Measurement properties of the ASAS Health Index: results of a global study in patients with axial and peripheral spondyloarthritis

Kiltz, Uta; Heijde, Desirée van der; Boonen, Annelies; Akkoç, Nurullah; Bautista-Molano, Wilson; Burgos‐Vargas, Rubén; Wei, James Cheng‐Chung; Chiowchanwisawakit, Praveena; Dougados, Maxime; Duruöz, Mehmet Tuncay; Elzorkany, Bassel; Gaydukova, I.; Gensler, Lianne S.; Gilio, Michele; Grazio, Simeon; J, Gu; Inman, Robert D.; Kim, Tae Jong; Navarro-Compán, Victoria; Marzo‐Ortega, Helena; Özgöçmen, Salih; Santos, Fernando P.; Schirmer, Michael; Stebbings, Simon; Bosch, Filip E Van den; Tubergen, Astrid van; Braun, J.

doi:10.1136/annrheumdis-2017-212076

Cited by 88 publications

(96 citation statements)

References 27 publications

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“…We excluded patients who were unwilling to give informed consent, as well as patients with cognitive impairment who may thus be unable to give accurate responses to the questionnaires. We also excluded patients from statistical analyses if they had more than 20% missing data from ASAS HI and other PROMs …”

Section: Methodsmentioning

confidence: 99%

“…ASAS HI is a disease‐specific questionnaire, with 17 dichotomous items (dichotomous response option: “I agree” and “I do not agree”) to assess health status in patients with all forms of SpA . Health status refers to the entire range of functioning, disability, and health in patients with SpA, such as aspects of pain, emotional functions, sleep, sexual functions, mobility, self‐care, and community life . During the development of the ASAS HI, the performance of the item pool was tested and analyzed with Rasch analysis .…”

Section: Methodsmentioning

confidence: 99%

“…Since the ASAS HI is a relatively new PROM, few studies have assessed its psychometric properties. A study that recruited patients with SpA from 23 countries demonstrated good validity, reliability, and responsiveness for ASAS HI . However, very few countries were in Asia and no validation study of the ASAS HI was conducted in Singapore .…”

Section: Introductionmentioning

confidence: 99%

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Validity and reliability of the Assessment of Spondyloarthritis International Society Health Index in English‐speaking patients with axial spondyloarthritis in Singapore

Kwan

Fong

et al. 2019

Int J of Rheum Dis

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Objectives To assess the validity and reliability of the Assessment of Spondyloarthritis International Society Health Index (ASAS HI) among patients with axial spondyloarthritis (axSpA) in Singapore. Methods We collected data from English‐speaking patients with axSpA seen at a dedicated axSpA clinic in a Singapore tertiary referral hospital from 2017 to 2018. Face validity of the English version of ASAS HI was assessed through cognitive debriefing interviews (CDIs). Structural validity was assessed with confirmatory factor analysis. Convergent construct validity was assessed with 12 a priori hypotheses about the magnitude and direction of correlations between the ASAS HI summary score and other patient‐reported outcome measures. Internal consistency was assessed using Cronbach's alpha. Test‐retest reliability was assessed by intraclass correlation coefficient (ICC). Measurement error was assessed by analyzing smallest detectable change (SDC). Results Ten patients (age range 22‐46 years, 50% male) participated in CDIs and face validity was supported. Among 108 patients (median age: 37 [21‐77], 80.6% males), unidimensionality was confirmed (comparative fit index = 0.960, Tucker‐Lewis Index = 0.952, root mean square error of approximation = 0.038, standardized root mean residuals = 0.068, model Chi‐square test P = 0.1251) in the 17‐item ASAS HI. The ASAS HI showed good internal consistency of 0.83 and excellent test‐retest reliability (ICC = 0.95; 95% CI 0.91‐0.98) when baseline was compared with week 2. SDC was 1.02. Convergent validity was supported as hypotheses were confirmed in 100% of the results. Conclusions This study supports the ASAS HI as a valid and reliable measure of health status for use in patients with axSpA in Singapore.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Validity and reliability of the Assessment of Spondyloarthritis International Society Health Index in English‐speaking patients with axial spondyloarthritis in Singapore

Kwan

Fong

et al. 2019

Int J of Rheum Dis

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“…However, pitfalls in interpretation of MRI-SIJ were recently acknowledged(1). Thus reader's expertise might be a source of heterogeneity in patient populations diagnosed with non-radiographic axSpA.…”

