Background Patients naïve to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) questionnaires and those with spondyloarthritis other than ankylosing spondylitis (AS) have voiced confusion in our clinic over the use of the term “AS” (ankylosing spondylitis), as it appears in these instruments. It is unclear whether the current construction of these tools may be applied to other spondyloarthritis-(SpA) associated conditions. The time required to complete the BASFI and BASDAI is also unknown.
Objectives To validate slightly modified versions of the BASDAI and BASFI questionnaires that replace references to “AS” with the term “inflammatory arthritis” for use in SpA. We also determined the time to complete these questionnaires, and patients’ assessment of the difficulty in completing the questionnaires.
Methods Adult patients with SpA-associated conditions from three U.S. Department of Veterans Affairs medical centers associated with the Program to Understand the Longterm outcomes of SpondyloARthritis (PULSAR) completed both traditional BASDAI and BASFI questionnaires and modified versions of these instruments (PULSAR-modified Bath Disease Activity Index [PuBaDAI] and PULSAR-modified Bath Functional Index and [PuBaFI]) during visits with health care providers. The order of completing each set of questionnaires (one set prior to the provider encounter and one immediately following the encounter) was randomized. Time to complete each set of forms was recorded and patients rated the difficulty of completing each set of questionnaires on a 10-point Likert scale. Scores from the traditional and modified versions of the questionnaires were compared using Spearman correlations. The association of BASFI and PuBaFI scores with disability status (according to federal institutions) was determined using logistic regression.
Results Patients (n=62) participating in the study required similar time to complete the questionnaires (3.33 vs. 3.27 minutes, p=0.82) and reported similar levels of difficulty in completing the traditional and alternate versions of the questionnaires (1.95 vs. 1.78, p=0.31). The correlation between BASDAI and PuBaDAI total scores was high (Spearman’s rho=0.92, p<0.001), and the correlation of BASFI and PuBaFI total scores was also high (Spearman’s rho=0.92, p<0.001). The alternate version (PuBaFI) performed at least as well (OR 2.12, 95% C.I. 1.22-3.66) as the traditional BASFI (OR 1.66, 95% C.I. 1.12-2.47) in predicting federally-determined disability.
Conclusions Preliminary data suggest that the PuBaDAI and PuBaFI may be used in non-ankylosing spondylitis SpA and that scores from these instruments correlate well with traditional forms of these questionnaires. The time and difficulty in completing these modified questionnaires do not differ from traditionally-worded BASDAI and BASFI.
Disclosure of Interest None Declared
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