Susan J Bartlett1,2,3, Vivian P Bykerk4, Orit Schieir5, Marie-France Valois6, Janet E Pope7, Gilles Boire8, Carol Hitchon9, Glen Hazlewood10,11, Louis Bessette12, Edward Keystone13, Carter Thorne14, Diane Tin14, Clifton O Bingham15. 1. Centre for Outcomes Research and Evaluation, McGill University, 5252 de Maisonneuve, #3D.57, Montreal, QC, H4A 3S5, Canada. Susan.bartlett@mcgill.ca. 2. Research Institute, McGill University Health Center, Montreal, QC, Canada. Susan.bartlett@mcgill.ca. 3. Arthritis Research Canada, Vancouver, Canada. Susan.bartlett@mcgill.ca. 4. Hospital for Special Surgery, Weill Cornell Medical College, New York, NY, USA. 5. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 6. Centre for Outcomes Research and Evaluation, McGill University, 5252 de Maisonneuve, #3D.57, Montreal, QC, H4A 3S5, Canada. 7. St. Joseph's Health Care London, University of Western Ontario, London, ON, Canada. 8. University of Sherbrooke, Sherbrooke, QC, Canada. 9. University of Manitoba, Winnipeg, MB, Canada. 10. Arthritis Research Canada, Vancouver, Canada. 11. University of Calgary, Calgary, AB, Canada. 12. University of Laval, Quebec City, QC, Canada. 13. Mount Sinai Hopsital, Toronto, ON, Canada. 14. The Arthritis Center, Newmarket, ON, Canada. 15. Johns Hopkins Medicine, Baltimore, MD, USA.
Abstract
PURPOSE: The Rheumatoid Arthritis Flare Questionnaire (RA-FQ) is a patient-reported measure of disease activity in RA. We estimated minimal and meaningful change from the perspective of RA patients, physicians, and using a disease activity index. METHODS: Data were from 3- to 6-month visits of adults with early RA enrolled in the Canadian Early Arthritis Cohort. Participants completed the RA-FQ, the Patient Global Assessment of RA, and the Patient Global Change Impression at consecutive visits. Rheumatologists recorded joint counts and MD Global. Clinical Disease Activity Index (CDAI) scores were computed. We compared mean RA-FQ change across categories using patients, physicians, and CDAI anchors. RESULTS: The 808 adults were mostly white (84%) women (71%) with a mean age of 55 and moderate-high disease activity (85%) at enrollment. At V2, 79% of patients classified their RA as changed; 59% were better and 20% were worse. Patients reporting they were a lot worse had a mean RA-FQ increase of 8.9 points, whereas those who were a lot better had a -6.0 decrease. Minimal worsening and improvement were associated with a mean 4.7 and - 1.8 change in RA-FQ, respectively, while patients rating their RA unchanged had stable scores. Physician and CDAI classified more patients as worse than patients, and minimal and meaningful RA-FQ thresholds differed by group. CONCLUSION: Thresholds to identify meaningful change vary by anchor used. These data offer new evidence demonstrating robust psychometric properties of the RA-FQ and offer guidance about improvement or worsening, supporting its use in RA care, research, and decision-making.
PURPOSE: The Rheumatoid Arthritis Flare Questionnaire (RA-FQ) is a patient-reported measure of disease activity in RA. We estimated minimal and meaningful change from the perspective of RA patients, physicians, and using a disease activity index. METHODS: Data were from 3- to 6-month visits of adults with early RA enrolled in the Canadian Early Arthritis Cohort. Participants completed the RA-FQ, the Patient Global Assessment of RA, and the Patient Global Change Impression at consecutive visits. Rheumatologists recorded joint counts and MD Global. Clinical Disease Activity Index (CDAI) scores were computed. We compared mean RA-FQ change across categories using patients, physicians, and CDAI anchors. RESULTS: The 808 adults were mostly white (84%) women (71%) with a mean age of 55 and moderate-high disease activity (85%) at enrollment. At V2, 79% of patients classified their RA as changed; 59% were better and 20% were worse. Patients reporting they were a lot worse had a mean RA-FQ increase of 8.9 points, whereas those who were a lot better had a -6.0 decrease. Minimal worsening and improvement were associated with a mean 4.7 and - 1.8 change in RA-FQ, respectively, while patients rating their RA unchanged had stable scores. Physician and CDAI classified more patients as worse than patients, and minimal and meaningful RA-FQ thresholds differed by group. CONCLUSION: Thresholds to identify meaningful change vary by anchor used. These data offer new evidence demonstrating robust psychometric properties of the RA-FQ and offer guidance about improvement or worsening, supporting its use in RA care, research, and decision-making.
Authors: Elena Myasoedova; Arun Chandran; Birkan Ilhan; Brittny T Major; C John Michet; Eric L Matteson; Cynthia S Crowson Journal: Ann Rheum Dis Date: 2015-01-30 Impact factor: 19.103
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Authors: Susan J Bartlett; Sarah Hewlett; Clifton O Bingham; Thasia G Woodworth; Rieke Alten; Christoph Pohl; Ernest H Choy; Tessa Sanderson; Annelies Boonen; Vivian Bykerk; Amye L Leong; Vibeke Strand; Daniel E Furst; Robin Christensen Journal: Ann Rheum Dis Date: 2012-07-06 Impact factor: 19.103
Authors: Josef S Smolen; Ferdinand C Breedveld; Gerd R Burmester; Vivian Bykerk; Maxime Dougados; Paul Emery; Tore K Kvien; M Victoria Navarro-Compán; Susan Oliver; Monika Schoels; Marieke Scholte-Voshaar; Tanja Stamm; Michaela Stoffer; Tsutomu Takeuchi; Daniel Aletaha; Jose Louis Andreu; Martin Aringer; Martin Bergman; Neil Betteridge; Hans Bijlsma; Harald Burkhardt; Mario Cardiel; Bernard Combe; Patrick Durez; Joao Eurico Fonseca; Alan Gibofsky; Juan J Gomez-Reino; Winfried Graninger; Pekka Hannonen; Boulos Haraoui; Marios Kouloumas; Robert Landewe; Emilio Martin-Mola; Peter Nash; Mikkel Ostergaard; Andrew Östör; Pam Richards; Tuulikki Sokka-Isler; Carter Thorne; Athanasios G Tzioufas; Ronald van Vollenhoven; Martinus de Wit; Desirée van der Heijde Journal: Ann Rheum Dis Date: 2015-05-12 Impact factor: 19.103