A Delphi study with 12 international experts reached 88.9% consensus on 40 items for a cannabis risk assessment tool in rheumatology, emphasizing patient demographics, medical history, substance use disorders, and cannabis consumption patterns.
Rheumatologists, pain specialists, and clinicians who need structured guidance for discussing cannabis use with patients.
88.9% consensus on 40 risk assessment items
What the researchers found
Consensus (75%+ agreement) was achieved on 40 of 45 items (88.9%) after two rounds, confirmed in a third validation round. Key risk factors included age, gender, history of substance use disorders, schizophrenia, cannabis consumption patterns, age of first use, method, and frequency of use.
Why it matters
With cannabis legalization expanding, rheumatology patients increasingly use cannabis for chronic pain. A standardized risk assessment tool helps clinicians move from subjective judgment to evidence-informed screening when discussing cannabis with patients.
The numbers in context
12 experts participated. 45 statements rated. 40 items reached 75%+ consensus (88.9%). Four categories: patient demographics, medical history, lifestyle, socioeconomic. All 40 confirmed in validation round.
How the study worked
Modified Delphi study with 12 international experts from different healthcare professions in rheumatology. Statements developed from literature review and focus groups. Three rounds conducted: two for consensus, one for validation. Agreement threshold set at 75%.
What this study cannot tell us
Only 12 experts participated. Delphi consensus does not equal clinical validation. The tool has not been tested in clinical practice. Expert panel composition may not represent all relevant perspectives.
How to read the evidence
Moderate: structured Delphi process with international experts, though small panel size and no clinical validation yet.
When this study was published
Published 2026.
The bigger picture
This is one of the first efforts to develop a structured clinical tool for cannabis risk assessment in a specific medical specialty. If validated, it could serve as a model for other specialties where patients use cannabis for symptom management.
Questions still open
- How well does the tool predict actual adverse outcomes from cannabis use in rheumatology patients? Would primary care providers find it practical? How should the tool be modified for different legal and cultural contexts?
Common questions
Is there a tool for assessing cannabis risk in arthritis patients?
What risk factors are important for cannabis use in rheumatology?
Read the original research
The development of a cannabis risk assessment tool for patients with rheumatologic conditions: a Delphi study.
Clinical rheumatology, 45(3), 1971-1979
Citation
Turk, Tarek; Watson, Kaitlyn; Aref, Heba; Patel, Dimple; Jones, Allyson; Olson, Joanne; Paul, Pauline; Sadowski, Cheryl A; Yacyshyn, Elaine. (2026). The development of a cannabis risk assessment tool for patients with rheumatologic conditions: a Delphi study.. Clinical rheumatology, 45(3), 1971-1979. https://doi.org/10.1007/s10067-025-07807-z
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