Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
self-administered comorbidity questionnaire (SCQ) was developed to understand
the impact of 13 common comorbidities on functioning and resource utilisation.
In patients with ankylosing spondylitis, we recently showed that criterion- and
construct validity of the SCQ was good, and improved after removing rheumatic items from the questionnaire
(SpA-SCQ) (1). However, this modification (SpA-SCQ)
does not address uveitis, psoriasis and inflammatory bowel disease,
which are frequently occurring extra-articular manifestations (EAMs) in
spondyloarthritis (SpA), and might have a relevant impact on disease specific
and generic outcomes. The aim of the present study was to assess and compare criterion and construct validity
of the SpA-SCQ and the SpA-SCQ with 3 items representing the EAMs
Methods: Data from the CO-MOrbidities in SPA (COMOSPA) study, conducted in 22 countries, were
used. We hypothesised that the criterion validity of the added EAM, assessed by agreement (kappa) between patients’
self-reported and physicians’ confirmed diagnoses of each of the three EAM, was good. For construct validity, we hypothesised that the
SpA-SCQ-EAM would correlate moderate (r>0.30) and somewhat better (r-difference
>0.05) than SpA-SCQ with demographics, physical function (BASFI), work-ability
(WPAI) and health utility (EQ-5D),and that both would have low correlation with
disease activity (ASDAS-CRP). We further hypothesized that the SpA-SCQ(-EAM)
correlated better with these outcomes (but not disease activity) than the rheumatic disease comorbidity index (RDCI).
Results: 3,984 patients
(age 43.6 (SD 13.9) years, 2,588 (65.0%) male, disease duration 8.2 (SD 9.3)
years, of which 2,217/3,067 (72.4%) HLA-B27 positive) contributed to the analyses.
The mean SpA-SCQ was 2.0 (SD 2.8) and the SpA-SCQ-EAM 2.8 (SD 3.3). The
agreement between patient and physician diagnosed EAMs was substantial to
almost perfect (uveitis ĸ=0.81, IBD ĸ=0.74, psoriasis ĸ=0.78),
and was not systematically different across countries. Table 1 shows the
correlations between the SpA-SCQ-(EAM) and outcomes, and makes clear that the
hypothesis of a better correlation of the SpA-SCQ-EAM than SpA-SCQ with
outcomes could not be confirmed. On the other hand, both
the SpA-SCQ and the SpA-SCQ-EAM performed better with respect to the correlations
with outcomes than the RDCI (Table 1). Similar results were found for patients
with axial and ‘pure’ peripheral SpA.
EAMs can be reliably assessed through
self-report by patients with SpA. Notwithstanding, adding the EAMs to the
SpA-SCQ can improve the face validity of this questionnaire. Both the SpA-SCQ
and SpA-SCQ-EAM correlated better with health outcomes than the RDCI in
patients with (axial and peripheral) SpA.
To cite this abstract in AMA style:Essers I, Stolwijk C, Etcheto A, Molto A, van Den Bosch F, van der Heijde D, Landewé RBM, van Tubergen A, Dougados M, Boonen A. Does the Inclusion of Extra-Articular Manifestations Improve Validity of the Self-Administered Comorbidity Questionnaire Modified for Spondyloarthritis (SpA-SCQ)? Results from ASAS-Comospa [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/does-the-inclusion-of-extra-articular-manifestations-improve-validity-of-the-self-administered-comorbidity-questionnaire-modified-for-spondyloarthritis-spa-scq-results-from-asas-comospa/. Accessed July 31, 2021.
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