AB1256 Development of a national service for biologic drug monitoring

M.E. Perry, on behalf of Effective Prescribing Programme Biologics Working Group, National Services Scotland
2018 Public health, health services research and health economics   unpublished
Observational cohort studies have been utilised extensively in early Rheumatoid Arthritis (RA), regularly conducted across multiple centres spanning regional and national boundaries. Case-mix and centre effect are considerations essential for determining comparability of results, and likely prevalence of bias. There is currently no standardised approach for case-mix and centre effect adjustment in early RA observational cohorts. Objectives: Describe the spectrum of methodologies used to address
more » ... ies used to address case-mix and centre level effects on outcomes in multi-centre early RA observational cohort studies. Methods: Inclusion criteria were cohorts recruiting from 2 or more centres with 100 or more subjects, with a Rheumatologist diagnosis of RA or EIA within the last 24 months. A systematic electronic search of publications was undertaken. Papers were reviewed by two researchers independently. Reference lists of included papers were reviewed for further relevant publications. A search of all included papers' authors was also conducted. Detail on cohort characteristics, case-mix data collection and adjustment, and consideration of centre-level effect in analyses were collected. Results: 1047 papers were identified from the initial search. A total of 20 unique cohorts were identified. Reference review and author search produced 14 more, to make a total of 34 unique observational cohorts drawn from 205 papers. The cohorts were mainly conducted in Europe (24/34, 71%), With 2 (6%) from less economically developed regions. The period of data collection was between 1955 and 2017. Case-mix: All cohorts considered case-mix in some form (e.g. age and gender), but with heterogenous approaches. The figure displays the relative frequencies of sociodemographic variable consideration across all included papers. Centre effect: 18/205 (9%) of the included papers accounted for centre in their results, utilising a range methodologies. Where reported, centre had a significant impact. Abstract AB1255 - Figure 1
doi:10.1136/annrheumdis-2018-eular.2259 fatcat:qdlsij26wjaqffvjfuw7ne2no4