Rheumatology Department, Leiden University Medical Center, Leiden, The Netherlands
Rheumatology Department, La Paz University Hospital, Madrid, Spain.
RMD Open. 2021 Dec;7(3). doi: 10.1136/rmdopen-2021-001839.
Aim of this study was to assess test-retest reliability of candidate instruments for the mandatory domains of the Assessment of Spondyloarthritis international Society (ASAS)-Outcome Measures in Rheumatology core set for axial spondyloarthritis (axSpA).
Screening and baseline data from COAST-V, COAST-X and RAPID-axSpA was used to evaluate test-retest reliability of each candidate instrument for the mandatory domains (disease activity, pain, morning stiffness, fatigue, physical function, overall functioning and health). A maximum time interval of 28 days between both visits was used for inclusion in this study. Test-retest reliability was assessed by intraclass correlation coefficient (ICC). Bland and Altman plots provided mean difference and 95% limits of agreement, which were used to calculate the smallest detectable change (SDC). Data were analysed for radiographic and non-radiographic axSpA separately.
Good reliability was found for Ankylosing Spondylitis Disease Activity Score (ICC 0.79, SDC 0.6), C reactive protein (ICC 0.72-0.79, SDC 12.3-17.0), Bath Ankylosing Spondylitis Functional Index (ICC 0.87, SDC 1.1) and 36-item Short-Form Health Survey (ICC Physical Component Summary 0.81, SDC 4.7, Mental Component Summary 0.80, SDC 7.3). Moderate reliability was found for Bath Ankylosing Spondylitis Disease Activity Index (ICC 0.72, SDC 1.1), patient global assessment (ICC 0.58, SDC 1.5), total back pain (ICC 0.64, SDC 1.3), back pain at night (ICC 0.67, SDC 1.3), morning stiffness (ICC 0.52-0.63, SDC 1.5-2.2), fatigue (ICC 0.65, SDC 1.3) and ASAS-Health Index (ICC 0.74, SDC 2.5). Reliability and SDC for the radiographic and non-radiographic axSpA subgroups were similar.
Overall reliability was good, and comparable levels of reliability were found for patients with radiographic and non-radiographic axSpA, even though most instruments were developed for radiographic axSpA. Composite measures showed higher reliability than single-item measures in assessing disease activity in patients with axSpA.
本研究旨在评估强制性领域的候选工具在评估强直性脊柱炎国际学会（ASAS）-风湿病核心组的强制性领域的测试-重测信度，用于评估轴性强直性脊柱炎（axSpA）。
使用 COAST-V、COAST-X 和 RAPID-axSpA 的筛选和基线数据来评估每个候选工具对于强制性领域（疾病活动、疼痛、晨僵、疲劳、身体功能、整体功能和健康）的测试-重测信度。两次就诊之间的最大时间间隔为 28 天。通过组内相关系数（ICC）评估测试-重测信度。Bland 和 Altman 图提供了平均差异和 95%的一致性区间，用于计算最小可检测变化（SDC）。分别对影像学和非影像学 axSpA 进行数据分析。
强直性脊柱炎疾病活动评分（ICC 0.79，SDC 0.6）、C 反应蛋白（ICC 0.72-0.79，SDC 12.3-17.0）、巴斯强直性脊柱炎功能指数（ICC 0.87，SDC 1.1）和 36 项简明健康调查问卷（ICC 生理成分综合评分 0.81，SDC 4.7，心理成分综合评分 0.80，SDC 7.3）的可靠性较好。巴斯强直性脊柱炎疾病活动指数（ICC 0.72，SDC 1.1）、患者总体评估（ICC 0.58，SDC 1.5）、总背痛（ICC 0.64，SDC 1.3）、夜间背痛（ICC 0.67，SDC 1.3）、晨僵（ICC 0.52-0.63，SDC 1.5-2.2）、疲劳（ICC 0.65，SDC 1.3）和 ASAS-健康指数（ICC 0.74，SDC 2.5）的可靠性为中度。影像学和非影像学 axSpA 亚组的可靠性和 SDC 相似。
整体可靠性良好，影像学和非影像学 axSpA 患者的可靠性水平相当，尽管大多数工具都是为影像学 axSpA 开发的。在评估 axSpA 患者的疾病活动时，综合测量比单项测量具有更高的可靠性。
