Winter 2019 (Volume 29, Number 4)

Highlights from the Guidelines Committee

By Glen Hazlewood, MD, FRCPC

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The CRA put out its first recommendations (for rheumatoid arthritis [RA]) in 2012. Since then, through the hard work of our members, we have published guidelines across a wide range of topics, all of which can be found on the CRA website (

The Guidelines Committee recognizes the need to develop “Canadian-ized” recommendations, while at the same time not duplicating the work of others or sacrificing guideline quality. The CRA has now adopted Grading of Recommendations, Assessment, Development and Evaluation or GRADE as our preferred approach, in line with other major groups. As we move into the next decade, we are also constantly looking for new and novel approaches to improve the efficiency of our guidelines and increase their impact. Highlights include the following:

  • Adopting or adapting recommendations of other groups, where possible;
  • Transitioning to a "living" model of guideline development, where appropriate;
  • Collaboration with other groups including Cochrane, American College of Rheumatology (ACR), and the Australian Rheumatology Association, to coordinate efforts and reduce duplication;
  • Incorporating novel approaches to improve the efficiency of reviews including machine learning and "crowd- sourcing" with trainees in Canada and Australia;
  • Incorporating health equity and patient preferences into our recommendations;
  • Partnering with the CRA-supported rheumatoid arthritis (RA) registry initiative to use “real-world” data when contextualizing our recommendations.

We are grateful for the hard work of everyone involved. In particular, a big shout out to our engaged group of 22 trainees who have been helping review articles for the RA and spondyloarthritis (SpA) guidelines. We are always looking for more reviewers. If you are interested in joining our team, please e-mail Jordi Pardo at

Stay tuned in 2020!

Glen Hazlewood, MD, FRCPC
Assistant Professor,
Departments of Medicine and Community Health Sciences,
Cumming School of Medicine,
University of Calgary,
Calgary, Alberta

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