rheumatoid arthritis.</p><p>The committee unanimously agreed that a treat-to-target
approach to managing rheumatoid arthritis was essential to
achieving rapid and sustained disease control and was the
cornerstone of modern rheumatology practice. The lay members
of the committee strongly emphasised the difference made to
the lives of people with rheumatoid arthritis when a
treat-to-target approach is implemented. Without a
treat-to-target approach, people with rheumatoid arthritis
risk being left in a moderate disease activity state, and
these disease levels will have a significant impact on their
daily life. If implemented appropriately, a treat-to-target
approach should also avoid many people with rheumatoid
arthritis having high disease activity levels warranting
biologic DMARD treatment in the future. Although the quality
of evidence from this review was not of high quality, the GC
agreed that the importance of this recommendation in
clinical practice, combined with this evidence and the
indirect evidence from other reviews where the strategy was
employed, all supported a strong recommendation for all
people with rheumatoid arthritis.</p></div><div id="chd1.s9.1.3.2"><h5>Remission or low disease activity as the target</h5><p>Having agreed that a treat-to-target approach is beneficial,
the committee discussed what the disease activity target
should be. The committee discussed the existing
recommendation, which did not specify a target, and agreed
that although no evidence was identified for this review, it
was important to specify a target to ensure that people were
fully treated and achieved the best possible outcomes and
understood the goal of the treatment.</p><p>In the absence of available evidence the committee discussed
which of the 2 targets was most appropriate based on their
experience and expertise. The committee agreed that the aim
should always be to control disease activity to the lowest
possible level, but that this would depend on the individual
as in some people, treatment will not be able to achieve
very low targets. The committee decided by consensus that
remission (for example, DAS28 less than 2.6) is the ideal
target for most people with rheumatoid arthritis, but for
people who were unable to achieve this target despite a
treat-to-target approach with appropriate escalation, low
disease activity (for example, DAS28 less than 3.2) would be
acceptable as this is more achievable for some people and
agreed as a good outcome if remission can&#x02019;t be
achieved. The committee noted that remission and low disease
activity can be measured using various composite scoring
measures. The committee were of the view that the most
appropriate measures were validated scoring systems that
incorporated inflammatory markers and a swollen joint count.
Such measures include DAS, DAS28 and SDAI.</p><p>In order to treat-to-target using a target of remission or
low disease activity, it is essential that a disease
activity score such as the DAS28 is measured at each visit.
The committee acknowledged that the DAS28 can be calculated
using either ESR or CRP (both inflammatory markers), but
agreed that current consensus is that CRP is subject to less
variability as it is a direct measure of inflammatory
protein. Hence, CRP is generally the preferred measure for
people treated with conventional DMARDs. Therefore, the
committee agreed to maintain the previous recommendation to
measure CRP and disease activity using a composite score
such as DAS28.</p></div><div id="chd1.s9.1.3.3"><h5>Frequency of monitoring</h5><p>The committee discussed how frequently people should be
monitored (a) while their disease is active as part of a
treat-to-target approach, (b) after they have achieved the
treatment target, and (c) once they have maintained disease
activity below the treatment target for a period of time and
their disease is considered well-controlled.</p><p>No evidence was identified specifically looking at how often
people with active disease should be monitored. The
committee noted that the previous guideline recommended
monthly monitoring for people with active disease. The
committee also considered the monitoring regimens in the
studies included in the treat-to-target review. These varied
between studies, however, the study considered to be the
most applicable evidence (discussed above) employed monthly
monitoring in the treat-to-target arm, compared with three
monthly in the usual care arm. The committee agreed by
consensus that monthly review of people with active disease
remained the most appropriate monitoring frequency as part
of the treat-to-target approach. Monthly monitoring in
active disease was considered necessary in order to escalate
DMARD doses, to consider the need for short-term
glucocorticoids while waiting for DMARDs to take effect, to
establish whether people were tolerating the drug and assess
side effects, and to provide support and encourage
adherence. Any more frequent was considered to be
unnecessary from both an effectiveness and resource impact
perspective, and would increase the burden for people with
RA.</p><p>The committee discussed how frequently people should be
monitored once their disease was below the target activity
level of remission or low disease activity. The committee
discussed the previous guideline recommendation, which was
to provide appointments at a frequency and location suitable
to [the person&#x02019;s] needs. The committee agreed that
this should be more specific if possible, to improve
consistency and avoid under or over monitoring of this group
of people. It was agreed by consensus that a review
appointment should be considered 6 months after a person
achieves the treatment target, to assess whether the disease
control has been maintained.</p><p>The committee discussed whether people with sustained disease
levels below the treatment target required regular
monitoring between annual reviews in the absence of
worsening symptoms or deterioration (annual reviews were not
updated in this guideline). The committee considered the
study included in the frequency of monitoring review to be
somewhat applicable to this situation, as it enrolled
participants with long term, established disease. The
evidence suggested that patient-initiated rapid access
(median 8 reviews over 6 years) was no less effective than
traditionally scheduled medical review every 3-6 months
(median 13 reviews over 6 years) in this group of people
with rheumatoid arthritis. The committee acknowledged the
limitations of this evidence (discussed above), but agreed