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confidence: 99%

“…:[1] Varkas G, de Hooge M, Renson T, De Mits S, Carron P, Jacques P, et alEffect of mechanical stress on magnetic resonance imaging of the sacroiliac joints: assessment of military recruits by magnetic resonance imaging study. Rheumatology (Oxford).…”

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confidence: 99%

Thu0373 active Sacroiliitis on Magnetic Resonance Imaging in Patients With Anterior Uveitis

Bubová¹,

Gregová²,

Zegzulková³

et al. 2019

Poster Presentations

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BackgroundAnterior uveitis (AU) is a common extraarticular manifestation in spondyloarthritis (SpA). The disease can precede the typical axial and peripheral features. Additionally, some studies had described positive bone marrow edema in patients with AU lacking chronic back pain.ObjectivesThe aim of this study was to examine patients with AU, to determine whether the patients already fulfil criteria for axial and/or peripheral SpA and compare the findings to healthy controls (HC).MethodsWe recruited 65 patients without prior rheumatologic diagnosis who developed at least one episode of AU and 33 age and sex matched HC. The clinical data were collected and rheumatology examinations were performed by trained rheumatologists. Magnetic resonance imaging (MRI) of sacroiliac joints (SIJ) was read by trained rheumatologist who was blinded to the patient’s data. Patients were divided into SpA subsets (axial: imaging and clinical arm and peripheral SpA) fulfilling The Assessment of SpondyloArthritis international Society (ASAS) classification criteria and non-SpA subset. The ASAS modified Berlin algorithm for diagnosis of axial SpA (axSpA) was also applied.ResultsAltogether, 72% (n=47) patients referred back pain including 22.0% (n=14) patients referring inflammatory back pain, 28% (n=18) did not refer back pain. Similar results were found in HC subset. Bone marrow edema (BME) was found in 51% (n=33) of all patients with AU, however 35% (n=23) had highly suggestive BME (hsBME) corresponding to typical findings in sacroiliitis compared to HC where 30% (n=10) had BME, however none had hsBME (p=0.08, p< 0.0001, respectively). Furthermore, patients with AU had higher serum CRP levels compared to HC (p=0.001), no other significant differences were observed. The diagnosis of SpA was confirmed in 46% (n=30) of all patients with AU, 34% (n=22) patients fulfilled the imaging arm and 12% (n=7) fulfilled the clinical arm of ASAS classification criteria for axSpA, 3% (n=2) patients fulfilled ASAS classification criteria for peripheral SpA. Two patients lacking back pain developed hsBME on SIJ. The diagnosis of axSpA according to the ASAS modified Berlin algorithm was confirmed in 42% (n=27) patients. Analysis of clinical characteristics showed significant difference between BASDAI in SpA vs. non-SpA (1.6±1.5 vs 0.8±1.0, p=0.007, respectively), and remained significant in those fulfilling imaging arm of axial SpA (p=0.04). The levels of CRP were significantly higher in SpA compared to non-SpA subsets (8.6±9.7 vs 2.6±2.7 mg/L, p=0.003). Presence of back pain and inflammatory back pain were more often in SpA compared to non-SpA subsets (97% and 43% vs. 51% and 3%, p=0.001 and p=0.001 respectively). Patients with hsBME had significantly higher serum CRP levels compared to patients lacking hsBME (9.0±10.4 vs 3.3±4.2 mg/L, p=0.005), no other significant differences were observed.ConclusionMore than one third of patients with AU fulfilled the criteria for axial or peripheral SpA. Furthermore, the prevalence of back pain, increased BASDAI a...

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Measuring Outcomes in Axial Spondyloarthritis

Ogdie

Duarte‐García

Hwang

et al. 2020

Arthritis Care & Research

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Measurement properties of the ASAS Health Index: results of a global study in patients with axial and peripheral spondyloarthritis

Abstract: The ASAS HI proved to be valid, reliable and responsive. It can be used to evaluate the impact of SpA and its treatment on functioning and health. Furthermore, comparison of disease impact between populations is possible.

Cited by 88 publications

References 27 publications

Validity and reliability of the Assessment of Spondyloarthritis International Society Health Index in English‐speaking patients with axial spondyloarthritis in Singapore

Validity and reliability of the Assessment of Spondyloarthritis International Society Health Index in English‐speaking patients with axial spondyloarthritis in Singapore

Thu0373 active Sacroiliitis on Magnetic Resonance Imaging in Patients With Anterior Uveitis

Measuring Outcomes in Axial Spondyloarthritis

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