Background/Purpose: The Outcome Measures in Rheumatology group (OMERACT) developed methodological steps to select instrument(s) to assess content appropriateness of outcomes, as well as tools to accomplish this task. In this study we present the results obtained following these steps to select instrument(s) to assess flares in osteoarthritis, based on the associated domains

Methods: An update of a previous 2017 literature review was conducted in PubMed, Web of Science and Psych Info databases over the period from 2017 to 2021, with the primary goal of searching instruments associated with flare in knee and hip OA or their correlated characteristics. Using the OMERACT Handbook Filter 2.2¹, we evaluated the content of instruments included according to five core domains endorsed by OMERACT², and then classified into three categories: “sure match with domains of flare in OA”; “uncertain match with domains of flare in OA”; and “sure not match with domains of flare in OA”. The instruments retained in the first two categories were analyzed by the experts of the working group (WG) Flares in OA, composed of patients, physicians, and researchers, in two rounds of Delphi survey using limesurvey. The goal was to identify among these five instruments which one best matches with the target domain (trust) and which one is more practical to use (feasibility). The final selection was obtained by a vote of the group.

Results: Initially 575 papers were filtered. After experts’ analysis, 59 studies were included, and 44 instruments associated with flare in OA were identified. Most were studies about pain in knee or hip OA (35%), cultural adaptation of a measure (33%) or studies investigating psychometric properties of full (16%) or short form (4%) instruments. An international panel of 26 group members participated in the Delphi surveys. In Delphi Survey Round 1, we had 15 instruments flagged by experts with green, amber and red and we proposed: reject instrument with less than 50% in red flag, classify uncertain when they received between 50 and 70% in amber flag and keep instruments that received more than 70% in green flag. Five instruments were pre-selected: ICOAP, HOOS, KOOS, OAKHQOL and Flare-OA. WOMAC was clearly not focused on flare, and we decided to substitute the full length OAKHQOL with the short form Mini-OAKHQOL. For the Delphi Round 2, we set a unique threshold of 70% to make decision. The instruments obtained at least 75% in questions about trust and feasibility,which carried them all to the last phase, it means, to vote on the instrument. Only the Flare-OA questionnaire obtained 100% of votes in favor.

Conclusion: The OMERACT Handbook Filter 2.2 has proven helpful tool for selecting an instrument. The Flare-OA questionnaire was selected as the best matching and practical instrument to assess flare in lower limb osteoarthritis. References 1. Guillemin F, Ricatte C, Barcenilla-Wong A, et al. Developing a Preliminary Definition and Domains of Flare in Knee and Hip Osteoarthritis (OA): Consensus Building of the Flare-in-OA OMERACT Group. J Rheumatol. 2019;46(9):1188-1191. doi:10.3899/jrheum.181085 2. Berton B, Maxwell L, Grosskleg S, et al. THE OMERACT HANDBOOK. Filter 2.2. The OMERACT Handbook © 2021 by OMERACT is licensed under CC BY-ND 4.0; 2021.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/selection-of-a-candidate-instrument-to-assess-flare-in-osteoarthritis-with-content-matching-with-endorsed-domains/