TY - JOUR
T1 - Feasibility and Domain Validation of Rheumatoid Arthritis (RA) Flare Core Domain Set
T2 - Report of the OMERACT 2014 RA Flare Group Plenary
AU - Bartlett, Susan J.
AU - Bykerk, Vivian
AU - Cooksey, Roxanne
AU - Choy, Ernest H.
AU - Alten, Rieke
AU - Christensen, Robin
AU - Furst, Daniel E.
AU - Guillemin, Francis
AU - Halls, Serena
AU - Hewlett, Sarah E.
AU - Leong, Amy L.
AU - Lyddiatt, Anne
AU - March, Lyn
AU - Montie, Pamela
AU - Orbai, Ana Maria
AU - Pohl, Christoph
AU - Scholte-Voshaar, Marieke
AU - Woodworth, Thasia G.
AU - Bingham, Clifton O.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - 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.
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.
KW - Flare
KW - Disease exacerbation
KW - Rheumatoid arthritis
KW - Omeract
KW - n/a OA procedure
U2 - 10.3899/jrheum.141169
DO - 10.3899/jrheum.141169
M3 - Article
SN - 0315-162X
VL - 42
SP - 2185
EP - 2189
JO - Journal of rheumatology
JF - Journal of rheumatology
IS - 11
ER -