Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of the Iranian versions of the bath ankylosing spondylitis disease activity index (BASDAI), the bath ankylosing spondylitis functional index (BASFI) and the patient acceptable symptom state (PASS) in patients with ankylosing spondylitis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) are widely used instruments in assessment of patients suffering from ankylosing spondylitis (AS). The Patient Acceptable Symptom State (PASS) is regarded as a target for patients’ well-being. The aim of this study was to translate and adapt BASDAI, BASFI and PASS into the Iranian official language, Farsi, and evaluate their reliability and validity. Ninety patients with AS were included in this study. The questionnaires were translated into Farsi and back translated into English, modified until the final versions were approved with minor adaptations and the VAS was changed to numerical rating scales from 0 to 10. Forty-eight-hour test–retest agreement showed good reliability: interclass correlation coefficient (ICC) for BASDAI was 0.93 (CI at 95%, 0.90–0.95), for BASFI was 0.96 (CI at 95%, 0.94–0.97) and for PASS was 0.87 (CI at 95%, 0.79–0.92). Chronbach’s alpha was 0.95, 0.96 and 0.87 for BASDAI, BASFI and PASS, respectively. BASDAI showed a significant correlation with patient global disease activity index, nocturnal back pain, total back pain, number of swollen joints, number of enthesites, morning stiffness, Bath Ankylosing Spondylitis Global Score (BAS-G), BASFI and BASMI. A significant correlation was also found between BASFI and occiput-to-wall distance, mentum-to-sternum distance, chest expansion, finger-to-floor distance, number of swollen joints, number of enthesites, nocturnal back pain, total back pain, BAS-G, BASDAI and BASMI. Patients who answered “no” to PASS (found their condition unsatisfactory) reported significantly increased pain scores, patient global disease activity scores, BAS-G, BASDAI and BASFI scores. The results showed that the Iranian versions of BASDAI, BASFI and PASS are adequately reliable and valid in patients with AS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hajjaj-Hassouni N, Burgos-Vargas R (2008) Ankylosing spondylitis and reactive arthritis in the developing world. Best Pract Res Clin Rheumatol 22(4):709–723

    Article  PubMed  Google Scholar 

  2. Madsen OR, Rytter A, Hansen LB, Suetta C, Egsmose C (2010) Reproducibility of the Bath ankylosing spondylitis indices of disease activity (BASDAI), functional status (BASFI) and overall well-being (BAS-G) in anti-tumour necrosis factor-treated spondyloarthropathy patients. Clin Rheumatol 29(8):849–854

    Article  PubMed  Google Scholar 

  3. Zochling J, Braun J (2007) Quality indicators, guidelines and outcome measures in ankylosing spondylitis. Clin Exp Rheumatol 25(6 Suppl 47):147–152

    PubMed  CAS  Google Scholar 

  4. Yanik B, Gursel YK, Kutlay S, Ay S, Elhan AH (2005) Adaptation of the bath ankylosing spondylitis functional index to the Turkish population, its reliability and validity: functional assessment in AS. Clin Rheumatol 24(1):41–47

    Article  PubMed  Google Scholar 

  5. Pham T, van der Heijde D, Calin A, Khan MA, van der Linden S, Bellamy N, Dougados M (2003) Initiation of biological agents in patients with ankylosing spondylitis: results of a Delphi study by the ASAS group. Ann Rheum Dis 62(9):812–816

    Article  PubMed  CAS  Google Scholar 

  6. van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthr Rheum 27(4):361–368

    Article  Google Scholar 

  7. Jones SD, Steiner A, Garrett SL, Calin A (1996) The bath ankylosing spondylitis patient global score (BAS-G). Br J Rheumatol 35(1):66–71

    Article  PubMed  CAS  Google Scholar 

  8. Jenkinson TR, Mallorie PA, Whitelock HC, Kennedy LG, Garrett SL, Calin A (1994) Defining spinal mobility in ankylosing spondylitis (AS). The bath AS metrology index. J Rheumatol 21(9):1694–1698

    PubMed  CAS  Google Scholar 

  9. Garrett S, Jenkinson T, Kennedy LG, Whitelock H, Gaisford P, Calin A (1994) A new approach to defining disease status in ankylosing spondylitis: the bath ankylosing spondylitis disease activity index. J Rheumatol 21(12):2286–2291

    PubMed  CAS  Google Scholar 

  10. Calin A, Garrett S, Whitelock H, Kennedy LG, O’Hea J, Mallorie P, Jenkinson T (1994) A new approach to defining functional ability in ankylosing spondylitis: the development of the bath ankylosing spondylitis functional index. J Rheumatol 21(12):2281–2285