it reflected their experience that regular scheduled
appointments (over and above an annual review) were not
necessary in people with well-controlled disease.</p><p>Overall, the committee agreed that once people with
rheumatoid arthritis had achieved the treatment target, and
this was sustained at a 6 month follow-up appointment, there
was no need for additional routine appointments to be
scheduled other than the annual review. However, the
committee emphasised the importance of all people with
rheumatoid arthritis having rapid access to specialist care
for disease flares, and the need for ongoing drug
monitoring. The committee agreed this was addressed by the
existing recommendations on rapid access, which had not been
reviewed in the update, with some amendments to the wording
to improve clarity.</p><div id="chd1.s9.1.3.3.1"><h5>People at risk of poor outcomes</h5><p>The committee agreed that there was no evidence
suggesting people with a poor prognosis should be
managed any differently to the general rheumatoid
arthritis population, in terms of the treatment target
or the frequency of monitoring. The committee agreed
that the standard recommendations regarding
treatment-to-target with monthly monitoring should
ensure that people with a poor prognosis receive
effective treatment of their disease.</p></div></div></div></div><div id="chd1.s9.2"><h4>1.9.2. Cost effectiveness and resource use</h4><p>For the treat-to-target review, 2 economic evaluations were
identified, comparing a treat-to-target approach to usual care (Nair
2015, Grigor 2004). Nair 2015 was a cost&#x02013;utility analysis
based on a cohort of people with early RA. This evaluation used
clinical effectiveness data from the CAMERA trial, which was also
included in the clinical review for treat-to-target. Analysis within
this study identified treat-to-target to be cost effective, and in
fact cost saving compared to usual practice (being less costly and
more effective). The treat-to-target strategy resulted in less
medical consumption and improved quality of life due to better
DAS28/HAQ; however, drug costs were higher. The committee noted the
relatively short time horizon of the study and questioned the
ability of the study to capture the long-term cost benefits
associated with the treat-to-target approach. The second analysis
(Grigor 2004) was a cost&#x02013;consequences analysis based on the
TICORA RCT (same paper) which was also included in the clinical
review. This analysis also found that treat-to-target was less
costly and more effective than usual care. No analysis of
uncertainty was conducted however; confidence intervals indicate
that there is some uncertainty in both the costs and outcomes. The
committee considered these confidence intervals and concluded that
at a minimum treat-to-target was likely to be cost neutral.</p><p>Based on the clinical and economic evidence reviewed, the committee
concluded that treat-to-target appeared to improve outcomes at no
additional cost. As treat-to-target is already considered current
practice and was recommended in the previous guideline, it is not
anticipated that this recommendation will have a substantial
resource impact.</p><p>No health economic studies were identified regarding the frequency of
monitoring or the target for monitoring. Unit costs were provided
for rheumatologist consultations to aid the consideration of cost
effectiveness. The committee considered the potential economic
impact of increasing frequency of monitoring from monthly to
fortnightly and agreed that this would have a substantial impact on
NHS resources and that there was no clinical evidence to support it.
The committee agreed to keep the previous recommendation of monthly
monitoring based on the clinical evidence reviewed. The committee
noted that monthly visits may not have been implemented nationwide
and this is reflected in a survey of the 2009 guideline
implementation in the Midlands (25&#x02013;62% receiving monthly
monitoring). If this is reflective of practice across the country,
this recommendation will likely involve a change in practice in many
clinics around the country and may have a resource impact. Although
there was no direct health economic evidence for the frequency of
monitoring, the Grigor 2004 and Nair 2015 treat-to-target economic
analyses suggested that even with more frequent visits (monthly
versus every 3 months), a treat-to-target approach was cost saving.
Finally, the committee noted that these monthly visits are often
conducted by a nurse specialist rather than a consultant. The unit
costs of different healthcare professionals were presented to the
committee and it was noted that the cost of a nurse consultation
would be less expensive than that of a consultant.</p><p>Regarding the target, aiming for low disease activity or remission is
considered unlikely to have a resource impact. With either target,
the individual will require ongoing monitoring and treatment
adjustment, both of which have cost implications that are unlikely
to differ depending on the target.</p><p>The committee made a recommendation to consider a review appointment
within 6 months of stabilising. This recommendation was made based
on expert opinion and consensus. The committee considered that this
recommendation might reduce unwarranted variation in follow-up
across the country as the prior recommendation may have led to
unnecessary consultations for some or others receiving no
follow-up.</p></div></div></div><div id="ptd.rl.r1"><h2 id="_ptd_rl_r1_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="ptd.ref1">Barlow
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London. National
Institute for Health and Care Excellence,
2014. Available from: <a href="http://www.nice.org.uk/article/PMG20/chapter/1%20Introduction%20and%20overview" ref="pagearea=cite-ref&amp;targetsite=external&amp;targetcat=link&amp;targettype=uri">http://www<wbr style="display:inline-block"></wbr>&#8203;.nice.org.uk<wbr style="display:inline-block"></wbr>&#8203;/article/PMG20/chapter<wbr style="display:inline-block"></wbr>&#8203;/1%20Introduction%20and%20overview</a> [<a href="https://pubmed.ncbi.nlm.nih.gov/26677490" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 26677490</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>11.</dt><dd><div class="bk_ref" id="ptd.ref11">Pincus
T,
Castrejon
I. Evidence
that the strategy is more important than the agent to treat
rheumatoid arthritis. Data from clinical trials of combinations of
non-biologic DMARDs, with protocol-driven intensification of therapy
for tight control or treat-to-target.
Bulletin of the Hospital for Joint Disease
2013; 71 (Suppl
1):S33&#x02013;40 [<a href="https://pubmed.ncbi.nlm.nih.gov/24219039" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 24219039</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>12.</dt><dd><div class="bk_ref" id="ptd.ref12">Pope
JE,
Haraoui
B,
Rampakakis
E,
Psaradellis
E,
Thorne
C,
Sampalis
JS
et al. Treating to a target in established active
rheumatoid arthritis patients receiving a tumor necrosis factor
inhibitor: results from a real-world cluster-randomized adalimumab
trial. Arthritis Care &#x00026;
Research. 2013;
65(9):1401&#x02013;9 [<a href="https://pubmed.ncbi.nlm.nih.gov/23509040" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 23509040</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>13.</dt><dd><div class="bk_ref" id="ptd.ref13">Radner
H,
Smolen
JS,
Aletaha
D. Remission
in rheumatoid arthritis: benefit over low disease activity in
patient-reported outcomes and costs.
Arthritis Research &#x00026; Therapy.
2014;
16:R56 [<a href="/pmc/articles/PMC3979137/" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pmc">PMC free article<span class="bk_prnt">: PMC3979137</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/24555808" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 24555808</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>14.</dt><dd><div class="bk_ref" id="ptd.ref14">Schoels
M,
Knevel
R,
Aletaha
D,
Bijlsma
JW,
Breedveld
FC,
Boumpas
DT
et al. Evidence for treating rheumatoid arthritis to
target: results of a systematic literature search.
Annals of the Rheumatic Diseases.
2010;
69(4):638&#x02013;43 [<a href="/pmc/articles/PMC3015093/" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pmc">PMC free article<span class="bk_prnt">: PMC3015093</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/20237123" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 20237123</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>15.</dt><dd><div class="bk_ref" id="ptd.ref15">Smolen
JS,
Breedveld
FC,
Burmester
GR,
Bykerk
V,
Dougados
M,
Emery
P
et al. Treating rheumatoid arthritis to target: 2014
update of the recommendations of an international task
force. Annals of the Rheumatic
Diseases. 2016;
75(1):3&#x02013;15 [<a href="/pmc/articles/PMC4717393/" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pmc">PMC free article<span class="bk_prnt">: PMC4717393</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25969430" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 25969430</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>16.</dt><dd><div class="bk_ref" id="ptd.ref16">Stoffer
MA,
Schoels
MM,
Smolen
JS,
Aletaha
D,
Breedveld
FC,
Burmester
G
et al. Evidence for treating rheumatoid arthritis to
target: results of a systematic literature search
update. Annals of the Rheumatic
Diseases. 2016;
75(1):16&#x02013;22 [<a href="/pmc/articles/PMC4717391/" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pmc">PMC free article<span class="bk_prnt">: PMC4717391</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25990290" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 25990290</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>17.</dt><dd><div class="bk_ref" id="ptd.ref17">van
Tuyl
LH,
Lems
WF,
Voskuyl
AE,
Kerstens
PJ,
Garnero
P,
Dijkmans
BA
et al. Tight control and intensified COBRA combination
treatment in early rheumatoid arthritis: 90% remission in a pilot
trial. Annals of the Rheumatic
Diseases. 2008;
67(11):1574&#x02013;7 [<a href="https://pubmed.ncbi.nlm.nih.gov/18625629" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 18625629</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="ptd.ref18">Wells
G,
Boers
M,
Tugwell
P, M. D. A. Working
Group. Low disease activity state in
rheumatoid arthritis: concepts and derivation of minimal disease
activity. Clinical and Experimental
Rheumatology. 2006;
24(6 Suppl
43):S-52&#x02013;9 [<a href="https://pubmed.ncbi.nlm.nih.gov/17083764" ref="pagearea=cite-ref&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">PubMed<span class="bk_prnt">: 17083764</span></a>]</div></dd></dl></dl></div><div id="appendixes.appgroupd"><h2 id="_appendixes_appgroupd_">Appendices</h2><div id="ptd.appa"><h3>Appendix A. Review protocols</h3><p id="ptd.appa.et1"><a href="/books/NBK577120/bin/ptd-appa-et1.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 3. Review protocol: Which target to monitor in rheumatoid
arthritis?</a><span class="small"> (PDF, 165K)</span></p><p id="ptd.appa.et2"><a href="/books/NBK577120/bin/ptd-appa-et2.pdf" class="bk_dwnld_icn bk_dwnld_pdf">Table 4. Health economic review protocol</a><span class="small"> (PDF, 147K)</span></p></div><div id="ptd.appb"><h3>Appendix B. Literature search strategies</h3><p>The literature searches for this review are detailed below and complied
with the methodology outlined in Developing NICE guidelines: the manual
2014, updated 2017. <a href="https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869" ref="pagearea=body&amp;targetsite=external&amp;targetcat=link&amp;targettype=uri">https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-pdf-72286708700869</a></p><p><i>For more detailed information, please see the Methodology
Review</i>.</p><div id="ptd.appb.s1"><h4>B.1. Clinical search literature search strategy</h4><p>Searches were constructed using a PICO framework where population (P)
terms were combined with Intervention (I) and in some cases
Comparison (C) terms. Outcomes (O) are rarely used in search
strategies for interventions as these concepts may not be well
described in title, abstract or indexes and therefore difficult to
retrieve. Search filters were applied to the search where
appropriate.</p><p id="ptd.appb.tab1"><a href="/books/NBK577120/table/ptd.appb.tab1/?report=objectonly" target="object" rid-ob="figobptdappbtab1" class="figpopup">Table 5. Database date parameters and filters used</a></p><p id="ptd.appb.tab2"><a href="/books/NBK577120/table/ptd.appb.tab2/?report=objectonly" target="object" rid-ob="figobptdappbtab2" class="figpopup">Medline (Ovid) search terms</a></p><p id="ptd.appb.tab3"><a href="/books/NBK577120/table/ptd.appb.tab3/?report=objectonly" target="object" rid-ob="figobptdappbtab3" class="figpopup">Embase (Ovid) search terms</a></p><p id="ptd.appb.tab4"><a href="/books/NBK577120/table/ptd.appb.tab4/?report=objectonly" target="object" rid-ob="figobptdappbtab4" class="figpopup">Cochrane Library (Wiley) search terms</a></p></div><div id="ptd.appb.s2"><h4>B.2. Health Economics literature search strategy</h4><p>Health economic evidence was identified by conducting a broad search
relating to rheumatoid arthritis population in NHS Economic
Evaluation Database (NHS EED &#x02013; this ceased to be updated
after March 2015) and the Health Technology Assessment database
(HTA) with no date restrictions. NHS EED and HTA databases are
hosted by the Centre for Research and Dissemination (CRD).
