Prevalence, determinants and ethnic disparities of rheumatoid arthritis among older adults in Canada: protocol for a systematic review and meta-analysis
Bibliographic record
Abstract
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterised by progressive joint inflammation, pain and functional decline, disproportionately affecting older adults. In Canada, evidence regarding the prevalence, determinants and ethnic disparities of RA among older populations remains fragmented. This protocol outlines a systematic review and meta-analysis designed to estimate the pooled prevalence of RA, identify its key determinants and examine ethnic disparities among Canadian adults aged 60 years and older. METHODS AND ANALYSIS: A comprehensive literature search will be undertaken across MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, and relevant grey literature sources to identify studies published between January 2000 and October 2025, with the search scheduled to be conducted between 15 and 30 November 2025. Observational studies reporting RA prevalence or determinants in Canadian adults aged ≥60 years will be eligible. Two reviewers will independently perform study selection, data extraction and risk-of-bias assessment using the Joanna Briggs Institute critical appraisal tools. Data will be synthesised using a random-effects model (logit-transformed or binomial GLMM), with subgroup analyses by ethnicity, sex/gender and geographic region. Equity-related factors will be examined using the PROGRESS-Plus framework. The protocol has been reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2020 guidelines. ETHICS AND DISSEMINATION: This study uses publicly available, published data and does not require ethics approval. The review will commence in November 2025 and is expected to conclude by April 2026. Findings will be shared through peer-reviewed journals, conferences and policy briefs, reaching clinicians, researchers and health policymakers. By presenting results to both academic and broader audiences, the review seeks to promote equitable, evidence-informed decision-making in rheumatology care across Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.071 | 0.114 |
| Meta-epidemiology (narrow) | 0.006 | 0.005 |
| Meta-epidemiology (broad) | 0.017 | 0.025 |
| Bibliometrics | 0.011 | 0.013 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.008 | 0.005 |
| Open science | 0.006 | 0.004 |
| Research integrity | 0.006 | 0.006 |
| Insufficient payload (model declined to judge) | 0.070 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".