Table 1

 Selected research questions for a literature search

DMARD, disease modifying antirheumatic drug; NSAID, non-steroidal anti-inflammatory drug.
• What is the clinical presentation of early arthritis that a GP should recognise in order to refer to the rheumatologist?
• How early should patients with arthritis be referred to a medical specialist?
• What are the diagnostic procedures that need to be undertaken in order to confirm early synovitis?
• What are the minimum diagnostic procedures necessary in a patient with early arthritis in order to exclude other diseases?
• What are the prognostic procedures that need to be carried out in a patient with confirmed early arthritis?
• Can we substitute distinct disease classifications (rheumatoid arthritis, psoriatic arthritis) with prognostic eponyms such as “persistent” or “persistent and erosive”?
• What is the efficacy of non-pharmaceutical interventions compared to efficacy of drug treatment in early arthritis? (Note: most findings are in established rheumatoid arthritis.)
• How should information be given (route of administration) in early arthritis?
• Are NSAIDs (classical and/or coxibs) more efficacious (efficacy in relation to toxicity) than analgesics (including opioids) in early arthritis? (Note: there have been no trial in early arthritis.)
• Is there a place for (intra-articular and/or systemic) corticosteroids in the treatment of early arthritis?
• Is an early treatment start with DMARDs better than a delayed treatment start in early arthritis?
• Is aggressive treatment (for example, combination therapy with or without corticosteroids) better than less aggressive treatment (monotherapy) in early arthritis?
• Can an optimal starting point (for example, X weeks of arthritis) be defined in early arthritis? (Is the starting point dependent on the prognosis?)
• Can consensus be obtained with regard to the choice of DMARD strategies in early arthritis?
• Can consensus be obtained on whether or not disease activity, radiographic progression, and function should be monitored, and if yes, how (by what instruments) and how often?