Measurement properties of the ASAS Health Index

Results of a global study in patients with axial and peripheral spondyloarthritis

Uta Kiltz, Désirée Van Der Heijde, Annelies Boonen, Nurullah Akkoc, Wilson Bautista-Molano, Ruben Burgos-Vargas, James Cheng Chung Wei, Praveena Chiowchanwisawakit, Maxime Dougados, M. Tuncay Duruoz, Bassel Kamal Elzorkany, Inna Gaydukova, Lianne S. Gensler, Michele Gilio, Simeon Grazio, Jieruo Gu, Robert D. Inman, Tae Jong Kim, Victoria Navarro-Compan, Helena Marzo-Ortega & 7 others Salih Ozgocmen, Fernando Pimentel Dos Santos, Michael Schirmer, Simon Stebbings, Filip E. Van Den Bosch, Astrid Van Tubergen, Juergen Braun

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objectives: To evaluate construct validity, interpretability, reliability and responsiveness as well as determination of cut-off points for good and poor health within the original English version and the 18 translations of the disease-specific Assessment of Spondyloarthritis international Society Health Index (ASAS HI) in 23 countries worldwide in patients with spondyloarthritis (SpA). Methods: A representative sample of patients with SpA fulfilling the ASAS classification criteria for axial (axSpA) or peripheral SpA was used. The construct validity of the ASAS HI was tested using Spearman correlation with several standard health outcomes for axSpA. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) in patients with stable disease (interval 4-7 days). In patients who required an escalation of therapy because of high disease activity, responsiveness was tested after 2-24weeks using standardised response mean (SRM). Results: Among the 1548 patients, 64.9% were men, with a mean (SD) age 42.0 (13.4) years. Construct validity ranged from low (age: 0.10) to high (Bath AnkylosingSpondylitisFunctioning Index: 0.71). Internal consistency was high (Cronbach's α of 0.93). The reliability among 578 patients was good (ICC=0.87 (95% CI 0.84 to 0.89)). Responsiveness among 246 patients was moderate-large (SRM= '0.44 for non-steroidal anti-inflammatory drugs, '0.69 for conventional synthetic disease-modifying antirheumatic drug and '0.85 for tumour necrosis factor inhibitor). The smallest detectable change was 3.0. Values ≤5.0 have balanced specificity to distinguish good health as opposed to moderate health, and values ≥12.0 are specific to represent poor health as opposed to moderate health. Conclusions: 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.

Original languageEnglish
JournalAnnals of the rheumatic diseases
DOIs
Publication statusAccepted/In press - 9 Jun 2018

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Health
Reproducibility of Results
Patient Advocacy
Antirheumatic Agents
Baths
Anti-Inflammatory Agents
Tumor Necrosis Factor-alpha
Therapeutics
Pharmaceutical Preparations
Population