Additional searches were run on Medline and Embase for health
economics studies.</p><p id="ptd.appb.tab5"><a href="/books/NBK577120/table/ptd.appb.tab5/?report=objectonly" target="object" rid-ob="figobptdappbtab5" class="figpopup">Table 6. Database date parameters and filters used</a></p><p id="ptd.appb.tab6"><a href="/books/NBK577120/table/ptd.appb.tab6/?report=objectonly" target="object" rid-ob="figobptdappbtab6" class="figpopup">Medline (Ovid) search terms</a></p><p id="ptd.appb.tab7"><a href="/books/NBK577120/table/ptd.appb.tab7/?report=objectonly" target="object" rid-ob="figobptdappbtab7" class="figpopup">Embase (Ovid) search terms</a></p><p id="ptd.appb.tab8"><a href="/books/NBK577120/table/ptd.appb.tab8/?report=objectonly" target="object" rid-ob="figobptdappbtab8" class="figpopup">NHS EED and HTA (CRD) search terms</a></p></div></div><div id="ptd.appc"><h3>Appendix C. Clinical evidence selection</h3><p id="ptd.appc.fig1"><a href="/books/NBK577120/figure/ptd.appc.fig1/?report=objectonly" target="object" rid-ob="figobptdappcfig1" class="figpopup">Figure 1. Flow chart of clinical study selection for the review of
&#x02018;Which target to monitor in rheumatoid
arthritis?&#x02019;</a></p></div><div id="ptd.appd"><h3>Appendix D. Clinical evidence tables</h3><p>No relevant clinical studies were identified.</p></div><div id="ptd.appe"><h3>Appendix E. Forest plots</h3><p>No relevant clinical studies were identified.</p></div><div id="ptd.appf"><h3>Appendix F. GRADE tables</h3><p>No relevant clinical studies were identified.</p></div><div id="ptd.appg"><h3>Appendix G. Health economic evidence selection</h3><p id="ptd.appg.fig2"><a href="/books/NBK577120/figure/ptd.appg.fig2/?report=objectonly" target="object" rid-ob="figobptdappgfig2" class="figpopup">Figure 2. Flow chart of economic study selection for the
guideline</a></p></div><div id="ptd.apph"><h3>Appendix H. Health economic evidence tables</h3><p>No relevant economic studies were identified.</p></div><div id="ptd.appi"><h3>Appendix I. Excluded studies</h3><div id="ptd.appi.s1"><h4>I.1. Excluded clinical studies</h4><p id="ptd.appi.tab1"><a href="/books/NBK577120/table/ptd.appi.tab1/?report=objectonly" target="object" rid-ob="figobptdappitab1" class="figpopup">Table 7. Studies excluded from the clinical review</a></p></div><div id="ptd.appi.s2"><h4>I.2. Excluded health economic studies</h4><p id="ptd.appi.tab2"><a href="/books/NBK577120/table/ptd.appi.tab2/?report=objectonly" target="object" rid-ob="figobptdappitab2" class="figpopup">Table 8. Studies excluded from the health economic review</a></p></div></div></div></div><div class="fm-sec"><div><p>Final</p></div><div><p>Intervention evidence review</p><p>Developed by the National Guideline Centre, hosted by the Royal College of
Physicians</p></div><div><p>The recommendations in this guideline represent the view of NICE, arrived at after
careful consideration of the evidence available. When exercising their judgement,
professionals are expected to take this guideline fully into account, alongside the
individual needs, preferences and values of their patients or service users. The
recommendations in this guideline are not mandatory and the guideline does not
override the responsibility of healthcare professionals to make decisions
appropriate to the circumstances of the individual patient, in consultation with the
patient and, where appropriate, their carer or guardian.</p><p>Local commissioners and providers have a responsibility to enable the guideline to be
applied when individual health professionals and their patients or service users
wish to use it. They should do so in the context of local and national priorities
for funding and developing services, and in light of their duties to have due regard
to the need to eliminate unlawful discrimination, to advance equality of opportunity
and to reduce health inequalities. Nothing in this guideline should be interpreted
in a way that would be inconsistent with compliance with those duties.</p><p>NICE guidelines cover health and care in England. Decisions on how they apply in
other UK countries are made by ministers in the <a href="http://wales.gov.uk/" ref="pagearea=body&amp;targetsite=external&amp;targetcat=link&amp;targettype=uri">Welsh Government</a>, <a href="http://www.scotland.gov.uk/" ref="pagearea=body&amp;targetsite=external&amp;targetcat=link&amp;targettype=uri">Scottish Government</a>, and
<a href="http://www.northernireland.gov.uk/" ref="pagearea=body&amp;targetsite=external&amp;targetcat=link&amp;targettype=uri">Northern Ireland
Executive</a>. All NICE guidance is subject to regular review and may be
updated or withdrawn.</p></div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> &#x000a9; NICE 2018.</div><div class="small"><span class="label">Bookshelf ID: NBK577120</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/35129925" title="PubMed record of this title" ref="pagearea=meta&amp;targetsite=entrez&amp;targetcat=link&amp;targettype=pubmed">35129925</a></span></div></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article><article data-type="table-wrap" id="figobchd1tab1"><div id="chd1.tab1" class="table"><h3><span class="label">Table 1</span><span class="title">PICO characteristics of review question</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/chd1.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chd1.tab1_lrgtbl__"><table><tbody><tr><th id="hd_b_chd1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Population</th><td headers="hd_b_chd1.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>Adults with RA, with at
least moderate disease activity (equivalent to DAS28
&#x02265; 3.2).</p>
<p>Studies in adults with poor
prognostic factors will be reviewed
separately.</p>
</td></tr><tr><th id="hd_b_chd1.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Intervention(s)</th><td headers="hd_b_chd1.tab1_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>Monitoring a composite
measure of disease activity with a target of
<b>disease remission</b></p>
<p>The following
composite measures will be considered: <ul id="l74"><li id="lt220" class="half_rhythm"><div>Disease activity score 28 (DAS28). DAS28
&#x0003c; 2.6 = remission</div></li><li id="lt221" class="half_rhythm"><div>Original disease activity score (DAS). DAS
&#x0003c; 1.6 = remission</div></li><li id="lt222" class="half_rhythm"><div>Simplified disease activity index (SDAI). SDAI
&#x02264; 3.3 = remission</div></li></ul> The different disease activity measures will
be pooled in the analysis.</p>
</td></tr><tr><th id="hd_b_chd1.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Comparison(s)</th><td headers="hd_b_chd1.tab1_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>Monitoring a composite
measure of disease activity with a target of
<b>low disease activity</b></p>
<p>The
following composite measures will be considered:
<ul id="l75"><li id="lt223" class="half_rhythm"><div>Disease activity score (DAS28; all versions).
DAS28 &#x0003c; 3.2 = low disease activity</div></li><li id="lt224" class="half_rhythm"><div>Original disease activity score (DAS; all
versions). DAS &#x0003c; 2.4 = low disease
activity</div></li><li id="lt225" class="half_rhythm"><div>Simplified disease activity index (SDAI). SDAI
&#x02264; 11.0 = low disease activity</div></li></ul> The different disease activity measures will
be pooled in the analysis.</p>
</td></tr><tr><th id="hd_b_chd1.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Outcomes</th><td headers="hd_b_chd1.tab1_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CRITICAL <ul id="l76"><li id="lt226" class="half_rhythm"><div>Disease Activity Score (continuous) at 12
months</div></li><li id="lt227" class="half_rhythm"><div>Quality of life (continuous) at 12 months</div></li><li id="lt228" class="half_rhythm"><div>Function (continuous) at 12 months</div></li></ul> IMPORTANT <ul id="l77"><li id="lt229" class="half_rhythm"><div>Fatigue (continuous) at 12 months</div></li><li id="lt230" class="half_rhythm"><div>Pain (continuous) at 12 months</div></li><li id="lt231" class="half_rhythm"><div>Radiological progression (continuous) at 12
months</div></li><li id="lt232" class="half_rhythm"><div>Withdrawal/adherence (dichotomous) at longest
