Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose
The Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI) –an index of only patient-self-report measures – has been the most widely used measure in axial spondyloarthritis (SpA). More recently the AS Disease Activity Score (ASDAS) has been developed as an algorithm that combines BASDAI elements and patient global assessment with laboratory measures. Both indices are specifically designed for AS patients. In busy clinical settings, it is more feasible to ask all patients to complete the same questionnaire, such as a multidimensional health assessment questionnaire (MDHAQ), with a Routine Assessment of Patient Index Data (RAPID3) score, which has proved useful in most of rheumatic diseases. RAPID3 may facilitate implementation of quantitative measures in routine care. This study compared RAPID3, BASDAI and ASDAS-CRP with one another and versus patient and physician global estimates.
Methods
The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR) is a prospective longitudinal cohort in France, which includes 708 patients with inflammatory back pain suggestive of SpA. 461 patients who fulfilled the Assessment of SpondyloArthritis International Society classification (ASAS) criteria for axial SpA were included in this analysis. As there is no universal gold standard to assess disease activity in AS, predefined external criteria were used based on patient and physician global estimates with 1, 3 and 6 as the specific cut points to define disease activity state: ‘inactive’, ‘low’, ‘moderate’, and ‘high’. Additionally, patients were classified using the disease activity cut points for BASDAI (3, 3.5 and 4), ASDAS-CRP (1.3, 2.1, 3.5) and RAPID3 (3, 6 and 12). Spearman correlations were performed and the level of agreement evaluated using weighted kappas.
Results
RAPID3 showed a high correlation with BASDAI (rho=0.84, p<0.001), ASDAS-CRP (rho=0.74, p<0.001), physician global estimate (rho=0.62, p<0.001), and patient global estimate (rho=0.90, p<0.001). The percentage of patients with inactive disease ranged from 9 to 31% and with high disease ranged from 18% to 56%, according to various disease activity measures (Table). Using PATGL as reference the strength of agreement was good for RAPID3 and moderate for BASDAI and ASDAS-CRP. Using DOCGL as reference, the strength of agreement was moderate for ASDAS-CRP and fair for BASDAI and RAPID3. The strength of agreement of RAPID3 with BASDAI and ASDAS-CRP was similar.
|
|
Disease Activity States |
Level of Agreement |
|||||
|
Inactive Disease |
Low Disease |
Moderate Disease |
High Disease |
PATGL % (Kappa) |
DOCGL % (Kappa) |
RAPID3 % (Kappa) |
|
|
PATGL (1/3/6) |
11% |
24% |
31% |
34% |
— |
79% (0.41) |
89% (0.70) |
|
DOCGL (1/3/6) |
12% |
29% |
42% |
18% |
79% (0.41) |
— |
77% (0.38) |
|
BASDAI (3/3.5/4) |
31% |
7% |
6% |
56% |
78% (0.51) |
71% (0.37) |
81% (0.55) |
|
RAPID3 (3/6/12) |
9% |
17% |
29% |
45% |
89% (0.70) |
77% (0.38) |
— |
|
ASDAS-CRP (1.3/2.1/3.5) |
14% |
23% |
45% |
18% |
81% (0.46) |
81% (0.41) |
79% (0.44) |
Conclusion
RAPID3 provide a similar disease activity score as BASDAI and ASDAS-CRP, which are specific measures for AS patients. Further studies are required to evaluate different psychometric properties such as the discriminant capacity and predictive validity of these tools. A generic measure for all rheumatic diseases such as RAPID3 may provide a feasible approach to quantitative assessment of AS patients in busy clinical settings.
Disclosure:
I. Castrejón,
None;
T. Pincus,
None;
D. Wendling,
None;
M. Dougados,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/routine-assessment-of-patient-index-data-rapid3-provides-similar-information-compared-to-ankylosing-spondylitis-specific-indices-analyses-of-the-desir-french-cohort/