Adaptation of Chinese and English versions of the Ankylosing Spondylitis quality of life (ASQoL) scale for use in Singapore

Ying Ying Leung, Weixian Lee, Nai Lee Lui, Matthew Rouse, Stephen P McKenna, Julian Thumboo, Ying Ying Leung, Weixian Lee, Nai Lee Lui, Matthew Rouse, Stephen P McKenna, Julian Thumboo

Abstract

Background: To cross-culturally adapt and validate the Singapore Chinese and Singapore English versions of the Ankylosing Spondylitis Quality of Life (ASQoL) scales.

Methods: Translation of the ASQoL into Singapore Chinese and English was performed by professional and lay translation panels. Field-testing for face and content validity was performed by interviewing ten Chinese speaking and ten English speaking axial spondyloarthritis (AxSpA) patients. AxSpA patients (either Chinese or English speaking) were invited to take part in validation surveys. The Health Assessment Questionnaire (HAQ), Short Form Health Survey (SF-36), Bath Indices, and other measures of disease activity were used as comparator scales for convergent validity. A separate sample of AxSpA patients were invited to participate in a test-retest postal study, with 2 weeks between administrations.

Results: The cross-sectional study included 183 patients (77% males, 82% English speaking), with a mean (SD) age of 39.4 (13.7) years. The ASQoL had excellent internal consistency (Cronbach's alpha = 0.88), and correlated moderately with all the comparator scales. The ASQoL was able to distinguish between patients grouped by disease activity and perceived general health. The ASQoL fulfilled the Rasch model analysis for fit, reliability and unidimensionality requirements. No significant differential item functioning was noted for gender, age below or above 50 years, and language of administration. Test-retest reliability was good (r = 0.81).

Conclusions: The ASQoL was adapted into Singapore Chinese and English language versions, and shown to be culturally relevant, valid and reliable when used with combined samples of AxSpA patients who speak either Chinese or English.

Keywords: Ankylosing spondylitis; Cultural adaptation; Quality of life.

Conflict of interest statement

Ethics approval and consent to participate

All study protocols were approved by the SingHealth Centralized Institutional Review Board (ref. CIRB 2012/498/E and 2012/696/E). Prior to their inclusion in the study, all patients gave informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Mean ASQoL scores stratified by known-groups. HAQ = health assessment questionnaire; BASDAI = Bath ankylosing spondylitis disease activity index; GH = general health status (Good = excellent/very good/good; poor = fair/poor)
Fig. 2
Fig. 2
Scattered plot of person measures comparing positive and negative loading items to the first factor of the Principal component analysis of residuals

