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Patients with rheumatoid arthritis (RA) who have contact with a rheumatologist have better health outcomes than those who do not.1 We found that only 27% of newly suspected cases of RA consulted with a rheumatologist.2 However, this study was based on physician billing data; quality control of diagnostic coding and absence of severity indicators limit the conclusions. We pursued this issue further with patients who had a confirmed diagnosis and were in an early arthritis cohort. We hypothesised that this group would represent a “best case scenario” where the majority would have consulted a rheumatologist within the 3-month recommended window.3 We also explored factors that may be associated with referral, including patient characteristics such as laboratory results (C-reactive protein (CRP), rheumatoid factor),4 5 sociodemographic factors and disease severity,2 6 …
Funding This study was funded by the Canadian Initiative for Outcomes in Rheumatoid Arthritis (CIORA). DEF is supported by the Arthritis Society and the Université de Montréal. SB is a Canadian Arthritis Network Scholar and is supported by the Canadian Institutes of Health Research, the Fonds de la recherche en santé du Québec (FRSQ) and the McGill University HealthCentre Research Institute and Department of Medicine.
Competing interests None.
Members of the The McGill Early Inflammatory Arthritis Research Group: Michael Starr, Michel Gagné, Michael Stein, Harb Kang, Morton Kapusta, François Couture, Mary-Ann Fitzcharles, Bruce Garfield, Henri André Ménard, Laeora Berkson, Christian Pineau, Andrzej Gutkowski, Michel Zummer, Jean-Pierre Mathieu, Marie Hudson, Suzanne Mercille, Sophie Ligier, Jiri Krasny, Carole Bertrand, Sai Yan Yuen, Jan Schulz.
Provenance and peer review Not commissioned; externally peer reviewed.