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Comparing the construct validity of measurement instruments for pain and stiffness in patients with axial spondyloartwhritis: cross-sectional analysis in the OASIS cohort

cross-sectional analysis in the OASIS cohort
Authors: Dafne Capelusnik; Elena Nikiphorou; Annelies Boonen; Robin Christensen; Désirée van der Heijde; Robert Landewé; Astrid van Tubergen; +1 Authors

Comparing the construct validity of measurement instruments for pain and stiffness in patients with axial spondyloartwhritis: cross-sectional analysis in the OASIS cohort

Abstract

Objectives To compare the construct validity, including discrimination between known groups, of three pain and three morning stiffness (MS) measurement instruments. Methods Patients with radiographic axial spondyloarthritis with 8-year data from the Outcome in Ankylosing Spondylitis International Study cohort were assessed cross-sectionally. Three instruments for pain and three for MS, all self-reported and scored 0–10, were compared. Construct validity was evaluated by testing (1) hypothesis of correlations’ strength and (2) discrimination between known groups using standardised mean differences (SMD) across external constructs. Influence of contextual factors (CFs) on SMDs was investigated. Results Of 85 patients, mean age was 54 (SD 11), mean symptom duration 31 (11) years, 71% males. All six instruments showed a good construct validity by fulfilling >75% of the hypotheses for the strength of correlation. Neck/back/hip pain (Bath Ankylosing Spondylitis Disease Activity Index-Question 2, BASDAI-Q2) and total back pain had higher SMDs compared with back pain at night across all between-group comparisons, with BASDAI-Q2 performing mostly slightly better (eg, SMD for external construct Axial Spondyloarthritis Disease Activity Score (ASDAS; ≥2.1 vs <2.1): 1.87 (BASDAI-Q2) vs 1.56 (total back pain) vs 1.07 (back pain at night)). MS-severity and severity/duration had higher SMDs across all external constructs (with MS-severity slightly better), while MS-duration performed worse (eg, SMD external construct ASDAS: 1.51 (MS-severity) and 1.39 (MS-severity/duration) vs 1.16 (MS-duration)). Influence of CFs on known group discrimination was limited. Conclusions The recommended Assessment of SpondyloArthritis international Society Core Outcome Set (ASAS-COS) pain measurement instrument total back pain BASDAI-Q2 has the best known group discrimination. For MS, the ASAS-COS stiffness measure (MS-severity/duration) performs well although MS-severity even slightly better. Known group discrimination is overall stable across CFs.

Countries
Denmark, Netherlands
Keywords

Male, Adult, Pain, Axial Spondyloarthritis/diagnosis, Severity of Illness Index, Cohort Studies, Axial Spondyloarthritis/diagnosis etiology, Spondyloarthritis, Humans, Spondylitis, Ankylosing, Patient Reported Outcome Measures, Pain Measurement/methods, Pain Measurement, Aged, R, Reproducibility of Results, Middle Aged, Back Pain/etiology, Back Pain/etiology diagnosis, Cross-Sectional Studies, Back Pain, Ankylosing/complications diagnosis physiopathology, Ankylosing/complications, Medicine, Female, Low Back Pain, Axial Spondyloarthritis, Spondylitis

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
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gold