Initial validation and results of the Symptoms in Persons At Risk of Rheumatoid Arthritis (SPARRA) questionnaire: a EULAR project

Research output: Contribution to journalArticlepeer-review


  • Marian H. van Beers-Tas
  • Marieke M. ter Wee
  • Lillian H. van Tuyl
  • Bertha Maat
  • Wijnanda Hoogland
  • Aase H. Hensvold
  • Anca I. Catrina
  • Erika Mosor
  • Tanja A. Stamm
  • Axel Finckh
  • Derlphine S. Courvoisier
  • Ilfita Sahbudin
  • Dirkjan van Schaardenburg

External organisations

  • University of Amsterdam


Objectives: To describe the development and assess the psychometric properties of the novel ‘Symptoms in Persons At Risk of Rheumatoid Arthritis’ (SPARRA) questionnaire in individuals at risk of rheumatoid arthritis (RA) and to
quantify their symptoms.

Methods: The questionnaire items were derived from a qualitative study in patients with seropositive arthralgia. The questionnaire was administered to 219 individuals at risk of RA on the basis of symptoms or autoantibody positivity: 74% rheumatoid factor and/or anticitrullinated protein antibodies positive, 26% seronegative. Validity, reliability and responsiveness were assessed. Eighteen
first degree relatives (FDR) of patients with RA were used for comparison.
Results Face and content validity were high. The test re-test showed good agreement and reliability (1 week and 6 months). Overall, construct validity was low to moderate, with higher values for concurrent validity, suggesting that
some questions reflect symptom content not captured with regular Visual Analogue Scale pain/well-being. Responsiveness was low (small subgroup). Finally, the burden of symptoms in both seronegative and seropositive
at risk individuals was high, with pain, stiffness and fatigue being the most common ones with a major impact on daily functioning. The FDR cohort (mostly healthy individuals) showed a lower burden of symptoms; however, the
distribution of symptoms was similar.

Conclusions: The SPARRA questionnaire has good psychometric properties and can add information to currently available clinical measures in individuals at risk of RA. The studied group had a high burden and impact of symptoms. Future studies should evaluate whether SPARRA data can improve the prediction of RA in at risk individuals.


Original languageEnglish
Article numbere000641
JournalRMD Open
Issue number1
Early online date21 May 2018
Publication statusE-pub ahead of print - 21 May 2018