Rheumatologists have been pioneers in the development and use of clinical measures for outcome assessment. The Lansbury Index (1958) and the Empire Rheumatism Gold Trial (1960) used sophisticated double-blind pseudo-placebo-controlled trial designs and standardized prespecified clinical outcome measures to establish the clinical usefulness of a drug whose benefit did not become evident until it was administered for several months. Since these studies, other studies have establish the clinical and statistical groundwork for rheumatoid arthritis outcome measures. In 1980, the Health Assessment Questionnaire and the Arthritis Impact Measurement Scales were added. Future development of paradigms for the decision process in the clinical management of individual rheumatoid arthritis patients will no doubt incorporate standard outcome measures to provide the data upon which management decisions can be based.