RT Journal Article
SR Electronic
T1 Identifying Preliminary Domains to Detect and Measure Rheumatoid Arthritis Flares: Report of the OMERACT 10 RA Flare Workshop
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1751
OP 1758
DO 10.3899/jrheum.110401
VO 38
IS 8
A1 CLIFTON O. BINGHAM III
A1 RIEKE ALTEN
A1 SUSAN J. BARTLETT
A1 VIVIAN P. BYKERK
A1 PETER M. BROOKS
A1 ERNEST CHOY
A1 ROBIN CHRISTENSEN
A1 DANIEL E. FURST
A1 SARAH E. HEWLETT
A1 AMYE LEONG
A1 JAMES E. MAY
A1 PAM MONTIE
A1 CHRISTOF POHL
A1 TESSA C. SANDERSON
A1 VIBEKE STRAND
A1 THASIA G. WOODWORTH
YR 2011
UL http://www.jrheum.org/content/38/8/1751.abstract
AB Background. While disease flares in rheumatoid arthritis (RA) are a recognized aspect of the disease process, there is limited formative research to describe them. Methods. The Outcome Measures in Rheumatology Clinical Trials (OMERACT) RA Flare Definition Working Group is conducting an international research project to understand the specific characteristics and impact of episodic disease worsening, or “flare,” so that outcome measures can be developed or modified to reflect this uncommonly measured, but very real and sometimes disabling RA disease feature. Patient research partners provided critical insights into the multidimensional nature of flare. The perspectives of patients and healthcare and research professionals are being integrated to ensure that any outcome measurement to detect flares fulfills the first OMERACT criteria of Truth. Through an iterative data-driven Delphi process, a preliminary list of key domains has been identified to evaluate flare. Results. At OMERACT 10, consensus was achieved identifying features of flare in addition to the existing core set for RA, including fatigue, stiffness, symptom persistence, systemic features, and participation. Patient self-report of flare was identified as a component of the research agenda needed to establish criterion validity for a flare definition; this can be used in prospective studies to further evaluate the Discrimination and Feasibility components of the OMERACT filter for a flare outcome measure. Conclusion. Our work to date has provided better understanding of key aspects of the RA disease process as episodic, potentially disabling disease worsening even when a patient is in low disease activity. It also highlights the importance of developing ways to enhance communication between patients and clinicians and improve the ability to achieve “tight control” of disease.