Keywords

  • ankylosing spondylitis
  • outcomes research
  • spondyloarthritis

Cite this

Kiltz, Uta ; Van Der Heijde, Désirée ; Boonen, Annelies ; Akkoc, Nurullah ; Bautista-Molano, Wilson ; Burgos-Vargas, Ruben ; Wei, James Cheng Chung ; Chiowchanwisawakit, Praveena ; Dougados, Maxime ; Duruoz, M. Tuncay ; Elzorkany, Bassel Kamal ; Gaydukova, Inna ; Gensler, Lianne S. ; Gilio, Michele ; Grazio, Simeon ; Gu, Jieruo ; Inman, Robert D. ; Kim, Tae Jong ; Navarro-Compan, Victoria ; Marzo-Ortega, Helena ; Ozgocmen, Salih ; Pimentel Dos Santos, Fernando ; Schirmer, Michael ; Stebbings, Simon ; Van Den Bosch, Filip E. ; Van Tubergen, Astrid ; Braun, Juergen. / Measurement properties of the ASAS Health Index : Results of a global study in patients with axial and peripheral spondyloarthritis. In: Annals of the rheumatic diseases. 2018.
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title = "Measurement properties of the ASAS Health Index: Results of a global study in patients with axial and peripheral spondyloarthritis",
abstract = "Objectives: To evaluate construct validity, interpretability, reliability and responsiveness as well as determination of cut-off points for good and poor health within the original English version and the 18 translations of the disease-specific Assessment of Spondyloarthritis international Society Health Index (ASAS HI) in 23 countries worldwide in patients with spondyloarthritis (SpA). Methods: A representative sample of patients with SpA fulfilling the ASAS classification criteria for axial (axSpA) or peripheral SpA was used. The construct validity of the ASAS HI was tested using Spearman correlation with several standard health outcomes for axSpA. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) in patients with stable disease (interval 4-7 days). In patients who required an escalation of therapy because of high disease activity, responsiveness was tested after 2-24weeks using standardised response mean (SRM). Results: Among the 1548 patients, 64.9{\%} were men, with a mean (SD) age 42.0 (13.4) years. Construct validity ranged from low (age: 0.10) to high (Bath AnkylosingSpondylitisFunctioning Index: 0.71). Internal consistency was high (Cronbach's α of 0.93). The reliability among 578 patients was good (ICC=0.87 (95{\%} CI 0.84 to 0.89)). Responsiveness among 246 patients was moderate-large (SRM= '0.44 for non-steroidal anti-inflammatory drugs, '0.69 for conventional synthetic disease-modifying antirheumatic drug and '0.85 for tumour necrosis factor inhibitor). The smallest detectable change was 3.0. Values ≤5.0 have balanced specificity to distinguish good health as opposed to moderate health, and values ≥12.0 are specific to represent poor health as opposed to moderate health. Conclusions: 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.",
keywords = "ankylosing spondylitis, outcomes research, spondyloarthritis",
author = "Uta Kiltz and {Van Der Heijde}, D{\'e}sir{\'e}e and Annelies Boonen and Nurullah Akkoc and Wilson Bautista-Molano and Ruben Burgos-Vargas and Wei, {James Cheng Chung} and Praveena Chiowchanwisawakit and Maxime Dougados and Duruoz, {M. Tuncay} and Elzorkany, {Bassel Kamal} and Inna Gaydukova and Gensler, {Lianne S.} and Michele Gilio and Simeon Grazio and Jieruo Gu and Inman, {Robert D.} and Kim, {Tae Jong} and Victoria Navarro-Compan and Helena Marzo-Ortega and Salih Ozgocmen and {Pimentel Dos Santos}, Fernando and Michael Schirmer and Simon Stebbings and {Van Den Bosch}, {Filip E.} and {Van Tubergen}, Astrid and Juergen Braun",
year = "2018",
month = "6",
day = "9",
doi = "10.1136/annrheumdis-2017-212076",
language = "English",
journal = "Annals of the rheumatic diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group: BMJ",

}

Kiltz, U, Van Der Heijde, D, Boonen, A, Akkoc, N, Bautista-Molano, W, Burgos-Vargas, R, Wei, JCC, Chiowchanwisawakit, P, Dougados, M, Duruoz, MT, Elzorkany, BK, Gaydukova, I, Gensler, LS, Gilio, M, Grazio, S, Gu, J, Inman, RD, Kim, TJ, Navarro-Compan, V, Marzo-Ortega, H, Ozgocmen, S, Pimentel Dos Santos, F, Schirmer, M, Stebbings, S, Van Den Bosch, FE, Van Tubergen, A & Braun, J 2018, 'Measurement properties of the ASAS Health Index: Results of a global study in patients with axial and peripheral spondyloarthritis', Annals of the rheumatic diseases. https://doi.org/10.1136/annrheumdis-2017-212076

Measurement properties of the ASAS Health Index : Results of a global study in patients with axial and peripheral spondyloarthritis. / Kiltz, Uta; Van Der Heijde, Désirée; Boonen, Annelies; Akkoc, Nurullah; Bautista-Molano, Wilson; Burgos-Vargas, Ruben; Wei, James Cheng Chung; Chiowchanwisawakit, Praveena; Dougados, Maxime; Duruoz, M. Tuncay; Elzorkany, Bassel Kamal; Gaydukova, Inna; Gensler, Lianne S.; Gilio, Michele; Grazio, Simeon; Gu, Jieruo; Inman, Robert D.; Kim, Tae Jong; Navarro-Compan, Victoria; Marzo-Ortega, Helena; Ozgocmen, Salih; Pimentel Dos Santos, Fernando; Schirmer, Michael; Stebbings, Simon; Van Den Bosch, Filip E.; Van Tubergen, Astrid; Braun, Juergen.

In: Annals of the rheumatic diseases, 09.06.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Measurement properties of the ASAS Health Index

T2 - Results of a global study in patients with axial and peripheral spondyloarthritis

AU - Kiltz, Uta

AU - Van Der Heijde, Désirée

AU - Boonen, Annelies

AU - Akkoc, Nurullah

AU - Bautista-Molano, Wilson

AU - Burgos-Vargas, Ruben

AU - Wei, James Cheng Chung

AU - Chiowchanwisawakit, Praveena

AU - Dougados, Maxime

AU - Duruoz, M. Tuncay

AU - Elzorkany, Bassel Kamal

AU - Gaydukova, Inna

AU - Gensler, Lianne S.

AU - Gilio, Michele

AU - Grazio, Simeon

AU - Gu, Jieruo

AU - Inman, Robert D.

AU - Kim, Tae Jong

AU - Navarro-Compan, Victoria

AU - Marzo-Ortega, Helena

AU - Ozgocmen, Salih

AU - Pimentel Dos Santos, Fernando

AU - Schirmer, Michael

AU - Stebbings, Simon

AU - Van Den Bosch, Filip E.

AU - Van Tubergen, Astrid

AU - Braun, Juergen

PY - 2018/6/9

Y1 - 2018/6/9

N2 - Objectives: To evaluate construct validity, interpretability, reliability and responsiveness as well as determination of cut-off points for good and poor health within the original English version and the 18 translations of the disease-specific Assessment of Spondyloarthritis international Society Health Index (ASAS HI) in 23 countries worldwide in patients with spondyloarthritis (SpA). Methods: A representative sample of patients with SpA fulfilling the ASAS classification criteria for axial (axSpA) or peripheral SpA was used. The construct validity of the ASAS HI was tested using Spearman correlation with several standard health outcomes for axSpA. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) in patients with stable disease (interval 4-7 days). In patients who required an escalation of therapy because of high disease activity, responsiveness was tested after 2-24weeks using standardised response mean (SRM). Results: Among the 1548 patients, 64.9% were men, with a mean (SD) age 42.0 (13.4) years. Construct validity ranged from low (age: 0.10) to high (Bath AnkylosingSpondylitisFunctioning Index: 0.71). Internal consistency was high (Cronbach's α of 0.93). The reliability among 578 patients was good (ICC=0.87 (95% CI 0.84 to 0.89)). Responsiveness among 246 patients was moderate-large (SRM= '0.44 for non-steroidal anti-inflammatory drugs, '0.69 for conventional synthetic disease-modifying antirheumatic drug and '0.85 for tumour necrosis factor inhibitor). The smallest detectable change was 3.0. Values ≤5.0 have balanced specificity to distinguish good health as opposed to moderate health, and values ≥12.0 are specific to represent poor health as opposed to moderate health. Conclusions: 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.

AB - Objectives: To evaluate construct validity, interpretability, reliability and responsiveness as well as determination of cut-off points for good and poor health within the original English version and the 18 translations of the disease-specific Assessment of Spondyloarthritis international Society Health Index (ASAS HI) in 23 countries worldwide in patients with spondyloarthritis (SpA). Methods: A representative sample of patients with SpA fulfilling the ASAS classification criteria for axial (axSpA) or peripheral SpA was used. The construct validity of the ASAS HI was tested using Spearman correlation with several standard health outcomes for axSpA. Test-retest reliability was assessed by intraclass correlation coefficients (ICCs) in patients with stable disease (interval 4-7 days). In patients who required an escalation of therapy because of high disease activity, responsiveness was tested after 2-24weeks using standardised response mean (SRM). Results: Among the 1548 patients, 64.9% were men, with a mean (SD) age 42.0 (13.4) years. Construct validity ranged from low (age: 0.10) to high (Bath AnkylosingSpondylitisFunctioning Index: 0.71). Internal consistency was high (Cronbach's α of 0.93). The reliability among 578 patients was good (ICC=0.87 (95% CI 0.84 to 0.89)). Responsiveness among 246 patients was moderate-large (SRM= '0.44 for non-steroidal anti-inflammatory drugs, '0.69 for conventional synthetic disease-modifying antirheumatic drug and '0.85 for tumour necrosis factor inhibitor). The smallest detectable change was 3.0. Values ≤5.0 have balanced specificity to distinguish good health as opposed to moderate health, and values ≥12.0 are specific to represent poor health as opposed to moderate health. Conclusions: 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.

KW - ankylosing spondylitis

KW - outcomes research

KW - spondyloarthritis

UR - http://www.scopus.com/inward/record.url?scp=85049042058&partnerID=8YFLogxK

U2 - 10.1136/annrheumdis-2017-212076

DO - 10.1136/annrheumdis-2017-212076

M3 - Article

JO - Annals of the rheumatic diseases

JF - Annals of the rheumatic diseases

SN - 0003-4967

ER -