Program Agenda In keeping with equity principles, open science, and the wisdom of crowds, we invited open applications for keynote speakers and symposia for February 15-16, 2023. The deadline for submissions has passed and the call has closed. English: Schedule & Speaker Bio Booklet [PDF 623KB] French: Déroulement de la journée virtuelle [PDF 673KB] CARC Day 1: Wednesday, February 15, 2023 Opening Remarks & Keynote Session Opening Remarks Welcome to CARC 2023! 11:30am-11:45am EST Welcome to CARC & Land Acknowledgement (Dr. Karim Khan) Opening Remarks by Canadian Rheumatology Association (Dr. Ahmad Zbib), Arthritis Society Canada (Carol Bishop on behalf of Dr. Sian Bevan), and CIHR-IMHA (Dr. Karim Khan) Housekeeping + Introduction to Keynote Session (Dr. Dawn Richards) Keynote Session Moderator: Dr. Andrea Knight Arthritis Across the Lifespan Ms. Lene Andersen (autoimmune/inflammatory), Ms. Maureen Quigely (OA), and Dr. Claire Barber 11:45-12:35 EST Arthritis can have many impacts on the quality of an individual's life. This session will review the impacts of arthritis from a patient perspective and some evidence-based strategies to optimize care with a focus on person-centered care. At the end of this session, participants will be able to: Learning Objective 1: Interpret the top patient priorities for arthritis management across the lifespan. Learning Objective 2: Identify patient-level strategies for managing arthritis across the lifespan. Learning Objective 3: Understand strategies for providers and health systems to support patients across the lifespan. Room Splitting Break 12:35-12:40 EST Room 1: Autoimmune/autoinflammatory disorders From Pediatric to Adult RA Moderator: Natasha Trehan Experiences of Trauma, Stress and Discrimination and Rheumatic Conditions Dr. Candace Feldman 12:40-13:05 EST This session will review studies that demonstrate the role of trauma, stress, and discrimination on rheumatic disease incidence, disease activity and outcomes. The intersecting contributions of structural factors, social determinants of health, and psychosocial factors on rheumatic disease disparities will be discussed. At the end of this session, participants will be able to: Learning Objective 1: Summarize the contributions of exposure to stress to rheumatic disease incidence. Learning Objective 2: Demonstrate the interplay between structural factors, social determinants of health and psychosocial factors as they relate to rheumatic disease disparities. Learning Objective 3: Appraise interventions that may reduce disparities by acknowledging and addressing the role of chronic stress and discrimination in rheumatic diseases. The Transition from Pediatric to Adult Rheumatology Care - What Have We Learned? Dr. Michelle Batthish 13:05-13:30 EST In this session, we will review the importance of preparing youth with chronic rheumatic disease in their transition to adult care. We will also review best practices in establishing a successful transition program. At the end of this session, participants will be able to: Learning Objective 1: Evaluate the importance of the transition to adult care in patients with chronic rheumatic disease. Learning Objective 2: Examine best practices of successful transition programs. Learning Objective 3: Recognize future directions in transition research. Comorbidities and clinical outcomes in rheumatic disease Dr. Carol Hitchon 13:30-13:55 EST This session will review data on the prevalence of comorbidity in inflammatory arthritis and explore how comorbidity may impact arthritis outcomes. At the end of this session, participants will be able to: Learning Objective 1: Describe the extent of comorbidity in early rheumatic disease. Learning Objective 2: Describe the impact of comorbidity on rheumatic disease outcomes. Learning Objective 3: Identify feasible approaches to address comorbidity in a busy practice. Panel: Ask Me Anything 13:55-14:10 EST Room 2: Osteoarthritis (OA) Risk Factors and Prevention Moderator: Dr. Jackie Whittaker The Role of Comorbidities in Osteoarthritis Dr. Leigh Callahan 12:40-13:05 EST This session will review the most prevalent comorbid conditions in individuals with osteoarthritis. The impact of the conditions on disease incidence, outcomes, and mortality will be discussed. Public health outcomes and approaches to addressing OA and comorbidities will be discussed. At the end of this session, participants will be able to: Learning Objective 1: Identify the common chronic conditions that are most prevalent in individuals with OA. Learning Objective 2: Diagnose the impact and role of comorbid conditions on the incidence. outcomes and mortality in OA. Learning Objective 3: Evaluate the approaches and interventions for people with OA that may mitigate the impact of comorbid conditions. Targeting Obesity to Prevent Knee Osteoarthritis Dr. Jos Runhaar 13:05-13:30 EST Obesity