| Name of the Instrument/Tool | Flare Assessment in Rheumatoid Arthritis (FLARE-RA) |
| First Description |
Fautrel B, Morel J, Berthelot JM, Constantin A, De Bandt M, Gaudin P, Maillefert JF, Meyer O, Pham T, Saraux A, Solau-Gervais E, Vittecoq O, Wendling D, Erpelding ML, Guillemin F; STPR Group of the French Society of Rheumatology. Validation of FLARE-RA, a Self-Administered Tool to Detect Recent or Current Rheumatoid Arthritis Flare. |
| Year | 2017 |
| Domains | |
| Concept of constructs | Disease activity |
| Population/Disease | Disease specific |
| Originally developed for | Rheumatoid Arthritis (RA) |
| Other rheumatic diseases where can be applied (only if validated) |
--- |
| Additional population with no rheumatic diseases |
No |
| Language: Originally published in | French |
| Available in Language | Dutch, Italian, Spanish, English, Danish, American English |
| REFERENCE IDENTIFICATION | |
| Author/s | Fautrel B, Morel J, Berthelot JM, Constantin A, De Bandt M, Gaudin P, Maillefert JF, Meyer O, Pham T, Saraux A, Solau-Gervais E, Vittecoq O, Wendling D, Erpelding ML, Guillemin F; STPR Group of the French Society of Rheumatology. |
| Title | Validation of FLARE-RA, a Self-Administered Tool to Detect Recent or Current Rheumatoid Arthritis Flare. |
| Journal | Arthritis Rheumatol |
| Year | 2017 |
| Vol | 69 |
| Num | 2 |
| Pages | 309-319 |
| Country | France |
| Language | English |
| Other references of interest | |
| Link | https://pubmed.ncbi.nlm.nih.gov/31526593/ |
| Brief Description |
Definition and construct validation of clinically relevant cutoffs on the Flare Assessment in Rheumatoid Arthritis (FLARE-RA) questionnaire. |
| Link | https://pubmed.ncbi.nlm.nih.gov/22072015/ |
| Brief Description |
A tool to identify recent or present rheumatoid arthritis flare from both patient and physician perspectives: The ‘FLARE’ instrument |
| Instrument/Tool Translations References | |
| Link | https://pubmed.ncbi.nlm.nih.gov/32292018/ |
| Brief Description |
Translation and cross-cultural adaptation into Italian of the self-administered FLARE-RA questionnaire for rheumatoid arthritis. Definition and construct validation of clinically relevant cutoffs on the Flare Assessment in Rheumatoid Arthritis (FLARE-RA) questionnaire. |
| Link | https://pubmed.ncbi.nlm.nih.gov/35943667/ https://pubmed.nc … |
| Brief Description |
Validation and predictive capacity of a Dutch version of the FLARE-RA questionnaire within the context of a TNFi-tapering trial. |
| Link | https://pubmed.ncbi.nlm.nih.gov/31493148/ https://pubmed.nc … |
| Brief Description |
The American English version of the validated French Flare Assessment in RA Questionnaire (FLARE-RA). Patient self-assessment of flare in rheumatoid arthritis: criterion and concurrent validity of the Flare instrument. |
| DEVELOPER CONTACT INFORMATION | |
| Correspondence to | Bruno Fautrel |
| bruno.fautrel@aphp.fr | |
| Address | Médecine and AP-HP, GH Pitié Salpêtrière, Service de Rhumatologie, Paris, France. |
| Website | --- |
| Available | --- |
| Links |
Link to platfom SeleQT, where the manual of scoring is available in French and English : Plateforme SELEQT: https://seleqt.univ-lorraine.fr/fiche-imec.html?acro=FLARE-RA |
| DESCRIPTION OF THE INSTRUMENT | |
| Type Of Measure | Questionnaire |
| Brief Description |
FLARE-RA aims to identify rheumatoid arthritis patients with fluctuating disease activity and suboptimal control of their disease. The initial FLARE development study involved developing two comprehensive lists of items that could define flare from a patient and/or a rheumatologist perspective with two qualitative methods: semistructured interviews to elicit patient views, and a Delphi exercise to reach consensus among physicians. The response modality was a Likert scale of six answers ranging from 0=‘absolutely true’ to 10=‘completely untrue’. The initial questionnaire included 13 questions examining 13 domains identified as being associated with RA flare by both patients and physicians (joint swelling, joint pain, night awakening, pain killer intake), only patients (fatigue, impossibility to do a thing, need for help, withdrawal from social activities, bad mood, and irritability), or only physicians (morning stiffness, daily dose of steroids, patient's global assessment). The FLARE was refined after Rasch analysis and further validation into the FLARE-RA questionnaire 11-item version. |
| Number of Items | 11 |
| Range | 0-10 |
| Responses options/scale |
Yes Numerical Rating 0-10 |
| Developed for | Clinical practice, Research |
| PRACTICAL APPLICATION | |
| Method of administration | Physician, Self-administered |
| Recommendations to score |
The total FLARE-RA score is the mean of the scores for the 11 items. Each 2 subscales (arthritis subscale and general symptom subscale) scores are the mean of the scores of their respective items. |
| Score Interpretation | Higher scores indicate worse control of their disease |
| Cut-off points | Observational studies, clinical detection/change of anti-rheumatic treatment: 2 and 5 (3.5, if RA duration >5 years). Clinical trials: 2.3, acceptable situation. |
| Cut-off points applied to | Routine care, Research |
| Smallest detectable change if described | --- |
| Smallest detectable change applied to | Routine care |
| Completion time by the patient | - minutes |
| Scoring time by the assessor | - minutes |
| Training to score | Not necessary |
| Strengths | Easy to use, Useful in clinical practice & research |
| Limitations | --- |
| OTHER COMMENTS | |
| Other Comments |
The cut-offs for the FLARE-RA score were lower using "patient report of flare" than DAS28-CRP and "change of anti-rheumatic treatment". Proposed FLARE-RA cut-offs for clinical detection and change of anti-rheumatic treatment are 2 and 5, respectively, for patients with RA duration 2-5 years, and 2 and 3.5, respectively, for patients with RA duration >5 years. From clinical trials (TOSCA study), a FLARE-RA cut-off of 2.3, below which the situation (i.e. without flare) is acceptable for patients. AUC for the global FLARE-RA score ranged from 0.71 to 0.92 |