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Validation of FLARE‐RA, a Self‐Administered Tool to Detect Recent or Current Rheumatoid Arthritis Flare
Author(s) -
Fautrel Bruno,
Morel Jacques,
Berthelot JeanMarie,
Constantin Arnaud,
De Bandt Michel,
Gaudin Philippe,
Maillefert JeanFrancis,
Meyer Olivier,
Pham Thao,
Saraux Alain,
SolauGervais Elisabeth,
Vittecoq Olivier,
Wendling Daniel,
Erpelding MarieLine,
Guillemin Francis
Publication year - 2017
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.39850
Subject(s) - medicine , intraclass correlation , rheumatoid arthritis , rheumatoid factor , construct validity , flare , physical therapy , surgery , psychometrics , patient satisfaction , clinical psychology , physics , astrophysics
Objective To validate the measurement properties and the detection performance of the FLARE‐RA questionnaire in a longitudinal prospective study. Methods To validate the FLARE‐RA self‐administered questionnaire, we conducted a prospective trial in rheumatoid arthritis (RA) patients to document: 1) content and construct validity by factor analysis, convergent validity by Pearson's correlation with routine assessment of patient index data (Routine Assessment of Patient Index Data 3 [RAPID‐3] questionnaire), RA Impact of Disease (RAID) score, Disease Activity Score in 28 joints (DAS28), and Health Assessment Questionnaire (HAQ), 2) reliability (intraclass correlation coefficient [ICC] and Bland‐Altman plot), and 3) feasibility of use. Patients were examined and questionnaires were collected at baseline and 3 months, and every week in between for RAPID‐3. Results We recruited 138 patients from 13 centers: 81.9% women, mean age 57.4 years, mean DAS28 2.9, mean C‐reactive protein level 6.2 mg/liter, 84.4% rheumatoid factor positive, 78.0% anti–citrullinated protein antibody positive, and 78.8% with erosive disease. At baseline, the mean ± SD FLARE‐RA score was 2.3 ± 2.3. The content and construct validity of FLARE‐RA was good. A substantial floor effect, but no ceiling effect, was observed. Principal components analysis revealed 1 domain disentangled in 2 subdomains: physical and emotional. The FLARE‐RA total score was correlated with the DAS28 (r = 0.63, P < 0.001), RAID (r = 0.80, P < 0.001), RAPID‐3 (r = 0.77, P < 0.001), and HAQ (r = 0.53, P < 0.001). The ICC for reliability was 0.94 (95% confidence interval 0.92–0.96). Conclusion The FLARE‐RA self‐administered questionnaire represents a valid and valuable instrument to detect RA flare between visits to the physician.