The EULAR Standing Committee for International clinical Studies Including Therapeutics (ESCISIT) encourages the production of international evidence based recommendations for the management of rheumatic diseases. This has already led to published recommendations in osteoarthritis,^1,2 and ankylosing spondylitis (AS),³ and recommendations for other disease states, including early rheumatoid arthritis and gout, have recently been completed. As a guide to the process for developing recommendations, standard operating procedures (SOPs) have been published,⁴ which include recommendations for the formation of a steering group, defining a target population, and the use of research evidence.

Although the SOP is generally straight­forward, several problems came up during the development of the recommen­dations for AS³ about wording and interpretation, which led to the decision to write this …