How did OMERACT start?
The first OMERACT conference on rheumatoid arthritis was held in Maastricht, the Netherlands in 1992. The motivation for this were discussions between 2 of the executive members, comparing the outcomes of rheumatoid arthritis used in European clinical trials with that of North American clinical trials, and noting that they used different endpoints. This made it extremely difficult to compare and combine in meta-analyses.
The first conference had 3 goals:
(1) To attempt to obtain agreement on the minimum number of outcome measures to be included in all RA clinical trials. This was implemented by a preconference questionnaire, presentation of the evidence on their validity, both small group and plenary discussions on their performance in trials and in individual patients, and then by voting using an electronic voting procedure.
(2) To review the range of magnitude of differences judged to be clinically important by experienced clinicians and clinical investigators. This was implemented by a baseline questionnaire and rank ordering of a series of clinical trials and individual patient scenarios, using a nominal group technique.
(3) To review the extent to which experienced clinicians and clinical investigators feel that aggregate measures (indices) are useful in the assessment of trials and individual patients. This was implemented by presentation of the concepts behind a variety of examples of indices, by questionnaire and a scenario ranking exercise incorporating the results of 3 indices.
What does OMERACT do?
Agreement regarding the use of standardized endpoints in randomized controlled trials and longitudinal observational studies is extremely important. Their use facilitates comparisons of outcomes across studies to provide the best estimates of benefit and safety of therapeutic interventions across differing patient populations. To improve outcome measurement, OMERACT organizes conferences that take place every two years and rotate around the globe. For these conferences, topics of interest are prepared by groups of experts. These topics are then prepared for the conference by literature review and specification of the points for discussion. Most topics are discussed in workshop format, where the aim is to make explicit the areas of agreement and disagreement, and to prioritize the research agenda. In several areas, the group has taken the lead in actually performing the necessary research to bring back to the conference.