title: Validation of FLARE-RA, a Self-Administered Tool to Detect Recent or Current Rheumatoid Arthritis Flare.
abstract: To validate the measurement properties and the detection performance of the FLARE-RA questionnaire in a longitudinal prospective study.
  
  
  
  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.
  
  
  
  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).
  
  
  
  The FLARE-RA self-administered questionnaire represents a valid and valuable instrument to detect RA flare between visits to the physician.
authors.affiliation: Université Pierre et Marie Curie Paris 6, UFR de Médecine and AP-HP, GH Pitié Salpêtrière, Service de Rhumatologie, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.affiliation: CHU Lapeyronie, Département de Rhumatologie, Montpellier, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Morel
authors.affiliation: INSERM ERI 7 (EA 3822) Centre Hospitalo-Universitaire de Nantes, Hôtel-Dieu, Service de Rhumatologie, Nantes, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Berthelot
authors.affiliation: Paul Sabatier Toulouse III University, Centre de Rhumatologie, Hôpital Purpan and UMR 1043, INSERM/UPS/CNRS, Hôpital Purpan, Toulouse, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Constantin
authors.affiliation: Centre Hospitalier La Meynard, Service de Rhumatologie, Fort de France, France.
authors.forename: Michel
authors.initials: M
authors.lastname: De Bandt
authors.affiliation: Hôpital Sud A. Michallon, Grenoble, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaudin
authors.affiliation: Centre Hospitalo-Universitaire du Dijon, Hôpital du Bocage, Service de Rhumatologie, Dijon, France.
authors.forename: Jean-Francis
authors.initials: JF
authors.lastname: Maillefert
authors.affiliation: Université Denis Diderot Paris 5, UFR de Médecine and AP-HP, GH Bichat, Service de Rhumatologie, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Meyer
authors.affiliation: CHU Sainte-Marguerite, Department of Rheumatology, Marseilles, France.
authors.forename: Thao
authors.initials: T
authors.lastname: Pham
authors.affiliation: Centre Hospitalo-Universitaire de Brest, Hôpital de la Cavale Blanche, Service de Rhumatologie, and EA 2216, INSERM ESPRI, ERI29 Université Bretagne Occidentale, Brest, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
authors.affiliation: CHU de Poitiers, Poitiers, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Solau-Gervais
authors.affiliation: Rouen University Hospital Department of Rheumatology and INSERM U905 (IFRMP 23), University of Rouen, Rouen, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vittecoq
authors.affiliation: Université de Franche-Comté EA4266, Agents pathogènes et Inflammation and Centre Hospitalo-Universitaire de Besançon, Hôpital Jean Minjoz, Service de Rhumatologie, Besançon, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.affiliation: INSERM CIC-EC 1433, University Hospital, Nancy, France.
authors.forename: Marie-Line
authors.initials: ML
authors.lastname: Erpelding
authors.affiliation: INSERM CIC-EC 1433, University Hospital and Université de Lorraine, Université Paris Descartes, EA 4360 APEMAC, Nancy, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000067251:Symptom Flare Up