{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T11:20:52Z","timestamp":1787570452106,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Ambulatory care\u2013sensitive conditions (ACSCs) serve as indicators of access, quality, and performance of the health system. This study aimed to determine rheumatoid arthritis (RA)\u2010specific ACSCs for use in the evaluation of care system access and quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A modified Delphi process was conducted on the preventability and importance of hospitalization for candidate medical conditions determined from a systematic literature review. Clinical panelists included health care providers with expertise in the care of people with RA. Patient panelists were people living with RA. Clinical panelists completed two rounds of anonymous voting, with an asynchronous discussion board hosted between rounds. Patient panelists completed the same process considering the remaining conditions for which consensus had not yet been reached. An interactive webinar preceded a final combined panel voting round. Consensus criteria were guided by the RAND\/UCLA Appropriateness Method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 22 clinical and 8 patient panelists provided their expert opinion on 49 candidate conditions. At the conclusion of all voting rounds, 13 conditions were identified as proposed RA\u2010specific ACSCs: those specific to RA disease activity (RA disease flare, vasculitis), RA\u2010related associations and complications (anemia\/pancytopenia, osteoporotic fracture, secondary osteoarthritis, cervical spine instability), and acute (upper respiratory infection, influenza\/pneumonia, septic arthritis) and opportunistic infections (herpes zoster, tuberculosis reactivation,\n                      <jats:italic>Pneumocystis jirovecii<\/jats:italic>\n                      pneumonia, and other).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Consensus was achieved for 13 proposed RA\u2010specific ACSCs that could be used to monitor care access and quality for persons living with RA, determine population\u2010level differences, and appropriately allocate resources. Next steps include operationalizing and testing performance of RA\u2010specific ACSCs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.80135","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:38:54Z","timestamp":1786365534000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Development of Rheumatoid Arthritis\u2013Specific Ambulatory Care\u2013Sensitive Conditions: Results of a Consensus Process"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7941-1114","authenticated-orcid":false,"given":"Kara","family":"Irwin","sequence":"first","affiliation":[{"name":"University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4980-9770","authenticated-orcid":false,"given":"Candace H.","family":"Feldman","sequence":"additional","affiliation":[{"name":"Harvard Medical School Harvard University and Brigham and Women's Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3062-5488","authenticated-orcid":false,"given":"Claire E. H.","family":"Barber","sequence":"additional","affiliation":[{"name":"University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Fabreau","sequence":"additional","affiliation":[{"name":"University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake","family":"Jennings","sequence":"additional","affiliation":[{"name":"Primary Care Alberta  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Patten","sequence":"additional","affiliation":[{"name":"University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3761-237X","authenticated-orcid":false,"given":"Cheryl","family":"Barnabe","sequence":"additional","affiliation":[{"name":"University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Inflammatory Arthritis\u2010Specific ACSC Consensus Process Working Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102016\u2010015704"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpopen.2021.100030"},{"key":"e_1_2_6_4_1","article-title":"Ambulatory care sensitive conditions hospitalization","author":"Canadian Institute for Health Information","year":"2025","journal-title":"Canadian Institute for Health Information"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2008.11.001"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0229465"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01349-6"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/XCE.0000000000000244"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25541"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2019.11.005"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24095"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.2024\u20100111"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2196\/33898"},{"issue":"3","key":"e_1_2_6_14_1","first-page":"470","article-title":"The RAND\/PPMD Patient\u2010Centeredness Method: a novel online approach to engaging patients and their representatives in guideline development","volume":"7","author":"Khodyakov D","year":"2019","journal-title":"Eur J Pers Cent Healthc"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06514-6"},{"issue":"1","key":"e_1_2_6_16_1","article-title":"Specific causes for hospitalization in persons with inflammatory arthritis conditions and gout: a systematic review","volume":"76","author":"Irwin K","year":"2024","journal-title":"Arthritis Rheumatol"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-020-0912-8"},{"key":"e_1_2_6_18_1","article-title":"The RAND\/UCLA Appropriateness Method User's Manual","author":"Fitch K","year":"2001","journal-title":"RAND"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23548"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.122226"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.06.011"}],"container-title":["Arthritis Care &amp; 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