FLARE-RA in patients with rheumatoid arthritis: translation and cross-cultural adaptation into Turkish

Background: Flare Assessment in Rheumatoid Arthritis (FLARE-RA) is a patient-reported outcome measure (PROM) to evaluate the flare-related symptoms of individuals with Rheumatoid Arthritis (RA) in the last three months. Objective: The present study aimed to demonstrate the translation, cultural adaptation and psychometric properties of the Turkish version of the FLARE-RA. Methods: A cross-sectional psychometric analysis study was conducted with a total of 80 patients (61 Women, 19 Men; 49.6 +/- 15.4 years). Patients filled-out the Global Health Assessment (GHA), Visual Analog Scale (VAS), Disease Activity Score-28 (DAS-28), Rheumatoid Arthritis Quality-of-Life Questionnaire (RAQoL), Health Assessment Questionnaire (HAQ) in addition to the Turkish FLARE-RA. In addition, participants' Erythrocyte Sedimentation Rate (ESR) and C-reactive protein (CRP) were recorded. Thirty patients refilled the FLARE-RA again, one-week later. Results: In the cross-cultural adaptation, translation procedures and pilot study, each item of the Turkish version of the FLARE-RA was found to be comprehensible. The ICC (two-way random-effect, single-measure model) and alpha values of the Turkish FLARE-RA were 0.97 and 0.96, respectively. The MDC95 values calculated for the FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms scores were 2.01, 1.60, and 1.18, respectively. FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms scores were highly correlated with VAS-rest, VAS-activity, DAS-28, RAQoL, and HAQ scores (r > 0.50). On the other hand, scores of FLARE-RA, FLARE-RA-arthritis, and FLARE-RA-symptoms were moderately correlated with the GHA-patient subscale, GHA-clinician subscale, ESR, and duration of morning stiffness (0.35 < r < 0.50). Conclusion: The present study results demonstrated the reliability and validity of the Turkish FLARE-RA. FLARE-RA is a practical tool to assess the flare of RA patients.

Automated summary

The present study aimed to translate, culturally adapt, and assess the psychometric properties of the Turkish version of FLARE-RA. A cross-sectional psychometric analysis was conducted with 80 patients, and the results demonstrated the good comprehensibility, feasibility, and reliability of the Turkish FLARE-RA, supporting its use in assessing disease flares in rheumatoid arthritis patients.