PT  - JOURNAL ARTICLE
AU  - P Machado
AU  - I Castrejon
AU  - W Katchamart
AU  - R Koevoets
AU  - B Kuriya
AU  - M Schoels
AU  - L Silva-Fernández
AU  - K Thevissen
AU  - W Vercoutere
AU  - E Villeneuve
AU  - D Aletaha
AU  - L Carmona
AU  - R Landewé
AU  - D van der Heijde
AU  - J W J Bijlsma
AU  - V Bykerk
AU  - H Canhão
AU  - A I Catrina
AU  - P Durez
AU  - C J Edwards
AU  - M D Mjaavatten
AU  - B F Leeb
AU  - B Losada
AU  - E M Martín-Mola
AU  - P Martinez-Osuna
AU  - C Montecucco
AU  - U Müller-Ladner
AU  - M Østergaard
AU  - B Sheane
AU  - R M Xavier
AU  - J Zochling
AU  - C Bombardier
TI  - Multinational evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative
AID  - 10.1136/ard.2010.130625
DP  - 2011 Jan 01
TA  - Annals of the Rheumatic Diseases
PG  - 15--24
VI  - 70
IP  - 1
4099  - http://ard.bmj.com/content/70/1/15.short
4100  - http://ard.bmj.com/content/70/1/15.full
SO  - Ann Rheum Dis2011 Jan 01; 70
AB  - Objective To develop evidence-based recommendations on how to investigate and follow-up undifferentiated peripheral inflammatory arthritis (UPIA). Methods 697 rheumatologists from 17 countries participated in the 3E (Evidence, Expertise, Exchange) Initiative of 2008–9 consisting of three separate rounds of discussions and modified Delphi votes. In the first round 10 clinical questions were selected. A bibliographic team systematically searched Medline, Embase, the Cochrane Library and ACR/EULAR 2007–2008 meeting abstracts. Relevant articles were reviewed for quality assessment, data extraction and synthesis. In the second round each country elaborated a set of national recommendations. Finally, multinational recommendations were formulated and agreement among the participants and the potential impact on their clinical practice was assessed. Results A total of 39 756 references were identified, of which 250 were systematically reviewed. Ten multinational key recommendations about the investigation and follow-up of UPIA were formulated. One recommendation addressed differential diagnosis and investigations prior to establishing the operational diagnosis of UPIA, seven recommendations related to the diagnostic and prognostic value of clinical and laboratory assessments in established UPIA (history and physical examination, acute phase reactants, autoantibodies, radiographs, MRI and ultrasound, genetic markers and synovial biopsy), one recommendation highlighted predictors of persistence (chronicity) and the final recommendation addressed monitoring of clinical disease activity in UPIA. Conclusions Ten recommendations on how to investigate and follow-up UPIA in the clinical setting were developed. They are evidence-based and supported by a large panel of rheumatologists, thus enhancing their validity and practical use.