Jones S D, Steiner A, Garrett S L, Calin A
Royal National Hospital for Rheumatic Diseases, Upper Borough Walls, Bath, UK.
Br J Rheumatol. 1996 Jan;35(1):66-71. doi: 10.1093/rheumatology/35.1.66.
In the absence of an ideal objective measure for assessing ankylosing spondylitis (AS), self-administered measures of disease activity (the Bath Ankylosing Spondylitis Disease Activity Index, BASDAI) and function (the Bath Ankylosing Spondylitis Functional Index, BASFI) have been developed, in addition to an objective measure of spinal mobility (the Bath Ankylosing Spondylitis Metrology Index, BASMI). However, a more global assessment is also desirable. We report on the design and validation of a global measure (the Bath Ankylosing Spondylitis Patient Global Score, BAS-G) which reflects the effect of AS on the patient's well-being. A pilot study was performed to select the most appropriate wording for BAS-G. Using 392 patients with AS, BAS-G's construct and predictive validity and test-retest reliability were assessed. Correlations between BAS-G and BASDAI/BASFI were calculated, and multiple regression was used to examine the significant correlates. The distribution of the responses covered the whole scale. As predicted, BAS-G correlated best with BASDAI (r=0.73), followed by BASFI (r=0.54). The best fitting regression equation included these scales as well as patients' gender and current age. One week and 6 month scores were significantly different (P<0.001). Construct validity was good: BAS-G correlated more strongly with each component of BASDAI and BASFI than with BASMI or with gender. Predictive validity was satisfactory: there was an improvement (mean=29%) in in-patient BAS-G scores over a 2 week treatment period (P<0.001). Test-retest reliability was excellent (1 week r=0.84, 6 months r=0.93). BAS-G correlates well with both BASDAI and BASFI, suggesting that disease activity and functional ability play a major role in patients' well-being, whereas metrology does not. The score is sensitive to change, reliable, and meets face, predictive and construct validity criteria.
由于缺乏评估强直性脊柱炎（AS）的理想客观指标，除了脊柱活动度的客观指标（巴斯强直性脊柱炎测量指数，BASMI）外，还开发了疾病活动度的自我评估指标（巴斯强直性脊柱炎疾病活动指数，BASDAI）和功能指标（巴斯强直性脊柱炎功能指数，BASFI）。然而，更全面的评估也是必要的。我们报告了一项全面评估指标（巴斯强直性脊柱炎患者整体评分，BAS-G）的设计与验证，该指标反映了AS对患者健康状况的影响。进行了一项试点研究以选择BAS-G最合适的措辞。使用392例AS患者，评估了BAS-G的结构效度、预测效度和重测信度。计算了BAS-G与BASDAI/BASFI之间的相关性，并使用多元回归分析来检验显著相关因素。应答分布覆盖了整个量表范围。正如预期的那样，BAS-G与BASDAI的相关性最佳（r = 0.73），其次是BASFI（r = 0.54）。最佳拟合回归方程包括这些量表以及患者的性别和当前年龄。1周和6个月的评分有显著差异（P<0.001）。结构效度良好：BAS-G与BASDAI和BASFI的各个组成部分的相关性比与BASMI或性别更强。预测效度令人满意：在2周的治疗期内，住院患者的BAS-G评分有改善（平均=29%）（P<0.001）。重测信度极佳（1周r = 0.84，6个月r = 0.93）。BAS-G与BASDAI和BASFI均具有良好的相关性，表明疾病活动度和功能能力在患者健康状况中起主要作用，而测量指标则不然。该评分对变化敏感、可靠，并且符合表面效度、预测效度和结构效度标准。
