Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.
Int J Rheum Dis. 2019 Sep;22(9):1644-1651. doi: 10.1111/1756-185X.13640. Epub 2019 Jun 27.
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.
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).
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.
This study supports the ASAS HI as a valid and reliable measure of health status for use in patients with axSpA in Singapore.
评估评估强直性脊柱炎国际学会健康指数（ASAS HI）在新加坡的中轴型脊柱关节炎（axSpA）患者中的有效性和可靠性。
我们从 2017 年至 2018 年在新加坡一家三级转诊医院的专门 axSpA 诊所就诊的讲英语的 axSpA 患者中收集数据。通过认知访谈（CDI）评估 ASAS HI 英文版的表面效度。通过验证性因子分析评估结构效度。通过 12 个关于 ASAS HI 总分与其他患者报告结局测量之间相关性的大小和方向的先验假设评估收敛结构效度。使用 Cronbach's alpha 评估内部一致性。使用组内相关系数（ICC）评估测试-重测信度。通过分析最小可检测变化（SDC）评估测量误差。
10 名患者（年龄 22-46 岁，50%为男性）参加了 CDI，表面效度得到支持。在 108 名患者（中位年龄：37 [21-77]，80.6%为男性）中，确认了单维性（比较拟合指数=0.960，塔克-刘易斯指数=0.952，均方根误差逼近=0.038，标准化均方根残差=0.068，模型卡方检验 P=0.1251）在 17 项 ASAS HI 中。当与第 2 周相比时，ASAS HI 显示出良好的内部一致性（0.83）和极好的测试-重测可靠性（ICC=0.95；95%CI 0.91-0.98）。SDC 为 1.02。当与第 2 周相比时，ASAS HI 显示出良好的内部一致性（0.83）和极好的测试-重测可靠性（ICC=0.95；95%CI 0.91-0.98）。SDC 为 1.02。当与第 2 周相比时，ASAS HI 显示出良好的内部一致性（0.83）和极好的测试-重测可靠性（ICC=0.95；95%CI 0.91-0.98）。SDC 为 1.02。当与第 2 周相比时，ASAS HI 显示出良好的内部一致性（0.83）和极好的测试-重测可靠性（ICC=0.95；95%CI 0.91-0.98）。SDC 为 1.02。支持了收敛有效性，因为 100%的结果都证实了假设。
本研究支持 ASAS HI 作为一种有效的、可靠的健康状况衡量标准，可用于新加坡的 axSpA 患者。