References

    1. Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369:1379–1390. doi: 10.1016/S0140-6736(07)60635-7.
    1. Jenks K, Treharne GJ, Garcia J, Stebbings S. The ankylosing spondylitis quality of life questionnaire: validation in a New Zealand cohort. Int J Rheum Dis. 2010;13:361–366. doi: 10.1111/j.1756-185X.2010.01554.x.
    1. Doward LC, Spoorenberg A, Cook SA, Whalley D, Helliwell PS, Kay LJ, et al. Development of the ASQoL: a quality of life instrument specific to ankylosing spondylitis. Ann Rheum Dis. 2003;62:20–26. doi: 10.1136/ard.62.1.20.
    1. Doward LC, McKenna SP, Meads DM, Twiss J, Revicki D, Wong RL, et al. Translation and validation of non-English versions of the Ankylosing Spondylitis quality of life (ASQOL) questionnaire. Health Qual Life Outcomes. 2007;5:7. doi: 10.1186/1477-7525-5-7.
    1. Pham T, van der Heijde DM, Pouchot J, Guillemin F. Development and validation of the French ASQoL questionnaire. Clin Exp Rheumatol. 2010;28:379–385.
    1. Zhao LK, Liao ZT, Li CH, Li TW, Wu J, Lin Q, et al. Evaluation of quality of life using ASQoL questionnaire in patients with ankylosing spondylitis in a Chinese population. Rheumatol Int. 2007;27:605–611. doi: 10.1007/s00296-006-0267-4.
    1. McKenna SP, Doward LC, Niero M, Erdman R. Development of needs-based quality of life instruments. Value Health. 2004;7(Suppl 1):S17–S21. doi: 10.1111/j.1524-4733.2004.7s105.x.
    1. Whalley D, McKenna SP, de Jong Z, van der Heijde D. Quality of life in rheumatoid arthritis. Br J Rheumatol. 1997;36:884–888. doi: 10.1093/rheumatology/36.8.884.
    1. Keenan AM, McKenna SP, Doward LC, Conaghan PG, Emery P, Tennant A. Development and validation of a needs-based quality of life instrument for osteoarthritis. Arthritis Rheum. 2008;59:841–848. doi: 10.1002/art.23714.
    1. McKenna SP, Doward LC, Whalley D, Tennant A, Emery P, Veale DJ. Development of the PsAQoL: a quality of life instrument specific to psoriatic arthritis. Ann Rheum Dis. 2004;63:162–169. doi: 10.1136/ard.2003.006296.
    1. Doward LC, McKenna SP, Whalley D, Tennant A, Griffiths B, Emery P, et al. The development of the L-QoL: a quality-of-life instrument specific to systemic lupus erythematosus. Ann Rheum Dis. 2009;68:196–200. doi: 10.1136/ard.2007.086009.
    1. Zochling J. Measures of symptoms and disease status in ankylosing spondylitis: Ankylosing Spondylitis disease activity score (ASDAS), Ankylosing Spondylitis quality of life scale (ASQoL), bath Ankylosing Spondylitis disease activity index (BASDAI), bath Ankylosing Spondylitis functional index (BASFI), bath Ankylosing Spondylitis global score (BAS-G), bath Ankylosing Spondylitis metrology index (BASMI), Dougados functional index (DFI), and health assessment questionnaire for the Spondylarthropathies (HAQ-S) Arthritis Care Res (Hoboken) 2011;63(Suppl 11):S47–S58. doi: 10.1002/acr.20575.
    1. Barkham N, Keen HI, Coates LC, O'Connor P, Hensor E, Fraser AD, et al. Clinical and imaging efficacy of infliximab in HLA-B27-positive patients with magnetic resonance imaging-determined early sacroiliitis. Arthritis Rheum. 2009;60:946–954. doi: 10.1002/art.24408.
    1. Barkham N, Coates LC, Keen H, Hensor E, Fraser A, Redmond A, et al. Double-blind placebo-controlled trial of etanercept in the prevention of work disability in ankylosing spondylitis. Ann Rheum Dis. 2010;69:1926–1928. doi: 10.1136/ard.2009.121327.
    1. Davis JC, Jr, Revicki D, van der Heijde DM, Rentz AM, Wong RL, Kupper H, et al. Health-related quality of life outcomes in patients with active ankylosing spondylitis treated with adalimumab: results from a randomized controlled study. Arthritis Rheum. 2007;57:1050–1057. doi: 10.1002/art.22887.
    1. Haywood KL, A MG, Jordan K, Dziedzic K, Dawes PT. Disease-specific, patient-assessed measures of health outcome in ankylosing spondylitis: reliability, validity and responsiveness. Rheumatology (Oxford) 2002;41:1295–1302. doi: 10.1093/rheumatology/41.11.1295.
    1. Singapore Ministry of Health. Cencus of the population. 2010. [online], available at: . Accessed 15 Aug 2017.
    1. Swaine-Verdier A, Doward LC, Hagell P, Thorsen H, McKenna SP. Adapting quality of life instruments. Value Health. 2004;7(Suppl 1):S27–S30. doi: 10.1111/j.1524-4733.2004.7s107.x.
    1. McKenna SP. Measuring patient-reported outcomes: moving beyond misplaced common sense to hard science. BMC Med. 2011;9:86. doi: 10.1186/1741-7015-9-86.
    1. Hagell P, Hedin PJ, Meads DM, Nyberg L, McKenna SP. Effects of method of translation of patient-reported health outcome questionnaires: a randomized study of the translation of the rheumatoid arthritis quality of life (RAQoL) instrument for Sweden. Value Health. 2010;13:424–430. doi: 10.1111/j.1524-4733.2009.00677.x.
