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  • Measuring impairments of functioning and health in patients with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set: translation and cross-cultural adaptation into 15 languages

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Spondyloarthritis
Original article
Measuring impairments of functioning and health in patients with axial spondyloarthritis by using the ASAS Health Index and the Environmental Item Set: translation and cross-cultural adaptation into 15 languages
  1. U Kiltz1,
  2. D van der Heijde2,
  3. A Boonen3,
  4. W Bautista-Molano4,
  5. R Burgos-Vargas5,
  6. P Chiowchanwisawakit6,
  7. T Duruoz7,
  8. B El-Zorkany8,
  9. I Essers3,
  10. I Gaydukova9,
  11. P Géher10,
  12. L Gossec11,
  13. S Grazio12,
  14. J Gu13,
  15. M A Khan14,
  16. T J Kim15,
  17. W P Maksymowych16,
  18. H Marzo-Ortega17,
  19. V Navarro-Compán18,
  20. I Olivieri19,
  21. D Patrikos20,
  22. F M Pimentel-Santos21,
  23. M Schirmer22,
  24. F van den Bosch23,
  25. U Weber24,25,
  26. J Zochling26 and
  27. J Braun1
  1. 1Rheumazentrum Ruhrgebiet, Herne, Germany
  2. 2Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
  3. 3Division of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
  4. 4Rheumatology Department, Faculty of Medicine, HMC/UMNG, Bogota, Colombia
  5. 5Department of Rheumatology, Hospital General de Mexico and Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
  6. 6Mahidol University, Bangkok, Thailand
  7. 7PM&R Department, Rheumatology Division, Marmara University, School of Medicine, Istanbul, Turkey
  8. 8Rheumatology Department, Cairo University, Cairo, Egypt
  9. 9Saratov State Medical University, Saratov, Russian Federation
  10. 10Semmelweis University, Budapest, Hungary
  11. 11Department of Rheumatology, Sorbonne Universités, UPMC Univ, Paris 06, Institut Pierre Louis d'Epidémiologie et de, Santé Publique, GRC-UPMC 08 (EEMOIS); AP-HP,Pitié Salpêtrière Hospital, Paris, France
  12. 12Sisters of Mercy University Hospital, Zagreb, Croatia
  13. 13Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
  14. 14Case Western Reserve University Cleveland, Cleveland, Ohio, USA
  15. 15Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, South Korea
  16. 16Division of Rheumatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
  17. 17Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and NHR Leeds Musculoskeletal Biomedical Research Unit, Chapel Alberton Hospital, Leeds, UK
  18. 18University Hospital La Paz, Madrid, Spain
  19. 19Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, Potenza, Italy
  20. 20Metropolitan Hospital, Athens, Greece
  21. 21NOVA Medical School and CEDOC, Chronic Diseases, NOVA University of Lisbon, Lisboa, Portugal
  22. 22Department of Internal Medicine VI, Medical University of Innsbruck, Innsbruck, Austria
  23. 23Ghent University Hospital, Ghent, Belgium
  24. 24King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark
  25. 25Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
  26. 26Menzies Institute for Medical Research, Hobart, Tasmania, Australia
  1. Correspondence to Dr UKiltz; uta.kiltz{at}elisabethgruppe.de

Abstract

Introduction The Assessments of SpondyloArthritis international society Health Index (ASAS HI) measures functioning and health in patients with spondyloarthritis (SpA) across 17 aspects of health and 9 environmental factors (EF). The objective was to translate and adapt the original English version of the ASAS HI, including the EF Item Set, cross-culturally into 15 languages.

Methods Translation and cross-cultural adaptation has been carried out following the forward–backward procedure. In the cognitive debriefing, 10 patients/country across a broad spectrum of sociodemographic background, were included.

Results The ASAS HI and the EF Item Set were translated into Arabic, Chinese, Croatian, Dutch, French, German, Greek, Hungarian, Italian, Korean, Portuguese, Russian, Spanish, Thai and Turkish. Some difficulties were experienced with translation of the contextual factors indicating that these concepts may be more culturally-dependent. A total of 215 patients with axial SpA across 23 countries (62.3% men, mean (SD) age 42.4 (13.9) years) participated in the field test. Cognitive debriefing showed that items of the ASAS HI and EF Item Set are clear, relevant and comprehensive. All versions were accepted with minor modifications with respect to item wording and response option. The wording of three items had to be adapted to improve clarity. As a result of cognitive debriefing, a new response option ‘not applicable’ was added to two items of the ASAS HI to improve appropriateness.

Discussion This study showed that the items of the ASAS HI including the EFs were readily adaptable throughout all countries, indicating that the concepts covered were comprehensive, clear and meaningful in different cultures.

  • Spondyloarthritis
  • Ankylosing Spondylitis
  • Outcomes research

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/rmdopen-2016-000311

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    Footnotes

    • Funding This study was funded by Assessment of Spondyloarthritis international Society (ASAS).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval National IRB in each country.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.