reported time point</div></li></ul></td></tr><tr><th id="hd_b_chd1.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study design</th><td headers="hd_b_chd1.tab1_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>RCT</p>
<p>Systematic review
of RCTs</p>
</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobchd1tab2"><div id="chd1.tab2" class="table"><h3><span class="label">Table 2</span><span class="title">UK costs of healthcare professional visits</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/chd1.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__chd1.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_chd1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Type of appointment</th><th id="hd_h_chd1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Unit cost</th><th id="hd_h_chd1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Source</th></tr></thead><tbody><tr><td headers="hd_h_chd1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">GP appointment lasting
9.22 minutes</td><td headers="hd_h_chd1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">&#x000a3;36</td><td headers="hd_h_chd1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PSSRU Unit costs 2016<a class="bibr" href="#ptd.ref4" rid="ptd.ref4"><sup>4</sup></a></td></tr><tr><td headers="hd_h_chd1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-admitted face to face
outpatient follow-up attendance, rheumatology
(consultant led)</td><td headers="hd_h_chd1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">&#x000a3;137</td><td headers="hd_h_chd1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS reference costs
2015-2016<a class="bibr" href="#ptd.ref5" rid="ptd.ref5"><sup>5</sup></a></td></tr><tr><td headers="hd_h_chd1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Non-admitted face to face
outpatient follow-up attendance, rheumatology
(non-consultant led)</td><td headers="hd_h_chd1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">&#x000a3;87</td><td headers="hd_h_chd1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">NHS reference costs
2015-2016<a class="bibr" href="#ptd.ref5" rid="ptd.ref5"><sup>5</sup></a></td></tr><tr><td headers="hd_h_chd1.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hospital based nurse, band
6, specialist nurse (per working hour/per hour of
patient contact)</td><td headers="hd_h_chd1.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">&#x000a3;44/&#x000a3;108</td><td headers="hd_h_chd1.tab2_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">PSSRU Unit costs 2016<a class="bibr" href="#ptd.ref4" rid="ptd.ref4"><sup>4</sup></a></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappbtab1"><div id="ptd.appb.tab1" class="table"><h3><span class="label">Table 5</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appb.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appb.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ptd.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ptd.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ptd.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_ptd.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline (Ovid)</td><td headers="hd_h_ptd.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1946 &#x02013; 09 October
2017</td><td headers="hd_h_ptd.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>Exclusions</p>
<p>Randomised controlled
trials</p>
<p>Systematic review studies</p>
</td></tr><tr><td headers="hd_h_ptd.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase (Ovid)</td><td headers="hd_h_ptd.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1974 &#x02013; 09 October
2017</td><td headers="hd_h_ptd.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>Exclusions</p>
<p>Randomised controlled
trials</p>
<p>Systematic review studies</p>
</td></tr><tr><td headers="hd_h_ptd.appb.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">The Cochrane Library
(Wiley)</td><td headers="hd_h_ptd.appb.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>Cochrane Reviews to
2017</p>
<p>Issue 10 of 12</p>
<p>CENTRAL to 2017
Issue 9 of 12</p>
<p>DARE, and NHSEED to
2015</p>
<p>Issue 2 of 4</p>
<p>HTA to 2016 Issue 4
of 4</p>
</td><td headers="hd_h_ptd.appb.tab1_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappbtab2"><div id="ptd.appb.tab2" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appb.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appb.tab2_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Arthritis,
Rheumatoid/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid adj2
(arthritis or arthrosis)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(caplan* adj2
syndrome).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(felty* adj2
syndrome).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid adj2
factor).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((inflammatory or
idiopathic) adj2 arthritis).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">&#x0201c;inflammatory
polyarthritis&#x0201d;.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-7</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 8 to English
language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical
article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or
comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/10-17</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled
trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 not 19</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp animal
experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or
mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/20-26</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9 not 27</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(tight* adj
control*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">t2t.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mission or aiming or aim
or aimed or aims or achiev* or sustain* or reach*)
adj2 remission).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((treat* or therap*) adj2
(target* or goal*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(symptom* adj2 (reduc* or
improv* or control*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">low disease
activity.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(abrogat* adj2
inflammat*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">optimi*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/29-36</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28 and 37</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled
trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">controlled clinical
trial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomi#ed.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">placebo.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">drug therapy.fs.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomly.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">groups.ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/39-46</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Clinical Trials as
topic.sh.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">trial.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/39-42,44,48-49</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Meta-Analysis as
Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly*
or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic* or
evidence*) adj3 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or
bibliograph* or hand search* or manual search* or
relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search
criteria or systematic search or study selection or
data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4
literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or
cochrane or embase or psychlit or psyclit or
psychinfo or psycinfo or cinahl or science citation
index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">59.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">60.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or
indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">61.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/51-60</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">62.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38 and (50 or 61)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappbtab3"><div id="ptd.appb.tab3" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appb.tab3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appb.tab3_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *rheumatoid
arthritis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid adj2
(arthritis or arthrosis)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(caplan* adj2
syndrome).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(felty* adj2
syndrome).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid adj2
factor).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((inflammatory or
idiopathic) adj2 arthritis).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">&#x0201c;inflammatory
polyarthritis&#x0201d;.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-7</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 8 to English
language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case
study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or
comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/10-14</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled
trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 not 16</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal
Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental
Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or
mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/17-24</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9 not 25</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(tight* adj
control*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">t2t.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mission or aiming or aim
or aimed or aims or achiev* or sustain* or reach*)
adj2 remission).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((treat* or therap*) adj2
(target* or goal*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(symptom* adj2 (reduc* or
improv* or control*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">low disease
activity.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(abrogat* adj2
inflammat*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">optimi*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/27-34</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26 and 35</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">factorial*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(crossover* or cross
over*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((doubl* or singl*) adj
blind*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(assign* or allocat* or
volunteer* or placebo*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">crossover procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">single blind
procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled
trial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">double blind
procedure/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/37-45</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">systematic review/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">meta-analysis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(meta analy* or metanaly*
or metaanaly* or meta regression).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((systematic or evidence)
adj3 (review* or overview*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(reference list* or
bibliograph* or hand search* or manual search* or
relevant journals).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search strategy or search
criteria or systematic search or study selection or
data extraction).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(search* adj4
literature).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(medline or pubmed or
cochrane or embase or psychlit or psyclit or
psychinfo or psycinfo or cinahl or science citation
index or bids or cancerlit).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cochrane.jw.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((multiple treatment* or
indirect or mixed) adj2 comparison*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">57.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/47-56</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">58.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36 and (46 or 57)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappbtab4"><div id="ptd.appb.tab4" class="table"><h3><span class="title">Cochrane Library (Wiley) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appb.tab4/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appb.tab4_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">[mh &#x0201c;Arthritis,
Rheumatoid&#x0201d;]</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid near/2
(arthritis or arthrosis)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(caplan* near/2
syndrome):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(felty* near/2
syndrome):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid near/2
factor):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((inflammatory or
idiopathic) near/2 arthritis):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">inflammatory
polyarthritis:ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #1-#7)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(tight* next
control*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">t2t:ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((mission or aiming or aim
or aimed or aims or achiev* or sustain* or reach*)
near/2 remission):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((treat* or therap*)
near/2 (target* or goal*)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(symptom* near/2 (reduc*
or improv* or control*)):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">low disease
activity:ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(abrogat* near/2
inflammat*):ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">optimi*:ti,ab</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(or #9-#16)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8 and #17</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappbtab5"><div id="ptd.appb.tab5" class="table"><h3><span class="label">Table 6</span><span class="title">Database date parameters and filters used</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appb.tab5/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appb.tab5_lrgtbl__"><table><thead><tr><th id="hd_h_ptd.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Database</th><th id="hd_h_ptd.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Dates searched</th><th id="hd_h_ptd.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Search filter used</th></tr></thead><tbody><tr><td headers="hd_h_ptd.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medline</td><td headers="hd_h_ptd.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2014 &#x02013; 06 October
2017</td><td headers="hd_h_ptd.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>Exclusions</p>
<p>Health
economics studies</p>
</td></tr><tr><td headers="hd_h_ptd.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Embase</td><td headers="hd_h_ptd.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2014 &#x02013; 06 October
2017</td><td headers="hd_h_ptd.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>Exclusions</p>
<p>Health
economics studies</p>
</td></tr><tr><td headers="hd_h_ptd.appb.tab5_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Centre for Research and
Dissemination (CRD)</td><td headers="hd_h_ptd.appb.tab5_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
<p>HTA - 2001 &#x02013; 06
October 2017</p>
<p>NHSEED - 2001 &#x02013; 31 March
2015</p>
</td><td headers="hd_h_ptd.appb.tab5_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappbtab6"><div id="ptd.appb.tab6" class="table"><h3><span class="title">Medline (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appb.tab6/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appb.tab6_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Arthritis,
Rheumatoid/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid adj2
(arthritis or arthrosis)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(caplan* adj2
syndrome).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(felty* adj2
syndrome).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid adj2
factor).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((inflammatory or