    1. Leung YY, Thumboo J, Rouse M, McKenna SP. Adaptation of Chinese and English versions of the psoriatic arthritis quality of life (PsAQoL) scale for use in Singapore. BMC Musculoskelet Disord. 2016;17:432. doi: 10.1186/s12891-016-1292-4.
    1. Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, et al. The development of assessment of SpondyloArthritis international society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009;68:777–783. doi: 10.1136/ard.2009.108233.
    1. Lee YX, Kwan YH, Png WY, Lim KK, Tan CS, Lui NL, et al. Association of obesity with patient-reported outcomes in patients with axial spondyloarthritis: a cross-sectional study in an urban Asian population. Clin Rheumatol. 2017; doi:.
    1. Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980;23:137–145. doi: 10.1002/art.1780230202.
    1. Koh ET, Seow A, Pong LY, Koh WH, Chan L, Howe HS, et al. Cross cultural adaptation and validation of the Chinese health assessment questionnaire for use in rheumatoid arthritis. J Rheumatol. 1998;25:1705–1708.
    1. Ware JE, Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483. doi: 10.1097/00005650-199206000-00002.
    1. Thumboo J, Wu Y, Tai ES, Gandek B, Lee J, Ma S, et al. Reliability and validity of the English (Singapore) and Chinese (Singapore) versions of the short-form 36 version 2 in a multi-ethnic urban Asian population in Singapore. Qual Life Res. 2013;22:2501–2508. doi: 10.1007/s11136-013-0381-1.
    1. Kwan YH, Fong WW, Lui NL, Yong ST, Cheung YB, Malhotra R, et al. Validity and reliability of the short form 36 health surveys (SF-36) among patients with spondyloarthritis in Singapore. Rheumatol Int. 2016;36:1759–1765. doi: 10.1007/s00296-016-3567-3.
    1. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A. A new approach to defining disease status in ankylosing spondylitis: the bath Ankylosing Spondylitis disease activity index. J Rheumatol. 1994;21:2286–2291.
    1. Calin A, Garrett S, Whitelock H, Kennedy LG, O'Hea J, Mallorie P, et al. A new approach to defining functional ability in ankylosing spondylitis: the development of the bath Ankylosing Spondylitis functional index. J Rheumatol. 1994;21(12):2281–2285.
    1. Jones SD, Steiner A, Garrett SL, Calin A. The bath Ankylosing Spondylitis patient global score (BAS-G) Br J Rheumatol. 1996;35:66–71. doi: 10.1093/rheumatology/35.1.66.
    1. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34–42. doi: 10.1016/j.jclinepi.2006.03.012.
    1. Hinkle D, Wiersma W, Jurs S. Applied statistics for the Behavioral sciences. 5. Boston: Bass; 2003.
    1. Tennant A, Conaghan PG. The Rasch measurement model in rheumatology: what is it and why use it? When should it be applied, and what should one look for in a Rasch paper? Arthritis Rheum. 2007;57:1358–1362. doi: 10.1002/art.23108.
    1. Leung YY, Png ME, Conaghan P, Tennant A. A systematic literature review on the application of Rasch analysis in musculoskeletal disease -- a special interest group report of OMERACT 11. J Rheumatol. 2014;41:159–164. doi: 10.3899/jrheum.130814.
    1. Tennant A, Pallant JF. Unidimensionality Matters! (A Tale of Two Smiths?). Rasch Measurement Transactions. 2006;20(1 Summer).
    1. Weiner E, Stewart B. Assessing individuals. Boston: Little Brown; 1984.
    1. van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum. 1984;27:361–368. doi: 10.1002/art.1780270401.
    1. Boers M, Brooks P, Strand CV, Tugwell P. The OMERACT filter for outcome measures in rheumatology. J Rheumatol. 1998;25:198–199.
    1. van der Heijde D, Dougados M, Davis J, Weisman MH, Maksymowych W, Braun J, et al. ASsessment in Ankylosing Spondylitis international working group/Spondylitis Association of America recommendations for conducting clinical trials in ankylosing spondylitis. Arthritis Rheum. 2005;52:386–394. doi: 10.1002/art.20790.
    1. Wolfe F, Lassere M, van der Heijde D, Stucki G, Suarez-Almazor M, Pincus T, et al. Preliminary core set of domains and reporting requirements for longitudinal observational studies in rheumatology. J Rheumatol. 1999;26:484–489.
    1. Braun J, van den Berg R, Baraliakos X, Boehm H, Burgos-Vargas R, Collantes-Estevez E, et al. 2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis. Ann Rheum Dis. 2011;70:896–904. doi: 10.1136/ard.2011.151027.
    1. Doward LC, Meads DM, Thorsen H. Requirements for quality of life instruments in clinical research. Value Health. 2004;7(Suppl 1):S13–S16. doi: 10.1111/j.1524-4733.2004.7s104.x.
    1. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. COSMIN checklist manual. 2010. [online]. Available at: . Accessed 15 Aug 2017.
    1. Guidance for Industry. Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims. 2009. [Online] Available at: . Accessed 27 May 2017.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel