During post-graduate thesis work in clinical epidemiology under the supervision of Peter Tugwell, MSc, MD, at McMaster University, Maarten Boers, MSc, MD, PhD, identified 22 different outcomes measurements that had been used as endpoints in arthritis trials worldwide. (Both men would later become founding members and executive committee members of OMERACT.) This led to a key realization, explains Dr. Tugwell, professor of medicine at the University of Ottawa and the Institute of Population Health in Ontario, Canada: “How on earth were we going to come up with a recommendation for clinicians to use in clinical practice if everyone was using a different outcome?”
Dr. Boers, professor of clinical epidemiology and biostatistics at VU University Medical Centre in Amsterdam, The Netherlands, fondly recalls these early discussions with Dr. Tugwell. “The story that should go into folklore is that, as my thesis supervisor, he had made all kinds of scribbly remarks throughout my manuscript—his handwriting is famously difficult to read—and there were two remarks I could not read,” says Dr. Boers. “One was ‘Do a review on combination therapy,’ and the other was ‘Suggest a conference on outcomes measures.’ ”
Clinical researchers weren’t the only ones challenged with disparities in outcomes measures. In discussions with regulatory agencies, Drs. Tugwell and Boers found that regulators, too, had expressed frustration with the Atlantic divide. “The idea was to get a small group of people together,” Dr. Strand says. “We were trying to make sure that there would be consensus [about which outcomes measures to use] on both sides of the pond.” OMERACT 1 took place in Maastricht, The Netherlands, in 1992, and was organized around a Delphi process to achieve consensus on outcomes measures in RA. Its objectives were:
- To broaden consensus on the minimum number of outcomes measures to be included in all RA clinical trials;
- To achieve consensus on criteria for minimum clinically important improvement in patients with RA, as well as minimum important differences between treatment groups in RA clinical trials; and
- To determine whether aggregate outcomes measures or indexes are useful in assessing patients and trials.1
Career Timeline
1990 – OMERACT concept is born.
1992 – OMERACT 1, Maastricht, The Netherlands, Attendance: 102.
1994 – OMERACT 2, Ottawa, Canada, Attendance: 112.
1996 – OMERACT 3, Cairns, Australia, Attendance: 92.
1998 – OMERACT 4, Cancun, Mexico, Attendance: 124.
2000 – OMERACT 5, Toulouse, France, Attendance: 120.
2002 – OMERACT 6, Gold Coast, Australia, Attendance: 132.
