Development of a health index in patients with ankylosing spondylitis (ASAS HI): final result of a global initiative based on the ICF guided by ASAS.
Development of a health index in patients with ankylosing spondylitis (ASAS HI): final result of a global initiative based on the ICF guided by ASAS.
复制标题
DOI：
10.1136/annrheumdis-2013-203967
复制
发表时间：
2015-05
影响因子：
27.4
通讯作者：
Braun J
中科院分区：
文献类型：
--
作者：
Kiltz U;van der Heijde D;Boonen A;Cieza A;Stucki G;Khan MA;Maksymowych WP;Marzo-Ortega H;Reveille J;Stebbings S;Bostan C;Braun J
强直性脊柱炎(AS)患者的疾病负担可能相当大。然而，国际脊椎关节炎评估协会(ASAS)的专家成员还没有就定义AS的严重程度达成一致。根据《国际功能、残疾和健康分类》(ICF)，为AS选择了一套核心项目，以代表功能方面可能出现的所有问题。在此基础上，本研究的目标是开发一种量化AS健康状况的工具，即ASAS健康指数。首先，基于文献检索、专家和患者的意见，生成了一个涵盖ICF核心集类别的大型题库。在两次横断面调查之后，根据可靠性、RASCH分析和建立共识，分几个步骤减少了这一项目库，以提出代表ICF为AS设置的大部分核心类别的最佳匹配项目。在对1754名患者进行第一次调查后，251个项目的项目库减少到82个。经过专家委员会的挑选，剩下的50个项目在第二次横断面调查中进行了测试。结果被用来将项目的数量减少到最终的17个项目。这一选择显示出最好的信度和符合Rasch模型，没有剩余相关，没有一致的差异项目函数和人的分离指数为0.82。在这项长时间的连续研究中，17个项目被确定为最能代表AS患者健康状况的项目，这些项目涵盖了ICF核心集的大部分。健康指数是一个线性综合衡量标准，不同于公共领域的其他衡量标准。
The burden of disease in patients with ankylosing spondylitis (AS) can be considerable. However, no agreement has been reached among expert members of Assessment of SpondyloArthritis International Society (ASAS) to define severity of AS. Based on the International Classification of Functioning, Disability and Health (ICF), a core set of items for AS has been selected to represent the entire spectrum of possible problems in functioning. Based on this, the objective of this study was to develop a tool to quantify health in AS, the ASAS Health Index. First, based on a literature search, experts’ and patients’ opinion, a large item pool covering the categories of the ICF core set was generated. In several steps this item pool was reduced based on reliability, Rasch analysis and consensus building after two cross-sectional surveys to come up with the best fitting items representing most categories of the ICF core set for AS. After the first survey with 1754 patients, the item pool of 251 items was reduced to 82. After selection by an expert committee, 50 items remained which were tested in a second cross-sectional survey. The results were used to reduce the number of items to a final set of 17 items. This selection showed the best reliability and fit to the Rasch model, no residual correlation, and absence of consistent differential item function and a Person Separation Index of 0.82. In this long sequential study, 17 items which cover most of the ICF core set were identified that showed the best representation of the health status of patients with AS. The ASAS Health Index is a linear composite measure which differs from other measures in the public domain.