Methodologic issues in international rheumatologic clinical epidemiology.

Those who provide, plan, or pay for health services must decide which rheumatologic health services should be provided to whom to effectively and efficiently reduce the burden of disease and disability from arthritis. The achievement of this goal demands the generation of epidemiologic information based on the burden of illness reported in a suitable format that allows policymakers to use the data in making decisions about health care. We have developed an approach based upon an "iterative measurement loop" consisting of a cycle of 6 epidemiologic research and evaluation steps that can be used to contribute to health policy decisions for allocation of health services to reduce the burden of illness from arthritis.