Importance of registries in informing clinical practice for arthritis

The gold standard in research for evidence that underlies clinical practice is the randomized controlled trial. In recent years it has been accepted that observational studies, which include disease and drug registries and cohort studies, are very important sources of data not available from randomized clinical trials, and the two different approaches complement one another. In rheumatology, the development of clinical guidelines, standards of care and health policies, and appraisal of new drugs by NICE, all rely on clinical outcomes, prognostic factors and responses to drug therapies provided by both sources. Observational studies and registries in arthritis have promoted greater collaborations between academics and clinicians, and with patient support groups and public health. The main strengths of observational studies are that, first, they reflect ‘real-world’ practice and, second, they can achieve prolonged follow-up. As the management of chronic conditions such as arthritis becomes more complex and health economic issues more important in the 21st century, it is probable that more reliance will be placed on these types of studies.