Background The BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) is a self-report index to assess disease activity in patients with ankylosing spondylitis (AS). The ASDAS (AS disease activity score) is recorded by the rheumatologist, based on the ASAS (Assessment of SpondyloArthritis International Society) core data set of 11 measures in 7 domains: patient global estimate of status, spinal pain, spinal stiffness, fatigue, physical function, spinal mobility, acute phase reactant. These quantitative measures are invaluable in clinical trials and clinical research, but difficult to administer in busy clinical care settings, in which the most feasible procedure generally is for the receptionist to provide the same questionnaire to all patients. A multidimensional health assessment questionnaire/routine assessment of patient index data (MDHAQ/RAPID3) is completed easily by all patients in 5-10 minutes, in a waiting area prior to seeing a rheumatologist, and has been found an informative in patients with all rheumatic diseases.
Objectives To compare scores on 3 indices, BASDAI, ASDAS and RAPID3 in 90 Korean patients with AS seen in a usual care setting.
Methods All patients complete an MDHAQ/RAPID3 in this setting. Patients with AS complete a BASDAI, and have ASDAS assessed by a rheumatologist. Indices and individual measures were computed and compared using Spearman correlation coefficients, cross-tabulations, and kappa statistics.
Results Ninety AS patients in usual clinical care were studied; median age was 39.1 years, median duration of disease 7.0 years, and 76.7% were male. RAPID3 scores were correlated significantly with BASDAI (rho=0.751) and ASDAS (rho=0.690), as well as with individual BASDAI and ASDAS scores for spinal pain, spinal stiffness, fatigue, Bath AS Functional Index (BASFI) physical function (rho >0.66) (all p<0.001) (data not shown). Overall, 39, 14, 17 and 20 patients had RAPID3 scores indicating high, moderate, low severity, and remission, respectively. All 21 patients with BASDAI scores ≥4, indicating active AS, had RAPID3 scores greater than 12, indicating high severity (Table). Among 56 patients with ASDAS ≥1.3 indicating active disease, 36 (64%) had high and an additional 8 (total=79%) moderate RAPID3 severity (Table).
Conclusions RAPID3 provides similar information to BASDAI and ASDAS. BASDAI and ASDAS are more specific for clinical trials and clinical research, but the feasibility of MDHAQ/RAPID3 in busy clinical settings suggests possible value in usual clinical care of patients with AS.
Disclosure of Interest None declared
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