accounts for up to 50% of new cases of knee osteoarthritis. With that, it is the most relevant risk factor for knee osteoarthritis. In this session, I will discuss the evidence and challenges of the prevention of knee osteoarthritis through targeting obesity. At the end of this session, participants will be able to: Learning Objective 1: Define the importance of maintaining/reaching a healthy body weight for osteoarthritis prevention. Learning Objective 2: Identify the challenges in studying osteoarthritis prevention. Learning Objective 3: Communicate the importance of healthy body weight for knee osteoarthritis development. Putting Injury Prevention Programs into Practice in Community Sport Dr. Brooke Patterson 13:30-13:55 EST Exercise-based injury prevention programs have been shown to reduce the risk of musculoskeletal injury in most field-based team sports, but their uptake by coaches, players, clubs, and organizations is low. Due to their high short- and long-term burden, reducing the risk of serious knee and head injuries is a high priority in many sporting codes, particularly in women playing football - where the risk and burden of injury is often higher. At the end of this session, participants will be able to: Learning Objective 1: Identify the role of health, sport and science professionals in preventing injuries in community sport. Learning Objective 2: Describe the key components of an injury prevention program and be able to access evidence-based resources. Learning Objective 3: Examine the injury profile and contextual factors that may influence injury prevention implementation strategies. Panel: Ask Me Anything 13:55-14:10 EST Lunch Break Lunch Break 14:10-14:45 EST Room 1: Best Research Presentations Best Research Presentations Moderator: Dr. Carolyn Goard (on behalf of Dr. Sian Bevan) Sex-related Measures of Inequity in Randomized Controlled Trials in Psoriatic Arthritis: A Systematic Literature Review and Meta-analysis Keith Colaco 14:45-15:00 EST Psoriatic arthritis (PsA) is a type of inflammatory arthritis that affects men and women differently. Female sex is an important determinant of an individual's response to medication. This session will summarize existing evidence of sexrelated dimensions of equity in clinical trials that assessed the efficacy of advanced therapies in PsA. At the end of this session, participants will be able to: Learning Objective 1: Understand the impact of psoriatic arthritis on men and women. Learning Objective 2: Describe the proportion of studies reporting sex-disaggregated data. Learning Objective 3: Compare the efficacy of advanced therapies between men and women in clinical trials. Diffuse idiopathic skeletal hyperostosis (DISH) in humans: Prevalence and imaging features across the lifespan in a Northern US population Dale E. Fournier 15:00-15:15 EST A cross-sectional retrospective evaluation of clinical computed tomography (CT) images of the thoracic spine was conducted in partnership with the Rochester Epidemiology Project (REP) to explore the clinical relevance of diffuse idiopathic skeletal hyperostosis (DISH). This session focuses on improving the clinical awareness of DISH and recognition of its early stages. At the end of this session, participants will be able to: Learning Objective 1: Assess the prevalence of diffuse idiopathic skeletal hyperostosis in a North American population Learning Objective 2: Analyze imaging features along the continuum of diffuse idiopathic skeletal hyperostosis Learning Objective 3: Evaluate the clinical implications for people living with diffuse idiopathic skeletal hyperostosis, health care providers, and society. Room 2: Best Research Presentations Best Research Presentations Moderator: Dr. David Hart Instruments to assess appropriateness of hip and knee arthroplasty: A systematic review Lissa Pacheco-Brousseau 14:45-15:00 EST This presentation will be on a systematic review of instruments to assess hip and knee arthroplasty appropriateness for adults with osteoarthritis. 55 instruments across 122 articles were found. Most instruments use traditional criteria to assess appropriateness and patient's perspective is not considered. Furthermore, there is limited evidence on instrument's psychometric properties. At the end of this session, participants will be able to: Learning Objective 1: Identify instruments to assess appropriateness of elective joint arthroplasty for adults with primary hip and knee OA Learning Objective 2: Evaluate instrument according to the Hawker et al. appropriateness criteria for total joint arthroplasty Learning Objective 3: Describe psychometric properties of instruments Characterizing the roles of miR-335-5p and miR-335-3p in knee and hip osteoarthritis Mr. Thomas Wilson 15:00-15:15 EST MicroRNAs are important regulatory molecules in the pathology of diseases including osteoarthritis (OA). Utilizing biospecimens from our HFH OA biobank, we characterized the expression of a pair of microRNAs in knee and hip OA. We found that one of these microRNAs (miR-335-5p) has high expression in knee OA tissues and functions to directly regulate gene targets that may contribute to OA pathology. At the end of this session, participants will be able to: Learning Objective 1: Define microRNAs and describe their biogenesis. Learning Objective 2: Discern how miR-335-5p and miR-335-3p expression differs in seven knee and seven hip OA tissues. Learning Objective 3: Identify direct gene targets of miR-335-5p in knee OA. Panel Discussion Panel Discussion Moderators: Dr. Carter Thorne and Dr. Tom Appleton Virtual Arthritis Care - Challenges and Opportunities Panelists: Ms. Cheryl Koehn, Mrs. Linda Truong, Dr. Brent Ohata, Dr. Vandana Ahluwalia, Dr. Deborah Levy 15:15-16:00 EST This session will bring together the perspectives of a diverse group of stakeholders from patient partners to clinicians on the topic of virtual arthritis care and challenges. Specifically, the panel will have a discussion on sub-topics such as, patient challenges, emerging virtual care models, changes in perspectives of arthritis associations & provincial ministries of health, gaps in virtual care delivery, and transferrable lessons learned from in-person rheumatology care models. At the end of this session, participants will be able to: Learning Objective 1: Describe the virtual arthritis care patient experience, including challenges and opportunities realized from the COVID-19 pandemic. Learning Objective 2: Identify opportunities for the research community to inform the delivery of virtual arthritis care. Learning Objective 3: Acknowledge emerging virtual care strategies that can support quality care in the future. Room 1: Networking Session - Virtual Health Networking Session Moderators: Dr. Carter Thorne and Cheryl Koehn Virtual Health 16:00 - 16:30 EST Room 2: Networking Session - Patients as Partners in Research Networking Session Moderators: Dr. Dawn Richards, Lene Andersen, and Laurie Proulx Patients as Partners in Research 16:00 - 16:30 EST CARC Day 2: Thursday, February 16, 2023 Day 2 Remarks & Keynote Session Housekeeping & Introduction to Keynote Session Dr. Mohit Kapoor 11:50-11:55 EST Keynote Session Moderator: Dr. Mohit Kapoor Role of AI in Early Diagnosis and Management of Arthritis Dr. Thomas Hügle 11:55-12:25 EST This session will explain how algorithms such as deep learning can be useful to move from prediction to clinical decision-making in arthritis. This concerns clinical data including PROs on the one hand and imaging on the other. It will also show the development of a new digital biomarker for arthritis based on computer vision and convolutional networks along with a discussion on the limitations and risks of artificial intelligence in clinical practice. At the end of this session, participants will be able to: Learning Objective 1: Identify suitable applications and limitations of algorithms in arthritis. Learning Objective 2: Distinguish Digital Biomarkers, Prediction Models, and Clustering Models. Learning Objective 3: Consider practical necessities in the application of algorithms for sustainable horizontal digitization. Room Splitting 12:25-12:30 EST Room 1: Autoimmune/autoinflammatory disorders Early Diagnosis and Intervention Moderator: Dr. Jillian Banfield (Patient Partner) Early Diagnosis in Autoimmune Disease: Autoantibodies & Machine Learning Dr. May Choi 12:30-12:55 EST An early and accurate diagnosis for many autoimmune rheumatic diseases can be challenging, leading to increased morbidity, mortality, and health care costs. The session will discuss how biomarkers and machine learning interpretation can be used as a novel approach to aid in the detection and prognosis of autoimmune rheumatic diseases. At the end of this session, participants will be able to: Learning Objective 1: Identify the current challenges in the detection of autoimmune rheumatic diseases. Learning Objective 2: Evaluate the role of autoantibodies and other biomarkers in autoimmune rheumatic diseases. Learning Objective 3: Propose machine learning interpretation as an approach to biomarker interpretation. Patient stratification and outcome prediction in JIA using a machine-learning approach Dr. Rae Yeung 12:55-13:20 EST This session aims to review approaches to integrating heterogenous data sets and strategies for collaboration and future studies JIA. At the end of this session, participants will be able to: Learning Objective 1: Evaluate the challenges to predicting outcomes in JIA. Learning Objective 2: Assess the challenges to the integration of clinical and biologic data. Learning Objective 3: Examine the role of biology in predicting outcomes. Panel: Ask Me Anything 13:20-13:30 EST Room 2: Osteoarthritis (OA) Early Diagnosis and Detection