idiopathic) adj2 arthritis).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">&#x0201c;inflammatory
polyarthritis&#x0201d;.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-7</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 8 to English
language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">news/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp historical
article/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Anecdotes as Topic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">comment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or
comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/10-17</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled
trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 not 19</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animals/ not humans/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Animals, Laboratory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp animal
experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodentia/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or
mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/20-26</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9 not 27</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Value of life/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp &#x0201c;Costs and Cost
Analysis&#x0201d;/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics,
Hospital/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Economics,
Medical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics, Nursing/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Economics,
Pharmaceutical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp &#x0201c;Fees and
Charges&#x0201d;/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Budgets/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or
pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or
pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effective* or
utilit* or benefit* or minimi* or unit* or estimat*
or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or
fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or
monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/29-44</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp models, economic/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Models, Theoretical/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*Models,
Organizational/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">markov chains/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">monte carlo method/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Decision Theory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(markov* or monte
carlo).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">econom* model*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(decision* adj2 (tree* or
analy* or model*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">55.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/46-54</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">56.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28 and (45 or 55)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappbtab7"><div id="ptd.appb.tab7" class="table"><h3><span class="title">Embase (Ovid) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appb.tab7/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appb.tab7_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *rheumatoid
arthritis/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid adj2
(arthritis or arthrosis)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(caplan* adj2
syndrome).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(felty* adj2
syndrome).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rheumatoid adj2
factor).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((inflammatory or
idiopathic) adj2 arthritis).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">&#x0201c;inflammatory
polyarthritis&#x0201d;.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/1-7</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">limit 8 to English
language</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">10.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">letter.pt. or letter/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">11.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">note.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">12.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">editorial.pt.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">13.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">case report/ or case
study/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(letter or
comment*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/10-14</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">16.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">randomized controlled
trial/ or random*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">17.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 not 16</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal/ not human/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">nonhuman/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Animal
Experiment/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Experimental
Animal/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">animal model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">23.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp Rodent/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">24.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(rat or rats or mouse or
mice).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">25.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/17-24</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9 not 25</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">statistical model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">28.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp economic aspect/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">29.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">27 and 28</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">30.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*theoretical model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">31.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*nonbiological model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">32.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">stochastic model/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">33.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">decision theory/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">34.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">decision tree/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">35.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">monte carlo method/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">36.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(markov* or monte
carlo).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">37.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">econom* model*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">38.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(decision* adj2 (tree* or
analy* or model*)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">39.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/29-38</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">40.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">*health economics/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">41.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *economic
evaluation/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">42.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *health care
cost/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">43.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">exp *fee/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">44.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">45.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">funding/</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">46.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">budget*.ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">47.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">cost*.ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">48.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(economic* or
