I was glad to see the article published online 5/23/2017 in Arthritis Care and Research , showing that "usual care" was as good as T2T in CDAI scores over 1 year . If one is careful, actually listens to patients ,examines them ,and does appropriate tests, it works just as well. It is unfortunate that this got zero coverage by the powers that be who tout T2T. I realize we would all love a real concrete way of achieving controlled remission or LDA. We just aren't there yet for most of us. The fact that this has been force fed to Rheums for years now with almost zero acceptance should tell us about the T2T approaches currently used . The thousands of Rheums in the US are not change averse to anything that advances the specialty . We accept new things that work well, all the time . We would all love something that makes our loves simpler . T2T , the ways it is currently constructed , just doesn't .