Moderator: Mrs. Lisa Hunter (Patient Partner) Towards Classification Criteria for Early-Stage Knee Osteoarthritis Dr. Lauren King 12:30-12:55 EST This talk with discuss the current international effort underway to develop classification criteria for knee osteoarthritis, including rationale, process, and work to date. At the end of this session, participants will be able to: Learning Objective 1: Apprehend the concept of early-stage knee osteoarthritis. Learning Objective 2: Describe the rationale for developing classification criteria for early-stage knee osteoarthritis. Learning Objective 3: Recognize the process and progress of the OARSI-endorsed early-stage knee osteoarthritis to develop classification criteria for early-stage knee OA. Early Diagnosis of OA: What Can Imaging Offer? Dr. Bruce Forster 12:55 -13:20 EST This session will discuss the limitations of traditional radiographic imaging of OA and therefore the appropriateness of advanced imaging for OA assessment, as well as promising research tools, including artificial intelligence. At the end of this session, participants will be able to: Learning Objective 1: Identify the limitations of plain x-rays for assessment of early OA. Learning Objective 2: Recognize the limited role of CT and MRI in the workup of pts with joint pain and known moderate to advanced OA. Learning Objective 3: Acknowledge evolving technologies such as cartilage mapping and artificial intelligence in the understanding of pathogenesis and treatment of OA. Panel: Ask Me Anything 13:20-13:30 EST Lunch Break Lunch Break 13:30-14:30 EST Room 1: Best Research Presentations Best Research Presentations Moderator: Michaela Khan Overexpression of mucin 16 and mesothelin promotes fibrosis in rapidly progressive systemic sclerosis patients Ms. Lamia Khan 14:30-14:45 EST Systemic sclerosis (SSc) is a rare form of inflammatory arthritis that causes severe day-to-day limitations and eventually death. Severe form of SSc is responsible for the highest mortality rate among all the rheumatic diseases due to abnormal skin thickening and overgrowth of skin cells that causes scarring or fibrosis. We are trying to understand how abnormalities in the known oncogene MUC16, promotes scarring or fibrosis. At the end of this session, participants will be able to: Learning Objective 1: Interpret how we think MUC16 promotes scarring in systemic sclerosis. Learning Objective 2: Identify the current knowledge gap(s) regarding the role of MUC16 and potential mutations that can promote abnormal cell growth in systemic sclerosis. Learning Objective 3: Appraise a mechanistic model that can then be utilized to develop novel insights and treatment strategies for systemic sclerosis. Assessing the Affordability of publicly funding GLA:D in Alberta Mr. Darren Mazzei 14:45-15:00 EST Alberta's publicly-funded health insurance system does not fund first-line osteoarthritis treatments, meaning access is based on the ability to pay instead of need. Many Albertans are not using first-line treatments before surgeon consultation while joint replacement wait times are two times longer than national targets. We constructed a budget impact analysis (BIA) model to estimate how more equitable funding scenarios could impact use of GLA:D, joint replacement wait times, and costs to the public health budget. At the end of this session, participants will be able to: Learning Objective 1: Describe how the treatments used to manage knee osteoarthritis in Alberta do not meet clinical guidelines. Learning Objective 2: Recognize how budget impact models are constructed to inform resource decisions. Learning Objective 3: Demonstrate how funding an evidence-based exercise and education program could improve equitable access and reduce joint replacement wait times. Room 2: Best Research Presentations Best Research Presentations Moderator: Dr. Jackie Whittaker The Impact of Diabetes Status on Pain and Disability Following Total Joint Arthroplasty for Hip and Knee Osteoarthritis: Variation By Sex and Body Mass Index Dr. J. Denise Power 14:30-14:45 EST Available research on the impact of diabetes on hip and knee total joint arthroplasty (TJA) outcomes will be presented. Current project findings examining the association between diabetes and post-TJA disability and pain, explicitly examining whether diabetes impact may differ by sex and BMI, will be described utilizing data from a longitudinal cohort of hip and knee osteoarthritis patients undergoing TJA. At the end of this session, participants will be able to: Learning Objective 1: Reflect on the variability in research findings on the impact of diabetes on TJA outcomes in osteoarthritis patients. Learning Objective 2: Recognize that a simple consideration of the potential impact of diabetes as present vs. absent in TJA patients may not be appropriate. Learning Objective 3: Compare the impact of diabetes