Development of a screening tool to identify patients with axial spondyloarthritis: a cognitive interview study

Shridharmurthy, Divya; Khan, Sara; Lapane, Kate L.; Yi, Esther; Kay, Jonathan; Liu, Shao‐Hsien

doi:10.1007/s10067-022-06072-8

Cited by 1 publication

(6 citation statements)

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“…Question 12 had low testretest reliability (0.46), with both physicians and patients pointing out the ambiguity of the term "rest" and therefore was excluded. In addition, the family history question experienced mixed agreement from rheumatologists and in our previous study with cognitive interviews with mechanical back pain and diagnosed axSpA patients believed the question needed specific examples [17].…”

Section: Plos Onementioning

confidence: 91%

“…Our prognostic screening tool improves upon these approaches. The proposed screening tool was informed by previous qualitative research and includes questions designed to test for a variety of axSpA symptoms [17]. Overall, we tested 19 items to capture multiple domains related to self-reported symptoms of axSpA, including IBP, stiffness, pain with movement, sleep, use of pain medications, other joint pain, and family history.…”

Section: Plos Onementioning

confidence: 99%

“…For each domain, multiple questions were included that captured essentially the same underlying construct. Through a process of multiple iterations, only those items which scored well under domains that were most relevant to axSpA, according to published literature and our previous work [17,[43][44][45], were included to develop a patient-friendly screener. For example, from the potential screening questions, three questions (Q5, Q6, Q7) related to movement were examined.…”

Section: Plos Onementioning

confidence: 99%

“…Considering the complexity of the US healthcare system and the challenges associated with implementation of a screening tool in primary care settings [15,46], evidence to ensure its usefulness in routine primary care practice will be important. In our previous work, we demonstrated that the proposed screener possesses the necessary properties to serve as an effective screening tool: it is brief, understandable at a grade 8 reading level, and can be self-administered [17]. Further, it should help clinicians to decide which of the screened patients will benefit from prompt rheumatology referral for evaluation and treatment.…”

Section: Plos Onementioning

confidence: 99%

“…Previously, we derived potential screening questions from qualitative interviews that we conducted with patients who had chronic back pain and refined the wording of these questions to improve their clarity and ease of administration as screening questions to be implemented in primary care settings [17]. The purpose of this study was to evaluate the psychometric properties of these proposed screening questions to develop a prognostic screening tool for axSpA for implementation in primary care settings.…”

Section: Introductionmentioning

confidence: 99%

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Development and test–retest reliability of a screening tool for axial spondyloarthritis

et al. 2022

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Background People with axial Spondyloarthritis (axSpA) suffer from lengthy diagnostic delays of ~7 years. The usage of screening tools to identify axSpA patients in primary care can reduce diagnostic delays by facilitating early referral to rheumatologic care. The purpose of this study was to examine the psychometric properties of a potential screening tool for patients with axSpA. Method Content validity was evaluated by soliciting feedback from 7 rheumatologists regarding the relevance and content representativeness of the proposed screening questions. For the test-retest study, participants ≥18 years of age with chronic back pain (≥3 months) without a diagnosis of mechanical or inflammatory back pain (n = 91) were e-recruited through ResearchMatch. Participation included completing identical baseline and follow-up questionnaires ~14 days apart. Weighted quadratic kappa was used to measure test-retest reliability between the two ratings of the ordinal scales. Construct validity was examined using exploratory factor analysis (EFA) and items with factor loadings ≥0.6 were extracted. Scale dimensionality and simplified factorial solutions were measured using Kaiser’s criteria (Eigenvalue >1). Cronbach’s alpha was used to measure internal consistency. Results Most participants were women, non-Hispanic white, and had at least some college education, with a mean age of 45 years. On average, the age at onset of back pain was 31 years. Eleven questions yielded test–retest reliabilities ranging from 0.6 to 0.76. Results from EFA extracted two factors relating to: 1) how pain affects daily life functioning and 2) whether pain improves with movement. Internal consistency was high for questions evaluating how pain affects life, with a Cronbach’s alpha of 0.81. Following assessment for validity and reliability, the questionnaire was revised to create the 6-item screening tool. Conclusions The 6-item SpA-SED screening tool designed to identify potential cases of axSpA was found to have good test–retest reliability and high internal consistency.

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Section: Plos Onementioning

confidence: 91%

Section: Plos Onementioning

confidence: 99%