rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2019-294-298rsp-2729Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHВалидация русскоязычной версии индекса здоровья ASASValidation of the Russian-language version of the ASAS Health IndexАкуловаА. И.AkulovaA. I.

410012, Саратов, ул. Большая Садовая, 112.

112, Bolshaya Sadovaya St., Saratov 410012.

РебровА. П.RebrovA. P.

410012, Саратов, ул. Большая Садовая, 112.

112, Bolshaya Sadovaya St., Saratov 410012.

ЭрдесШ.ErdesSh.

115522, Москва, Каширское шоссе, 34А.

ГайдуковаИ. З.GaydukovaI. Z.

3191015, Санкт-Петербург, ул. Кирочная, 41.

41, Kirochnaya St., Saint Petersburg 191015.

ubp1976@list.ruФГБОУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава РоссииРоссияV.I. Razumovsky Saratov State Medical University, Ministry of Health of RussiaRussian FederationФГБНУ «Научно-исследовательский институт ревматологии»РоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииРоссияI.I. Mechnikov North-Western State Medical University, Ministry of Health of RussiaRussian Federation201909072019573294298Copyright © Акулова А.И., Ребров А.П., Эрдес Ш., Гайдукова И.З., 20192019Акулова А.И., Ребров А.П., Эрдес Ш., Гайдукова И.З.Akulova A.I., Rebrov A.P., Erdes S., Gaydukova I.Z.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2729

Индекс здоровья ASAS (ASAS Health Index – ASAS HI) – комплексный инструмент количественной оценки здоровья пациентов с аксиальными спондилоартритами (аксСпА), включая анкилозирующий спондилит (АС). ASAS HI разработан на основе международной системы ICF (the International Classification of Functioning, Disability and Health). Опросник содержит 17 вопросов, каждый из которых связан со специфическим пулом ICF (боль, эмоции, сон, половая функция, способность к передвижению, самообслуживание и общение).

Цель исследования – изучение психометрических свойств русскоязычной версии ASAS HI.

Материал и методы

Материал и методы. Обследовано 245 пациентов старше 18 лет с аксиальным или периферическим СпА, со- ответствующих критериям ASAS. Проводилась оценка основных психометрических свойств опросника: валидности, надежности (воспроизводимости), чувствительности. Активность СпА оценивали при помощи индексов BASDAI и ASDAS, функциональный статус – по индексу BASFI, подвижность позвоночника – по BASMI. Для оценки качества жизни больных СпА применялись опросники SF-36 (The Short Form-36) и EQ-5D (EuroQoL) в версии 5L. Удовлетворенность больного своим состоянием оценивалась с помощью индекса PASS.

Результаты и обсуждение

Результаты и обсуждение. Медиана возраста пациентов, включенных в исследование, составила 39,5 [28,0; 48,0] года, длительности заболевания – 102,5 [23,0; 196,5] мес; 64,58% пациентов составили мужчины, 78% пациентов позитивны по HLA-B27. Медиана [25-й; 75-й перцентили]: BASDAI – 5,40 [3,20; 6,80], ASDAS – 3,19 [2,55; 4,15], BASFI – 5,60 [2,60; 7,50], BASMI – 4,20 [3,00; 6,60], ASAS HI – 9,00 [7,00; 12,00], ASAS EF Items Set – 4,00 [3,00; 7,00]. Установлены статистически значимые взаимосвязи между ASAS HI и уровнем С-реактивного белка (коэффициент корреляции Спирмена r=0,56), индексами BASDAI (r=0,62), BASFI (r=0,67), ASDAS (r=0,38), BASMI (r=0,46), общей оценкой состояния здоровья пациентом по визуальной аналоговой шкале (ВАШ; r=0,49; p<0,05 для всех показателей). Значения ASAS EF Items Set коррелировали с основными клиническими характеристиками пациентов. Установлены статистически значимые взаимосвязи ASAS HI/EF Items Set со значениями восьми шкал SF-36 и опросником EQ-5D. Выявлены статистически значимые различия по ASAS HI у пациентов, имеющих положительные и отрицательные значения индекса PASS (медиана ASAS HI составила 6,89 [3,00; 10,00] и 9,20 [7,00; 12,00] соответственно; р=0,000086). Коэффициент внутреннего постоянства Кронбаха χ для ASAS HI составил 0,988. Выявлены статистически значимые различия ASAS HI до и после назначения лечения (9 [7; 12] и 6 [3;10] соответственно; р=0,00025).

Заключение

Заключение. В данном исследовании подтверждены валидность, воспроизводимость и чувствительность к изменениям русскоязычной версии ASAS HI для пациентов в Российской Федерации.

The Assessment of Spondyloarthritis International Society (ASAS) Health Index (HI) is a comprehensive tool for quantifying the health of patients with axial (ax) spondyloarthritis (SpA), including ankylosing spondylitis (AS). ASAS HI was developed on the basis of the International Classification of Functioning, Disability, and Health (ICF). The questionnaire contains 17 questions, each of which is associated with a specific ICF pool (pain, emotions, sleep, sexual function, ambulation, self-care, and communication).

Objective

Objective: to study the psychometric properties of the Russian-language version of ASAS HI.

Subjects and methods

Subjects and methods. Examinations were made in 245 patients older than 18 years with axSpA or peripheral SpA, who met the ASAS criteria. The main psychometric properties of a questionnaire, such as validity, reliability (reproducibility), and sensitivity, were evaluated. SpA activity was assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS); the functional status of the patients was estimated by the Bath Ankylosing Spondylitis Functional Index (BASFI), and their spinal mobility was evaluated by the Bath Ankylosing Spondylitis Metrology Index (BASMI). The short-form 36 (SF-36) health questionnaire and the 5-dimensional EQ-5D version (EuroQoL) were used to assess quality of life in SpA patients. Patient satisfaction with their health status was estimated using the patient acceptable symptom state (PASS) index.

Results and discussion

Results and discussion. The median age of the patients enrolled in the investigation was 39.5 [28.00; 48.00] years; disease duration – 102.5 [23.0; 196.5] months; there were 64.58% of men were and 78% of HLA-B27 positive patients. The median scores were for: BASDAI, 5.40 [3.20; 6.80]; ASDAS, 3.19 [2.55; 4.15]; BASFI, 5.60 [2.60; 7.50]; BASMI, 4.20 [3.00; 6.60]; ASAS HI, 9.00 [7.00; 12.00]; ASAS EF Items Set, 4.00 [3.00; 7.00]. There were statistically significant relationships between ASAS HI scores and C-reactive protein levels (Spearman correlation coefficient r=0.56), BASDAI (r=0.62), BASFI (r=0.67), ASDAS (r=0.38), BASMI (r=0.46), and patient's global assessment on a visual analogue scale (VAS) (r=0.49; p<0.05 for all measures). The ASAS EF Items Set scores correlated with the main clinical characteristics of the patients. There were statistically significant relationships between the ASAS HI/EF Items Set scores and the latter of eight SF-36 scales and the EQ-5D ques tionnaire. Statistically significant differences in ASAS HI scores were found in patients with positive and negative PASS indices (the median value of ASAS HI was 6.89 [3.00; 10.00] and 9.20 [7.00; 12.00], respectively; p=0.000086). Cronbach's internal consistency for ASAS HI was 0.988. There were statistically significant differences in ASAS HI scores before and after treatment (9 [7; 12] and 6 [3; 10], respectively; p=0.00025).

Conclusion

Conclusion. This study confirmed validity, reproducibility, and sensitivity to changes of the Russian-language version of ASAS HI for patients in the Russian Federation.

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The authors declare that there are no conflicts of interest present.