on post-TJA disability and pain in males and females, and how this varies with increasing body mass index. Lumbar spinal stenosis impact on outcomes following patient education and exercise therapy in people with knee or hip osteoarthritis Dr. James Young 14:45-15:00 EST This session will first review the potential impact of co-occurring lumbar spinal stenosis with knee or hip osteoarthritis on treatment outcomes. Next, recent work exploring the impact on patient-reported outcomes following the GLA:D® education and exercise therapy program will be presented. Finally, the session will discuss the future research needed in this area. At the end of this session, participants will be able to: Learning Objective 1: Trace the latest evidence on the prevalence of co-occurring lumbar spinal stenosis and hip or knee osteoarthritis. Learning Objective 2: Explain the impact co-occurring lumbar spinal stenosis can have on treatment options for knee and hip osteoarthritis. Learning Objective 3: Assess the need to evaluate patients for the presence of cooccurring lumbar spinal stenosis and hip and/or knee osteoarthritis. Moderated Discussion #1 Moderated Discussion Moderator: Rachel Manion Working it out: Understanding the experiences of people with psoriatic disease at work in Canada Crowdsourced applicants: Ms. Margaret Peters, Laurie Proulx, Dr. Arif Jetha, Ms. Antonella Scali 15:00-15:30 EST The onset and diagnosis of psoriatic disease – including psoriasis and psoriatic arthritis – commonly affects people in the prime of their working lives. These episodic and chronic diseases can result in disability without appropriate care, treatment, and support – including in the workplace. This moderated panel will discuss the needs and priorities of people with psoriatic disease in the Canadian workplace, including perspectives from people with lived experience, policy experts, and patient organizations, and will provide information and resources for supporting people. At the end of this session, participants will be able to: Learning Objective 1: Describe challenges experienced by people with psoriatic disease in navigating workplace settings and accommodation needs. Learning Objective 2: Identify key gaps and needs of people with episodic disease in the workplace based on policy and research. Learning Objective 3: Apply knowledge of existing resources and tools to support people with psoriatic disease at work. Moderated Discussion #2 Moderated Discussion Moderator: Mrs. Linda Truong Guiding rehabilitation to prevent post-traumatic osteoarthritis after knee injury: the 2022 OPTIKNEE international consensus statement Crowdsourced applicants: Dr. Adam Culvenor, Dr. Erin Macri, Dr. Jackie Whittaker 15:30-16:00 EST Knee injuries can be life-altering and are a potent risk factor for osteoarthritis. Despite this long-held knowledge and the crippling hold that osteoarthritis has on healthcare systems globally, the prevention of post-traumatic knee osteoarthritis has not gained a foothold. OPTIKNEE is an international group of over ~40 clinician scientists, scientists, and patient and clinician partners working to overcome this. Over the last three years, this group has compiled evidence from ~230 studies, including >133,000 people with knee injuries in 7 systematic reviews and metanalyses. These reviews informed a consensus exercise that has produced 8 clinical recommendations that guide evidence-based practice and decision-making for the care of patients following a traumatic knee injury with post-traumatic OA prevention front of mind, and 6 research recommendations lay the foundation for best practice research and future data synthesis by harmonizing outcomes. During this interactive moderated discussion, the speakers will discuss the rationale for OPTIKNEE and provide an overview of the OPTIKNEE systematic reviews, consensus process, and consensus recommendations. At the end of this session, participants will be able to: Learning Objective 1: Describe the burden of knee injuries and risk factors for posttraumatic osteoarthritis. Learning Objective 2: Identify best management strategies and rehabilitation approaches for ACL tears. Learning Objective 3: Select the most appropriate patient reported outcome, muscle strength and functional performance tests to monitor people at risk of post-traumatic knee osteoarthritis. Conference Closing Remarks 16:00 - 16:10 EST: Closing Remarks Announcement of CARC 2024 Dates Post-Conference Evaluation Survey Distribution Details Room 1: Networking Session - Choosing a Career Path in Research Networking Session Moderators: Dr. Mohit Kapoor and Dr. Tom Appleton Choosing a Career Path in Research 16:10 - 16:40 EST Room 2: Networking Session - Multidisciplinary Research Networking Session Moderators: Dr. Andrea Knight, Dr. Jackie Whittaker, and Michaela Khan Multidisciplinary Research 16:10 - 16:40 EST