pharmaco?economic*).ti.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">49.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(price* or
pricing*).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">50.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(cost* adj2 (effective* or
utilit* or benefit* or minimi* or unit* or estimat*
or variable*)).ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">51.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(financ* or fee or
fees).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">52.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(value adj2 (money or
monetary)).ti,ab.</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">53.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">or/40-52</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">54.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">26 and (39 or 53)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappbtab8"><div id="ptd.appb.tab8" class="table"><h3><span class="title">NHS EED and HTA (CRD) search terms</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appb.tab8/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appb.tab8_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MeSH DESCRIPTOR Arthritis,
Rheumatoid EXPLODE ALL TREES</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#2.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((rheumatoid adj2
(arthritis or arthrosis)))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#3.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((caplan* adj2
syndrome))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#4.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((felty* adj2
syndrome))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#5.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">((rheumatoid adj2
factor))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#6.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(((inflammatory or
idiopathic) adj2 arthritis))</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#7.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">(&#x0201c;inflammatory
polyarthritis&#x0201d;)</td></tr><tr><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#8.</td><td rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">#1 OR #2 OR #3 OR #4 OR #5
OR #6 OR #7</td></tr></tbody></table></div></div></article><article data-type="fig" id="figobptdappcfig1"><div id="ptd.appc.fig1" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%201.%20Flow%20chart%20of%20clinical%20study%20selection%20for%20the%20review%20of%20%02018Which%20target%20to%20monitor%20in%20rheumatoid%20arthritis%3F%02019.&amp;p=BOOKS&amp;id=577120_ptdappcf1.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577120/bin/ptdappcf1.jpg" alt="Figure 1. Flow chart of clinical study selection for the review of &#x02018;Which target to monitor in rheumatoid arthritis?&#x02019;." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 1</span><span class="title">Flow chart of clinical study selection for the review of
&#x02018;Which target to monitor in rheumatoid
arthritis?&#x02019;</span></h3></div></article><article data-type="fig" id="figobptdappgfig2"><div id="ptd.appg.fig2" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Figure%202.%20Flow%20chart%20of%20economic%20study%20selection%20for%20the%20guideline.&amp;p=BOOKS&amp;id=577120_ptdappgf2.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img data-src="/books/NBK577120/bin/ptdappgf2.jpg" alt="Figure 2. Flow chart of economic study selection for the guideline." class="tileshop" title="Click on image to zoom" /></a></div><h3><span class="label">Figure 2</span><span class="title">Flow chart of economic study selection for the
guideline</span></h3><div class="caption"><p>* Non-relevant population, intervention, comparison, design or
setting; non-English language</p></div></div></article><article data-type="table-wrap" id="figobptdappitab1"><div id="ptd.appi.tab1" class="table"><h3><span class="label">Table 7</span><span class="title">Studies excluded from the clinical review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appi.tab1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appi.tab1_lrgtbl__"><table><thead><tr><th id="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Study</th><th id="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Exclusion reason</th></tr></thead><tbody><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Bykerk 2013<a class="bibr" href="#ptd.ref2" rid="ptd.ref2"><sup>2</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: methods
are not adequate/unclear</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cardiel 2013<a class="bibr" href="#ptd.ref3" rid="ptd.ref3"><sup>3</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: methods
are not adequate/unclear</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Edmonds 2007<a class="bibr" href="#ptd.ref6" rid="ptd.ref6"><sup>6</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate comparison.
conference abstract</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Hodkinson 2015<a class="bibr" href="#ptd.ref7" rid="ptd.ref7"><sup>7</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect interventions.
Inappropriate comparison</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jurgens 2012<a class="bibr" href="#ptd.ref8" rid="ptd.ref8"><sup>8</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: methods
are not adequate/unclear</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pincus 2013<a class="bibr" href="#ptd.ref11" rid="ptd.ref11"><sup>11</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review:
literature search not sufficiently rigorous</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pope 2013<a class="bibr" href="#ptd.ref12" rid="ptd.ref12"><sup>12</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate
comparison</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Radner 2014<a class="bibr" href="#ptd.ref13" rid="ptd.ref13"><sup>13</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study
design</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Schoels 2010<a class="bibr" href="#ptd.ref14" rid="ptd.ref14"><sup>14</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: methods
are not adequate/unclear</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Smolen 2016<a class="bibr" href="#ptd.ref15" rid="ptd.ref15"><sup>15</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: methods
are not adequate/unclear</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Stoffer 2016<a class="bibr" href="#ptd.ref16" rid="ptd.ref16"><sup>16</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Systematic review: methods
are not adequate/unclear</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">van Tuyl 2008<a class="bibr" href="#ptd.ref17" rid="ptd.ref17"><sup>17</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Inappropriate
comparison</td></tr><tr><td headers="hd_h_ptd.appi.tab1_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Wells 2006<a class="bibr" href="#ptd.ref18" rid="ptd.ref18"><sup>18</sup></a></td><td headers="hd_h_ptd.appi.tab1_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Incorrect study design.
Inappropriate comparison</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobptdappitab2"><div id="ptd.appi.tab2" class="table"><h3><span class="label">Table 8</span><span class="title">Studies excluded from the health economic review</span></h3><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK577120/table/ptd.appi.tab2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__ptd.appi.tab2_lrgtbl__"><table><thead><tr><th id="hd_h_ptd.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reference</th><th id="hd_h_ptd.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Reason for exclusion</th></tr></thead><tbody><tr><td headers="hd_h_ptd.appi.tab2_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td><td headers="hd_h_ptd.appi.tab2_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">None</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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