Research priorities in pediatric rheumatology: The Childhood Arthritis and Rheumatology Research Alliance (CARRA) consensus

We determined consensus using the Delphi approach. This approach has been used extensively in health research to reach consensus in large groups. It uses several successive iterations of surveys eliciting ideas and opinions from specialists in the field. Three surveys were designed based on this method and were distributed to members of CARRA to elicit and rank-order research priorities.A response rate of 87.6% was achieved in the final survey. The most highly ranked research suggestion was to study infliximab treatment of uveitis unresponsive to methotrexate. Other highly ranked suggestions were to study i) the treatment of systemic arthritis with anakinra and ii) the treatment of pediatric systemic lupus erythematosus with mycophenolate mofetil.The Delphi approach was an effective and practical method to define research priorities in this group. Ongoing discussion and cooperation among pediatric rheumatologists in CARRA and others world-wide will help in developing further research priorities and to facilitate the execution of clinical trials in the future.The rare nature of pediatric rheumatology conditions poses challenges in conducting adequately powered trials in single institutions. Recognizing the need for – and the previous successes of – multicentre collaborations, the Childhood Arthritis and Rheumatology Research Alliance (CARRA) was formed in 2002 as an investigator-initiated research network aiming to improve outcomes of children with pediatric rheumatic diseases through high-quality clinical trials and clinical translational research. [1]As a starting point, a CARRA sub-committee surveyed CARRA members to identify and prioritize research questions. The goal of this project was to identify research priorities for an intervention study addressing a pediatric rheumatology problem that is sufficiently common that centres across the network would have an opportunity to participate, but one that is sufficiently rare that the workload at each institution woul