Validation of the Japanese version of the Systemic Lupus Activity Questionnaire that includes physician-based assessments in a large observational cohort

Abstract

The Systemic Lupus Activity Questionnaire (SLAQ) is a patient-reported outcome for systemic lupus erythematosus (SLE). We aimed to translate it into Japanese and further investigate its validity and reliability. The English version of the SLAQ was translated into Japanese and administered to Japanese SLE patients at our university clinic. Physicians assessed disease activity using the SLE Disease Activity Index 2000 (SLEDAI-2K). The patients were prospectively followed for repeat assessment a year later. Ultimately, 255 patients participated. The patients' 10-point ratings of disease activity and SLAQ scores were significantly correlated (Spearman's ρ = 0.53). The SLAQ score was weakly correlated with the SLE Disease Activity Index 2000 (SLEDAI-2K)-nolab (omitting laboratory items; ρ = 0.18) but not with the SLEDAI-2K (ρ = 0.02). These results suggested its convergent and discriminant validity. The SLAQ demonstrated acceptable internal consistency (Cronbach's α = 0.80), and good test-retest reliability (intraclass correlation coefficient = 0.85). The effect sizes and the standardized response means of the SLAQ were as follows: clinical worsening, 0.26 and 0.31, and improvement, -0.39 and -0.41, respectively, which indicated a small but significant responsiveness. The Japanese version of the SLAQ demonstrated acceptable reliability and validity; its performance was comparable to that of the original version.

Translation, cultural adaptation and validation of the Systemic Lupus Erythematosus Activity Questionnaire (SLAQ) in a cohort of Italian systemic lupus erythematosus patients

“…The questionnaire was developed and initially validated in the United States; its validity was subsequently confirmed in the German, Japanese and Swedish versions. 11–13…”

Translation, cultural adaptation and validation of the Italian version of the Brief Index of Lupus Damage: the BILDit

“…Discrepancies in disease assessment between SLAQ and SLEDAI have been reported by others. 12,14 Indeed, despite significant overlapping between SLEDAI descriptors and SLAQ questions, the two instruments demonstrated low agreement when tested simultaneously. 12,14 Moreover, another explanation can rely on the fact that the timeframe for patient symptom recall varies significantly between the SLEDAI (that takes into account the previous 10 days) and the SLAQ (that covers a 3-month period).…”

“…The questionnaire was developed and initially validated in the United States; its validity was subsequently confirmed in the German, Japanese and Swedish versions. [11][12][13] After a careful process of translation and transcultural adaptation, the final version of the SLAQit was preliminary tested in a sample of 35 patients and it showed very good feasibility in routine clinical practice as it required less than 10 minutes to be completed by all patients, with a mean time required of less than 5 minutes. All patients filled in the questionnaire in the waiting room, just before attending the visit; all the patients declared that they understood the scope of the questionnaire and only mild (in only one or two questions) content comprehension problems were reported in a minority of patients.…”

“…This is in contrast to what was recently reported by Pettersson et al, who showed that patients' and physicians' assessments were more discordant for subjects with shorter disease durations. 12 With respect to the Scandinavian cohort, our sample was mainly composed of patients with long disease duration. This could justify the different result and could support the idea that patients tend to confuse features of organ damage with disease activity.…”

AB0640 Implausible anti-smith antibody is not implausible to autoimmune disease in chinese population using the euroimmun line immunoassays

“…Results: Total 130 patients were analysed; 91% of female, a mean age (SD) of 44 15 years, steroid use of 91%, immunosuppressant use of 54%, HCQ use of 70%. Median SLAQ, SLEDAI-2K and SLEDAI-2K-nolab scores were 4 [IQR: [2][3][4][5][6][7], 4 [IQR: 2-4] and 0 [IQR: 0-2], respectively. Among them, 86 (66%) were classified in the concordance group.…”