{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T22:41:22Z","timestamp":1759963282080,"version":"3.37.3"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,6,23]],"date-time":"2020-06-23T00:00:00Z","timestamp":1592870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To develop an alternative Ankylosing Spondylitis Disease Activity Score (ASDAS) to be used in research settings in axial SpA (axSpA) when Patient Global Assessment (PGA) is unavailable in databases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Longitudinal data from four axSpA cohorts and two randomized controlled trials were combined. Observations were randomly split in a development (N\u2009=\u20091026) and a validation cohort (N\u2009=\u20091059). Substitutes of PGA by BASDAI total score, single or combined individual BASDAI questions, and a constant value, were established in the development cohort. Conversion factors for each substitute were defined by Generalized Estimating Equations, obtaining seven \u2018alternative\u2019 formulae. Validation was performed in the validation cohort according to the OMERACT filter, taking into consideration: (i) truth (agreement with original-ASDAS in the continuous score, by intraclass correlation coefficient and in disease activity states, by weighted kappa); (ii) discrimination [standardized mean difference of ASDAS scores between high\/low disease activity states defined by external anchors, e.g. Patient Acceptable Symptom State; agreement (kappa) in the percentage of patients reaching ASDAS improvement criteria according to alternative vs original formulae]; and (iii) feasibility.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Comparing various options, alternative-ASDAS using BASDAI total as PGA replacement proved to be: truthful (intraclass correlation coefficient\u2009=\u20090.98, kappa\u2009=\u20090.90), discriminative [ASDAS scores between Patient Acceptable Symptom State no\/yes: standardized mean difference\u2009=\u20091.37 (original-ASDAS standardized mean difference\u2009=\u20091.43); agreement with original-ASDAS in major improvement\/clinically important improvement criteria: kappa\u2009=\u20090.93\/0.88] and feasible (BASDAI total often available, as questions required for the ASDAS; conversion coefficient\u2009\u2248\u20091).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Alternative-ASDAS using BASDAI total score as PGA replacement is the most truthful, discriminative and feasible instrument.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/rheumatology\/keaa241","type":"journal-article","created":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T19:11:26Z","timestamp":1587064286000},"page":"638-648","source":"Crossref","is-referenced-by-count":10,"title":["Development and validation of an alternative ankylosing spondylitis disease activity score when patient global assessment is unavailable"],"prefix":"10.1093","volume":"60","author":[{"given":"Augusta","family":"Ortolan","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy"}]},{"given":"Sofia","family":"Ramiro","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands"}]},{"given":"Floris","family":"van Gaalen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}]},{"given":"Tore K","family":"Kvien","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway"}]},{"given":"Robert B M","family":"Landewe","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands"},{"name":"Department of Clinical Immunology & Rheumatology, Amsterdam Rheumatology Center, Amsterdam, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8411-7972","authenticated-orcid":false,"given":"Pedro M","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Centre for Rheumatology & MRC Centre for Neuromuscular Diseases, University College London, London, UK"},{"name":"Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Department of Rheumatology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK"}]},{"given":"Adeline","family":"Ruyssen-Witrand","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Purpan Teaching Hospital, Toulouse, France"},{"name":"Department of Epidemiology, Inserm UMR1027 University Paul Sabatier Toulouse III, Toulouse, France"}]},{"given":"Astrid","family":"van Tubergen","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht and School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands"}]},{"given":"Caroline","family":"Bastiaenen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Maastricht University, Maastricht, The Netherlands"}]},{"given":"D\u00e9sir\u00e9e","family":"van der Heijde","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands"}]}],"member":"286","published-online":{"date-parts":[[2020,6,23]]},"reference":[{"key":"2021020119072563100_keaa241-B1","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1136\/ard.2009.108233","article-title":"The development of Assessment of SpondyloArthritis 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