Construct validity of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS) treatment target cut-offs in a BASDAI treat-to-target axial spondyloarthritis cohort: a cross-sectional study.

IF 2.2 4区医学 Q3 RHEUMATOLOGY Scandinavian Journal of Rheumatology Pub Date : 2024-05-01 Epub Date: 2023-06-20 DOI:10.1080/03009742.2023.2213509

Caj Michielsens, T E Bolhuis, F A van Gaalen, Fhj van den Hoogen, L M Verhoef, N den Broeder, A A den Broeder

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Abstract

Objective: In axial spondyloarthritis (axSpA), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score (ASDAS) are recommended for use in treat-to-target (T2T) strategies. However, BASDAI disease states may be a less suitable T2T instrument than ASDAS, since BASDAI contains non-disease activity related items. The objective of our study was to investigate the construct validity of BASDAI and ASDAS disease states.

Method: We performed a single-centre cross-sectional study on BASDAI and ASDAS construct validity in long-term BASDAI T2T-treated axSpA patients. Our hypothesis was that BASDAI is less representative of disease activity than ASDAS owing to the focus on pain and fatigue, and missing an objective item, e.g. C-reactive protein (CRP). This was operationalized using several subhypotheses.

Results: The study included 242 axSpA patients. BASDAI and ASDAS disease states showed a similar relation to Patient Acceptable Symptom State and T2T protocol adherence. The proportions of patients with high BASDAI and ASDAS disease activity fulfilling Central Sensitization Inventory and fibromyalgia syndrome criteria were similar. The correlation with fatigue was moderate for both BASDAI (Spearman's rho 0.64) and ASDAS (Spearman's rho 0.54) disease states. A high ASDAS was strongly correlated with increased CRP (relative risk 6.02, 95% CI 3.0-12.09), while this correlation was not seen for BASDAI (relative risk 1.13, 95% CI 0.74-1.74).

Conclusion: Our study showed moderate and comparable construct validity for BASDAI- and ASDAS-based disease activity states, with the expected exception of association with CRP. Therefore, no strong preference can be given for either measure, although the ASDAS seems marginally more valid.

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巴斯强直性脊柱炎疾病活动指数（BASDAI）和强直性脊柱炎疾病活动评分（ASDAS）治疗目标临界值的结构有效性：一项横断面研究。

目的：在轴性脊柱关节炎（axSpA）中，巴斯强直性脊柱炎疾病活动指数（BASDAI）和强直性脊柱炎疾病活动评分（ASDAS）被推荐用于目标治疗（T2T）策略。然而，与 ASDAS 相比，BASDAI 疾病状态可能不太适合作为 T2T 工具，因为 BASDAI 包含与疾病活动无关的项目。我们的研究目的是调查 BASDAI 和 ASDAS 疾病状态的构建有效性：我们对长期接受 BASDAI T2T 治疗的 axSpA 患者进行了一项关于 BASDAI 和 ASDAS 构建有效性的单中心横断面研究。我们的假设是，BASDAI 对疾病活动性的代表性不如 ASDAS，原因是 BASDAI 侧重于疼痛和疲劳，缺少一个客观项目，如 C 反应蛋白 (CRP)。我们通过几个子假设对这一结果进行了操作：研究共纳入 242 名 axSpA 患者。BASDAI和ASDAS疾病状态与患者可接受症状状态和T2T方案依从性的关系相似。BASDAI和ASDAS疾病活动度高且符合中枢敏感性量表和纤维肌痛综合征标准的患者比例相似。BASDAI（Spearman's rho 0.64）和ASDAS（Spearman's rho 0.54）疾病状态与疲劳的相关性为中等。高 ASDAS 与 CRP 升高密切相关（相对风险为 6.02，95% CI 为 3.0-12.09），而 BASDAI 没有这种相关性（相对风险为 1.13，95% CI 为 0.74-1.74）：我们的研究表明，基于 BASDAI 和 ASDAS 的疾病活动状态具有适度和可比的建构效度，但与 CRP 的相关性除外。因此，尽管 ASDAS 的有效性似乎略高一些，但我们并不倾向于使用这两种方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Scandinavian Journal of Rheumatology 医学-风湿病学

CiteScore

3.70

自引率

4.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Scandinavian Journal of Rheumatology is the official journal of the Scandinavian Society for Rheumatology, a non-profit organization following the statutes of the Scandinavian Society for Rheumatology/Scandinavian Research Foundation. The main objective of the Foundation is to support research and promote information and knowledge about rheumatology and related fields. The annual surplus by running the Journal is awarded to young, talented, researchers within the field of rheumatology.pasting The Scandinavian Journal of Rheumatology is an international scientific journal covering clinical and experimental aspects of rheumatic diseases. The journal provides essential reading for rheumatologists as well as general practitioners, orthopaedic surgeons, radiologists, pharmacologists, pathologists and other health professionals with an interest in patients with rheumatic diseases. The journal publishes original articles as well as reviews, editorials, letters and supplements within the various fields of clinical and experimental rheumatology, including; Epidemiology Aetiology and pathogenesis Treatment and prophylaxis Laboratory aspects including genetics, biochemistry, immunology, immunopathology, microbiology, histopathology, pathophysiology and pharmacology Radiological aspects including X-ray, ultrasonography, CT, MRI and other forms of imaging.