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High quality studies of the safety and efficacy of non-pharmacologic agents in the management of OA remain challenging due to difficulties with adequate blinding and appropriate selection of attention controls. High quality studies suggest modest, if any, benefit of many non-pharmacologic therapies over attention control or placebo, but a significant impact of both over no intervention at all.

Quality of care improvement has become a priority for decision-makers. Important variations in the quality and cost of care are being documented often without evidence of improved outcomes. Therapeutic advances are not consistently applied to practice despite efforts from professional organisations to create guidelines. The quality movement emerged following increasing evidence that the creation and measurement of quality indicators can improve quality of care and health outcomes. Quality indicators can measure healthcare system performance across providers, system levels and regions. In rheumatology, early efforts to develop quality measures have focused on examining all aspects of care while more recent efforts have focused on disease course monitoring. The American College Rheumatology has recently endorsed seven quality indicators for rheumatoid arthritis (RA) that are evidence based and measurable for use in routine rheumatology practices. This review provides an overview on quality indicators in rheumatology with a focus on RA, and discusses the application of quality measures into routine rheumatology practices to improve quality of care for RA.

Among healthy mid-life women receiving a baseline BMD test, few had low bone mass, supporting the need for guidance about testing. A prediction rule with four risk factors had improved sensitivity over the OST. Further validation is warranted.

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