RT Journal Article
SR Electronic
T1 Feasibility and Domain Validation of Rheumatoid Arthritis (RA) Flare Core Domain Set: Report of the OMERACT 2014 RA Flare Group Plenary
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2185
OP 2189
DO 10.3899/jrheum.141169
VO 42
IS 11
A1 Bartlett, Susan J.
A1 Bykerk, Vivian P.
A1 Cooksey, Roxanne
A1 Choy, Ernest H.
A1 Alten, Rieke
A1 Christensen, Robin
A1 Furst, Daniel E.
A1 Guillemin, Francis
A1 Halls, Serena
A1 Hewlett, Sarah
A1 Leong, Amye L.
A1 Lyddiatt, Anne
A1 March, Lyn
A1 Montie, Pamela
A1 Orbai, Ana Maria
A1 Pohl, Christoph
A1 Voshaar, Marieke Scholte
A1 Woodworth, Thasia G.
A1 Bingham, Clifton O.
YR 2015
UL http://www.jrheum.org/content/42/11/2185.abstract
AB Objective. The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Flare Group was established to develop an approach to identify and measure RA flares. An overview of our OMERACT 2014 plenary is provided.Methods. Feasibility and validity of flare domains endorsed at OMERACT 11 (2012) were described based on initial data from 3 international studies collected using a common set of questions specific to RA flare. Mean flare frequency, severity, and duration data were presented, and domain scores were compared by flare status to examine known-groups validity. Breakout groups provided input for stiffness, self-management, contextual factors, and measurement considerations.Results. Flare data from 501 patients in an observational study indicated 39% were in flare, with mean (SD) severity of 6.0 (2.6) and 55% lasting > 14 days. Pain, physical function, fatigue, participation, and stiffness scores averaged ≥ 2 times higher (2 of 11 points) in flaring individuals. Correlations between flare domains and corresponding legacy instruments were obtained: r = 0.46 to 0.93. A combined definition (patient report of flare and 28-joint Disease Activity Score increase) was evaluated in 2 other trials, with similar results. Breakout groups debated specific measurement issues.Conclusion. These data contribute initial evidence of feasibility and content validation of the OMERACT RA Flare Core Domain Set. Our research agenda for OMERACT 2016 includes establishing duration/intensity criteria and developing criteria to identify RA flares using existing disease activity measures. Ongoing work will also address discordance between patient and physician ratings, facilitate application of flare criteria to clinical care, elucidate the role of self-management, and finalize recommendations for RA flare measurement.