Validity and reliability of the Health Assessment Questionnaire among patients with spondyloarthritis in Singapore

Kwan, Yu Heng; Fong, Warren; Lui, Nai Lee; Yong, Si Ting; Cheung, Yin Bun; Malhotra, Rahul; Thumboo, Julian; Østbye, Truls

doi:10.1111/1756-185x.12989

Cited by 18 publications

(14 citation statements)

References 34 publications

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“…Also, as the study was conducted in tertiary referral centers, patients with milder disease treated in the primary‐care setting may not have been included. Similar to other published studies, non‐Chinese groups consisting of Malays, Indians and other ethnicities were too small for analysis . Furthermore, ethnicity has a ρ‐value more than 0.1 in our univariate analysis.…”

Section: Discussionsupporting

confidence: 68%

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

et al. 2018

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Section: Discussionsupporting

confidence: 68%

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

et al. 2018

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“…First, there were few patients of Malay and Indian ethnicity in our FGDs and the concerns expressed regarding QoL may not be generalizable to these groups. However, the lower representation of minorities in our study is comparable to the ethnic composition of the axSpA cohort in our center and in Singapore . Second, the results may not capture QoL domains affected by SpA in patients from other cultural backgrounds.…”

Section: Discussionmentioning

confidence: 57%

A qualitative study of quality of life domains and subdomains relevant to patients with spondyloarthritis

et al. 2018

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Aims:To identify quality of life (QoL) domains and subdomains relevant to patients with different spondyloarthritis (SpA) subtypes in Singapore, and to assess how identified QoL domains and subdomains map onto currently used patient-reported outcome measures (PROMs). Methods: Nine focus group discussions (FGDs), including two previously conductedFGDs from the Updating the Psoriatic Arthritis Core Domain Set Study, were conducted with patients with SpA in Singapore. The FGDs were organized by SpA subtype and language spoken. All FGDs were audio-taped, transcribed verbatim. After thematic analysis through open and axial coding, the domains were organized using the World Health Organization Quality of Life (WHOQOL) framework. Identified QoL domains and subdomains were mapped to currently used PROMs. Results: The nine FGDs included 51 patients. In total, 27 domains and 92 subdomains were identified and then organized within the 7 broad categories of the WHOQOL framework. Patients in Singapore were more concerned about "financial resources, " "work satisfaction" and "positive feelings" while less concerned about "freedom, physical safety and security" than patients in Western countries. "Home environment" and "work satisfaction" emerged as unique QoL domains relevant to patients with axial SpA (axSpA). PROMs for psoriatic arthritis (PsA) can capture both identified domains of PsA and axSpA. Conclusions: A wide range of QoL domains and subdomains are relevant to SpA patients in Singapore, and there appears to be minimal differences in their relative importance between SpA subtypes. This study supports the development and validation of common QoL-specific PROMs for usage in SpA. K E Y W O R D S psoriatic arthritis, qualitative research, quality of life, Singapore, spondyloarthritis 1 | INTRODUC TI ON Spondyloarthritis (SpA) is a chronic disease that causes significant pain, fatigue and mobility impairment. 1,2 Managing and improving the quality of life (QoL) for patients with SpA is central to achieving good outcomes. 3 SpA refers to a clinically heterogeneous group of diseases including ankylosing spondylitis (AS), psoriatic arthritis (PsA), inflammatory | 243 KWAN et al. HAQ, median (range: 0-3) 0.125 (0-1.625) 0.187 (0-1.571) 0.125 (0-1.625) Disease manifestations, ever (%)Inflammatory back pain, n (%) 37 (72.5) 34 (100.0) 3 (17.6) Peripheral joint arthritis, n (%) 40 (78.4) 23 (67.6) 17 (100.0) Uveitis, n (%) 13 (25.5) 11 (32.3) 2 (11.7) Enthesitis, n (%) 16 (31.3) 12 (35.2) 4 (23.5) Dactylitis, n (%) 15 (29.4) 3 (8.8) 12 (70.5) Psoriasis, n (%) 18 (35.3) 1 (2.9) 17 (100.0) Inflammatory bowel disease, n (%) 1 (2.0) 1 (2.9) 1 (5.8) Numbers are presented as median (range) or number (percentage). HAQ, Health Assessment Questionnaire; SpA, spondyloarthritis; PsA, psoriatic arthritis. a Patients were classified using the 2009 Assessment of Spondyloarthritis International Society (ASAS) criteria for axial spondyloarthritis. b Patients were diagnosed with psoriatic arthritis using the 2006 Classification criteria for Psori...

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“…(i) Score of ASAS HI is positively and highly correlated with summary score of BASDAI, 15 BASFI, 15 HAQ-DI, 22 pain, 15 WPAI absenteeism, presenteeism, work productivity loss, and activity impairment. 34 (ii) Score of ASAS HI is positively and moderately correlated with summary score of PGA.…”

Section: Discussionmentioning

confidence: 99%

“…HAQ‐DI (ranges from 0 to 3) is an instrument to measure disability and it has been validated among patients with SpA in Singapore . Higher scores reflect worse disability…”

Section: Methodsmentioning

confidence: 99%

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Validity and reliability of the Assessment of Spondyloarthritis International Society Health Index in English‐speaking patients with axial spondyloarthritis in Singapore

Kwan

Fong

et al. 2019

Int J of Rheum Dis

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Objectives 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. Methods 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). Results 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. Conclusions This study supports the ASAS HI as a valid and reliable measure of health status for use in patients with axSpA in Singapore.

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Validity and reliability of the Health Assessment Questionnaire among patients with spondyloarthritis in Singapore

Abstract: This study supports the HAQ as a valid and reliable measure of disability for use in patients with SpA.

Cited by 18 publications

References 34 publications

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

A qualitative study of quality of life domains and subdomains relevant to patients with spondyloarthritis

Validity and reliability of the Assessment of Spondyloarthritis International Society Health Index in English‐speaking patients with axial spondyloarthritis in Singapore

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