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Feasibility and domain validation of rheumatoid arthritis (RA) flare core domain set: Report of the OMERACT 2014 RA Flare Group plenary

Bartlett, Susan J.; Bykerk, Vivian P.; Cooksey, Roxanne; Choy, Ernest H.; Alten, Rieke; Christensen, Robin; Furst, Daniel E.; Guillemin, Francis; Halls, Serena; Hewlett, Sarah; Leong, Amye L.; Lyddiatt, Anne; March, Lyn; Montie, Pamela; Orbai, Ana Maria; Pohl, Christoph; Scholte Voshaar, Marieke; Woodworth, Thasia G.; Bingham, Clifton O.


Susan J. Bartlett

Vivian P. Bykerk

Roxanne Cooksey

Ernest H. Choy

Rieke Alten

Robin Christensen

Daniel E. Furst

Francis Guillemin

Amye L. Leong

Anne Lyddiatt

Lyn March

Pamela Montie

Ana Maria Orbai

Christoph Pohl

Marieke Scholte Voshaar

Thasia G. Woodworth

Clifton O. Bingham


The Journal of Rheumatology Copyright © 2015. All rights reserved. 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.


Bartlett, S. J., Bykerk, V. P., Cooksey, R., Choy, E. H., Alten, R., Christensen, R., …Bingham, C. O. (2015). Feasibility and domain validation of rheumatoid arthritis (RA) flare core domain set: Report of the OMERACT 2014 RA Flare Group plenary. Journal of Rheumatology, 42(11), 2185-2189.

Journal Article Type Article
Publication Date Nov 1, 2015
Deposit Date Sep 14, 2015
Journal Journal of Rheumatology
Print ISSN 0315-162X
Electronic ISSN 1499-2752
Publisher Journal of Rheumatology
Peer Reviewed Peer Reviewed
Volume 42
Issue 11
Pages 2185-2189
Keywords rheumatoid arthritis, RA flare group
Public URL
Publisher URL