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08-09-2022 | Special Section: Methodologies for Meaningful Change

“From Where I Stand”: using multiple anchors yields different benchmarks for meaningful improvement and worsening in the rheumatoid arthritis flare questionnaire (RA-FQ)

Auteurs: Susan J. Bartlett, Vivian P. Bykerk, Orit Schieir, Marie-France Valois, Janet E. Pope, Gilles Boire, Carol Hitchon, Glen Hazlewood, Louis Bessette, Edward Keystone, Carter Thorne, Diane Tin, Clifton O. Bingham III, CATCH Investigators

Gepubliceerd in: Quality of Life Research | Uitgave 5/2023

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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.
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Metagegevens
Titel
“From Where I Stand”: using multiple anchors yields different benchmarks for meaningful improvement and worsening in the rheumatoid arthritis flare questionnaire (RA-FQ)
Auteurs
Susan J. Bartlett
Vivian P. Bykerk
Orit Schieir
Marie-France Valois
Janet E. Pope
Gilles Boire
Carol Hitchon
Glen Hazlewood
Louis Bessette
Edward Keystone
Carter Thorne
Diane Tin
Clifton O. Bingham III
CATCH Investigators
Publicatiedatum
08-09-2022
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 5/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-022-03227-7