The terms used to describe the different phases before the development of RA are intentionally broad. Therefore, ‘genetic risk factors for RA’ and ‘environmental risk factors for RA’ delib- erately do not deﬁne any particular genetic and environmental risk factors. ‘Systemic autoimmunity associated with RA’ does not deﬁne any speciﬁc immune abnormalities, such as any spe- ciﬁc autoantibody, and ‘symptoms without clinical arthritis’ does not deﬁne any speciﬁc symptoms. This was a very conscious decision, as restricting these categories by specifying risk factors and features that are currently known will render the nomencla- ture rapidly redundant in this advancing ﬁeld. Future research will deﬁne additional risk factors and features relevant to each of these phases, beyond current knowledge, and will assess the predictive utility of each of these. In addition, there are currently recognised biomarkers that are known to be present before the development of RA, which are not speciﬁcally reﬂected in the nomenclature. The presence of synovitis on imaging, but not clinically, is an example of this. This is not to suggest that the study group viewed this as an unimportant biomarker. Rather, the nomenclature should provide a framework within which future research can assess at which phases, and for transit to which phases, this, like other biomarkers, is useful. A number of the research questions that have been deﬁned require new cohorts, of asymptomatic individuals and of patients, to be established and new techniques to be developed to image and collect material from different sites. The identi- ﬁcation of uniform core datasets that can be collected in stan- dardised ways across cohorts is an important goal. Furthermore, standard operating procedures for the collection, handling and storage of samples, such as serum and RNA, should be agreed to ensure good and consistent quality of the biomaterial. Given the inherent conﬂict between the desire to collect material in a uniform and optimal manner and the constraints of working in a clinical environment where such collection is not always feasible, the description of how each sample was collected, handled and stored, will be very important. As knowledge evolves it is important not to leave its true target audience behind. Individuals without RA need to be informed of the rationale for and value of predicting risk and intervening and the need to have a clear understanding of the risks and beneﬁts of such approaches. Clarity of terminology and the involvement of users through all phases of the research process will help achieve this. Contributors All authors contributed actively to the development of the recom- mendation proposed in this manuscript. They all had input in preparing and writing the manuscript. DMG and KR ﬁnalised the manuscript. The ﬁrst two authors contributed equally to the paper. Funding This work was supported in part by grants from the EULAR, the European BTCure IMI programme, Dutch Arthritis Foundation and ZonMw. Competing interests None. Provenance and peer review Not commissioned; externally peer reviewed. Author afﬁliations 1Division of Clinical Immunology and Rheumatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 2Rheumatology Research Group, MRC Centre for Immune Regulation, Institute for Biomedical Research, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK 3Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands 4Department of Rheumatology and Clinical Immunology, Charite University Hospital, Berlin, Germany 5Division of Rheumatology, University of Geneva School of Medicine, Geneva, Switzerland 6Rheumatology Unit, Department of Medicine, Karolinska Institute and Karolinska University Hospital, Solna, Sweden 7Academic Department of Rheumatology, Division of Immunology, Infection and Inﬂammatory Diseases, King’s College School of Medicine, London, UK 8GenHotel, University Evry, Clermont-Ferrand, France Ann Rheum Dis 2012;71:638–641. doi:10.1136/annrheumdis-2011-200990 Recommendation 9Department of Public Health and Clinical Medicine, Rheumatology, Umeå University, Umeå, Sweden 10Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK 11Manchester Academic Health Science Centre,The University of Manchester, Manchester, UK 12Department of Rheumatology, University Hospital, Zurich, Switzerland 13Department of Rheumatology, Erasmus MC, Rotterdam, The Netherlands 14Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands 15Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway 16Department of Rheumatology, Medical University of Vienna, Vienna, Austria 17Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden 18Jan van Breemen Research Institute, Department of Rheumatology, Amsterdam, The Netherlands 19Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany 20National Rheumatoid Arthritis Society, UK REFERENCES 1. van Zeben D, Hazes JM, Zwinderman AH, et al. 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