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Original article
EULAR ‘points to consider’ for the conduction of workforce requirement studies in rheumatology
  1. Christian Dejaco1,2,
  2. Polina Putrik3,
  3. Julia Unger4,
  4. Daniel Aletaha5,
  5. Gerolamo Bianchi6,
  6. Johannes W Bijlsma7,
  7. Annelies Boonen3,
  8. Nada Cikes8,
  9. Axel Finckh9,
  10. Laure Gossec10,11,
  11. Tore K Kvien12,
  12. Joao Madruga Dias13,
  13. Eric L Matteson14,
  14. Francisca Sivera15,
  15. Tanja A Stamm16,
  16. Zoltan Szekanecz17,
  17. Dieter Wiek18,
  18. Angela Zink19,20,
  19. Sofia Ramiro21,22 and
  20. Frank Buttgereit20
  1. 1 Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria
  2. 2 Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy
  3. 3 Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
  4. 4 Department of Health Studies, FH JOANNEUM, University of Applied Sciences, Bad Gleichenberg, Austria
  5. 5 Division of Rheumatology, Medical University Vienna, Vienna, Austria
  6. 6 Division of Rheumatology, ASL3-Azienda Sanitaria Genovese, Genova, Italy
  7. 7 Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
  8. 8 Division of Clinical Immunology & Rheumatology, School of Medicine, University of Zagreb, Zagreb, Croatia
  9. 9 Division of Rheumatology, Department of Internal Medicine Specialities, Geneva University Hospital, Geneva, Switzerland
  10. 10 Rheumatology Department, Pitié Salpêtrière hospital, APHP, Paris, France
  11. 11 Sorbonne Université, Paris, France
  12. 12 Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  13. 13 Department of Rheumatology, Centro Hospitalar Médio Tejo, Torres Novas, Portugal
  14. 14 Division of Rheumatology and Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, United States
  15. 15 Department of Rheumatology, Hospital General Universitario de Elda, Elda, Spain
  16. 16 Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
  17. 17 Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, University of Debrecen, Debrecen, Hungary
  18. 18 EULAR Standing Committee of PARE, Zurich, Switzerland
  19. 19 Deutsches Rheuma-Forschungszentrum, Berlin, Germany
  20. 20 Department of Rheumatology and Clinical Immunology, Charitè University Hospital, Berlin, Germany
  21. 21 Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands
  22. 22 Zuyderland Medical Center, Heerlen, The Netherlands
  1. Correspondence to Dr Christian Dejaco; christian.dejaco{at}


Objective Current methods used for forecasting workforce requirements in rheumatology are disparate, as are the parameters incorporated into workforce projection studies. The objective of these European League Against Rheumatism (EULAR points to consider (PTC) is to guide future workforce studies in adult rheumatology in order to produce valid and reliable manpower estimates.

Methods The EULAR Standardised Operating Procedures were followed. A multidisciplinary task force with experts including patients with rheumatic diseases from 11 EULAR countries and the USA was assembled. A systematic literature review (SLR) was conducted to retrieve workforce models in rheumatology and other medical fields. PTC were based on expert opinion informed by the SLR, followed by group discussions with consensus obtained through informal voting. The level of agreement with the PTC was voted anonymously.

Results A total of 10 PTC were formulated. The task force recommends models integrating supply (=workforce available in rheumatology), demand (=health services requested by the population) and need (=health services that are considered appropriate to serve the population). In general, projections of workforce requirements should consider all factors relevant for current and future workload in rheumatology inside and outside of direct patient care. Forecasts of workforce supply should consider demography and attrition of rheumatologists, as well as the effects of new developments in healthcare. Predictions of future need/demand should take demographic, sociocultural and epidemiological development of the population into account.

Conclusion These EULAR-endorsed PTC will provide guidance on the methodology and the parameters to be applied in future national and international workforce requirement studies in rheumatology.

  • arthritis
  • epidemiology
  • health services research

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  • SR and FB contributed equally.

  • Contributors All authors were involved in the discussion and formulation of the points to consider. CD wrote the first version of the manuscript. All authors reviewed it and made extensive comments and appropriate changes to it. All authors approved the final version of the manuscript.

  • Funding Funding was provided by the European League Against Rheumatism.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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