Development and validation of the Flare-OA questionnaire for measuring flare in knee and hip osteoarthritis,Osteoarthritis and Cartilage

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Development and validation of the Flare-OA questionnaire for measuring flare in knee and hip osteoarthritis
Osteoarthritis and Cartilage ( IF 7 ) Pub Date : 2022-01-20 , DOI: 10.1016/j.joca.2021.12.011
Y Traore ₁ , J Epstein ₂ , E Spitz ₃ , L March ₄ , J-F Maillefert ₅ , C Rutherford ₆ , C Ricatte ₃ , C Alleyrat ₁ , M Cross ₄ , L K King ₇ , L F Callahan ₈ , B Fautrel ₉ , T Buttel ₁₀ , G Hawker ₇ , D J Hunter ₄ , F Guillemin ₂

Affiliation

Inserm, CHRUNancy, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France.
Inserm, CHRUNancy, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France; Université de Lorraine, APEMAC - MICS, Nancy, France.
Université de Lorraine, APEMAC - EPSAM, Metz, France.
University of Sydney, Institute of Bone and Joint Research, Kolling Institute, And Royal North Shore Hospital, Rheumatology Department, Australia.
University Hospital, Department of Rheumatology, Dijon, France.
University of Sydney, Faculty of Science, School of Psychology, Sydney, Australia; University of Sydney, Faculty of Medicine and Health, Sydney Nursing School, Sydney, Australia.
University of Toronto, Department of Medicine, Canada.
University of North Carolina, Thurston Arthritis Research Center, Chapel Hill, USA.
Sorbonne Université - Assistance Publique Hôpitaux de Paris, Rheumatology Dept, Pitié-Salpêtrière Hospital, Paris, France; Institut Pierre Louis d'Epidémiologie et Santé Publique, Inserm UMR-S 1136, Paris, France.
University of Sydney, Institute of Bone and Joint Research, Kolling Institute, And Royal North Shore Hospital, Rheumatology Department, Australia; Inner West Psychology, Sydney, Australia.

Objective

Ability to assess flares in osteoarthritis (OA) of the knee and hip (KHOA) is important in clinical care and research. Using mixed methods, we developed a self-reported instrument measuring flare and assessed its psychometric properties.

Methods

We constructed questionnaire items from semi-structured interviews and a focus group (patients, clinicians) by using a dual-language (English-French) approach. A Delphi consensus method was used to select the most relevant items. Patients with OA from Australia, France and the United States completed the preliminary Flare-OA, HOOS, KOOS and Mini-OAKHQOL questionnaires online. We used a factor analysis and content approach to reduce items and determine structural validity. We tested the resulting questionnaire (score 0–100) for internal consistency, convergent and known-groups validity.

Results

Initially, 180 statements were generated and reduced to 33 items in five domains (response 0 = not at all, to 10 = absolutely) by Delphi consensus (50 patients, 116 professionals) and an expert meeting. After 398 patients (mean [SD] age 64 [8.5] years, 70.4% female, 86.7% knee OA) completed the questionnaire, it was reduced to 19 items by factor analysis and a content approach (RMSEA = 0.06; CFI = 0.96; TLI = 0.94). The Cronbach's alpha was >0.9 for the five domains and the whole questionnaire. Correlation coefficients between Flare-OA and other instrument scores were as predicted, supporting construct validity. The difference in Flare-OA score between patients with and without flare (31.8) largely exceeded 2 SEM (10.2).

Conclusion

Flare-OA is a valid and reliable patient-reported instrument for assessing the occurrence and severity of flare in patients with KHOA in clinical research.

中文翻译：

开发和验证用于测量膝关节和髋关节骨性关节炎发作的 Flare-OA 问卷

客观的

评估膝关节和髋关节骨关节炎 (OA) (KHOA) 发作的能力在临床护理和研究中非常重要。使用混合方法，我们开发了一种自我报告的测量耀斑的仪器，并评估了它的心理测量特性。

方法

我们通过使用双语（英语-法语）方法从半结构化访谈和焦点小组（患者、临床医生）中构建了问卷项目。Delphi 共识方法用于选择最相关的项目。来自澳大利亚、法国和美国的 OA 患者在线完成了初步的 Flare-OA、HOOS、KOOS 和 Mini-OAKHQOL 问卷。我们使用因子分析和内容方法来减少项目并确定结构有效性。我们测试了由此产生的问卷（得分 0-100）的内部一致性、收敛性和已知组有效性。

结果

最初，通过德尔福共识（50 名患者，116 名专业人员）和专家会议，生成了 180 条陈述，并将其减少到五个领域的 33 项（回答 0 = 完全没有，至 10 = 绝对）。在 398 名患者（平均 [SD] 年龄 64 [8.5] 岁，70.4% 女性，86.7% 膝关节 OA）完成问卷后，通过因子分析和内容法（RMSEA = 0.06；CFI = 0.96；CFI = 0.96； TLI = 0.94)。五个领域和整个问卷的 Cronbach's alpha > 0.9。Flare-OA 和其他仪器分数之间的相关系数与预测的一样，支持结构有效性。有和没有发作的患者之间的 Flare-OA 评分差异 (31.8) 大大超过 2 SEM (10.2)。