Evidence map›Paper›PMID 27252895›Full record

ArticleRMD open2016

Identifying flares in rheumatoid arthritis: reliability and construct validation of the OMERACT RA Flare Core Domain Set.

Vivian P Bykerk, Clifton O Bingham, Ernest H Choy, Daming Lin, Rieke Alten, Robin Christensen, Daniel E Furst, Sarah Hewlett, Amye Leong, Lyn March and 10 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in RMD open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 1 pooled it
9.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.

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  10. "From Where I Stand": using multiple anchors yields different benchmarks for meaningful improvement and worsening in the rheumatoid arthritis flare questionnaire (RA-FQ).Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 15 institutions in 7 countries.

Vivian P BykerkDepartment of Rheumatology, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, USA; Rebecca McDonald Center for Arthritis & Autoimmune Disease, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
Clifton O BinghamDivision of Rheumatology , Johns Hopkins School of Medicine , Baltimore, Maryland , USA.
Ernest H ChoySection of Rheumatology , Arthritis Research UK & Health and Care Research Wales CREATE Centre, Cardiff University , Cardiff , UK.
Daming LinRebecca McDonald Center for Arthritis & Autoimmune Disease, Mount Sinai Hospital, University of Toronto , Toronto, Ontario , Canada.
Rieke AltenSchlosspark Klinik, Charité University Medicine , Berlin , Germany.
Robin ChristensenMusculoskeletal Statistics Unit, Department of Rheumatology , The Parker Institute , Copenhagen University Hospital, Bispebjerg and Frederiksberg , Denmark.
Daniel E FurstDivision of Rheumatology, University of California, Los Angeles, Los Angeles, California, USA (Emeritus); University of Washington, Seattle Wash; University of Florence, Florence, Italy.
Sarah HewlettUniversity of the West of England , Bristol , UK.
Amye LeongBone and Joint Decade, Healthy Motivation , Santa Barbara, California , USA.
Lyn MarchDepartment of Rheumatology , University of Sydney, Institute of Bone and Joint Research, Royal North Shore Hospital , St Leonards, New South Wales , Australia.
Thasia WoodworthDivision of Rheumatology , University of California, Los Angeles , Los Angeles, California , USA.
Gilles BoireDivision of Rheumatology , Université de Sherbrooke , Sherbrooke, Québec , Canada.
Boulos HaraouiRheumatic Disease Unit , Institut de Rheumatologie , Montreal, Québec , Canada.
Carol HitchonArthritis Center, University of Manitoba , Winnipeg, Manitoba , Canada.
Shahin JamalVancouver Coastal Health Institute , Vancouver, British Columbia , Canada.
Edward C KeystoneRebecca McDonald Center for Arthritis & Autoimmune Disease, Mount Sinai Hospital, University of Toronto , Toronto, Ontario , Canada.
Janet PopeDivision of Rheumatology , St. Joseph's Health Care London, University of Western Ontario , London, Ontario , Canada.
Diane TinSouthlake Regional Health Centre , Newmarket, Ontario , Canada.
J Carter ThorneSouthlake Regional Health Centre , Newmarket, Ontario , Canada.
Susan J BartlettDivision of Rheumatology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Divisions of Clinical Epidemiology, Rheumatology, and Respiratory Clinical Trials Unit, McGill University, Montreal, Québec, Canada.ORCID 0000-0001-9755-2490
Johns Hopkins University · USMount Sinai Hospital · CASouthlake Regional Health Center · CAUniversity of California, Los Angeles · USFrederiksberg Hospital · DKHealth and Care Research Wales · GBHospital for Special Surgery · USSchlosspark-Klinik · DEThe University of Sydney · AUUnited States Bone and Joint Initiative · USUniversité de Sherbrooke · CAUniversity of Manitoba · CAUniversity of the West of England · GBVancouver Coastal Health Research Institute · CAWestern University · CA

Funding

Molecular Pathways in Treatment Response and Flare in RAUH2AR067691 · NIAMS · HOSPITAL FOR SPECIAL SURGERY · PI BYKERK, VIVIAN P, IVASHKIV, LIONEL B · 2014 to 2020
$2.0M
NIAMS NIH HHS UH2 AR067691
6 · The paper itself

Abstract

objectiveTo evaluate the reliability of concurrent flare identification using 3 methods (patient, rheumatologist and Disease Activity Score (DAS)28 criteria), and construct validity of candidate items representing the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RA Flare Core Domain Set.

methodsCandidate flare questions and legacy measures were administered at consecutive visits to Canadian Early Arthritis Cohort (CATCH) patients between November 2011 and November 2014. The American College of Rheumatology (ACR) core set indicators were recorded. Concordance to identify flares was assessed using the agreement coefficient. Construct validity of flare questions was examined: convergent (Spearman's r); discriminant (mean differences between flaring/non-flaring patients); and consequential (proportions with prior treatment reductions and intended therapeutic change postflare).

resultsThe 849 patients were 75% female, 81% white, 42% were in remission/low disease activity (R/LDA), and 16-32% were flaring at the second visit. Agreement of flare status was low-strong (κ's 0.17-0.88) and inversely related to RA disease activity level. Flare domains correlated highly (r's≥0.70) with each other, patient global (r's≥0.66) and corresponding measures (r's 0.49-0.92); and moderately highly with MD and patient-reported joint counts (r's 0.29-0.62). When MD/patients agreed the patient was flaring, mean flare domain between-group differences were 2.1-3.0; 36% had treatment reductions prior to flare, with escalation planned in 61%.

conclusionsFlares are common in rheumatoid arthritis (RA) and are often preceded by treatment reductions. Patient/MD/DAS agreement of flare status is highest in patients worsening from R/LDA. OMERACT RA flare questions can discriminate between patients with/without flare and have strong evidence of construct and consequential validity. Ongoing work will identify optimal scoring and cut points to identify RA flares.

Indexed as

Disease ActivityOutcomes researchPatient perspectiveRheumatoid Arthritis

Identifiers

PMID27252895
PMCPMC4885442
OpenAlexW2400511889

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.