    PubMed  CAS  Google Scholar 

  11. Maksymowych WP, Richardson R, Mallon C, van der Heijde D, Boonen A (2007) Evaluation and validation of the patient acceptable symptom state (PASS) in patients with ankylosing spondylitis. Arthr Rheum 57(1):133–139

    Article  Google Scholar 

  12. Dougados M, Luo MP, Maksymowych WP, Chmiel JJ, Chen N, Wong RL, Davis JC Jr, van der Heijde D (2008) Evaluation of the patient acceptable symptom state as an outcome measure in patients with ankylosing spondylitis: data from a randomized controlled trial. Arthr Rheum 59(4):553–560

    Article  Google Scholar 

  13. Van Tubergen A, Debats I, Ryser L, Londono J, Burgos-Vargas R, Cardiel MH, Landewe R, Stucki G, Van Der Heijde D (2002) Use of a numerical rating scale as an answer modality in ankylosing spondylitis-specific questionnaires. Arthr Rheum 47(3):242–248

    Article  Google Scholar 

  14. El Miedany Y, Youssef S, Mehanna A, Shebrya N, Gamra SA, El Gaafary M (2008) Defining disease status in ankylosing spondylitis: validation and cross-cultural adaptation of the Arabic bath ankylosing spondylitis functional index (BASFI), the bath ankylosing spondylitis disease activity index (BASDAI), and the bath ankylosing spondylitis global score (BASG). Clin Rheumatol 27(5):605–612

    Article  PubMed  Google Scholar 

  15. Hidding A, van Santen M, De Klerk E, Gielen X, Boers M, Geenen R, Vlaeyen J, Kester A, van der Linden S (1994) Comparison between self-report measures and clinical observations of functional disability in ankylosing spondylitis, rheumatoid arthritis and fibromyalgia. J Rheumatol 21(5):818–823

    PubMed  CAS  Google Scholar 

  16. Zochling J (2008) Assessment and treatment of ankylosing spondylitis: current status and future directions. Curr Opin Rheumatol 20(4):398–403

    Article  PubMed  Google Scholar 

  17. Claudepierre P, Sibilia J, Goupille P, Flipo RM, Wendling D, Eulry F, Clerc D, Berthelot JM, Vergne P, Roudot-Thoraval F, Larget-Piet B, Chevalier X (1997) Evaluation of a French version of the bath ankylosing spondylitis disease activity Index in patients with spondyloarthropathy. J Rheumatol 24(10):1954–1958

    PubMed  CAS  Google Scholar 

  18. Brandt J, Westhoff G, Rudwaleit M, Listing J, Zink A, Braun J, Sieper J (2003) Adaption and validation of the bath ankylosing spondylitis disease activity index (BASDAI) for use in Germany. Z Rheumatol 62(3):264–273

    PubMed  CAS  Google Scholar 

  19. Ruof J, Sangha O, Stucki G (1999) Evaluation of a German version of the bath ankylosing spondylitis functional index (BASFI) and Dougados functional index (D-FI). Z Rheumatol 58(4):218–225

    Article  PubMed  CAS  Google Scholar 

  20. Bonisch A, Ehlebracht-Konig I (2003) The BASDAI-D–an instrument to defining disease status in ankylosing spondylitis and related diseases. Z Rheumatol 62(3):251–263

    PubMed  CAS  Google Scholar 

  21. Waldner A, Cronstedt H, Stenstrom CH (1999) The Swedish version of the bath ankylosing spondylitis disease activity index. Reliability and validity. Scand J Rheumatol Suppl 111:10–16

    Article  PubMed  CAS  Google Scholar 

  22. Cronstedt H, Waldner A, Stenstrom CH (1999) The Swedish version of the bath ankylosing spondylitis functional index. Reliability and validity. Scand J Rheumatol Suppl 111:1–9

    Article  PubMed  CAS  Google Scholar 

  23. Heikkila S, Viitanen JV, Kautianen H, Kauppi M (2000) Evaluation of the Finnish versions of the functional indices BASFI and DFI in spondylarthropathy. Clin Rheumatol 19(6):464–469

    Article  PubMed  CAS  Google Scholar 

  24. Cardiel MH, Londono JD, Gutierrez E, Pacheco-Tena C, Vazquez-Mellado J, Burgos-Vargas R (2003) Translation, cross-cultural adaptation, and validation of the bath ankylosing spondylitis functional index (BASFI), the bath ankylosing spondylitis disease activity index (BASDAI) and the Dougados functional index (DFI) in a Spanish speaking population with spondyloarthropathies. Clin Exp Rheumatol 21(4):451–458

    PubMed  CAS  Google Scholar 

  25. Kchir MM, Hamdi W, Kochbati S, Azzouz D, Daoud L, Saadellaoui K, Ghannouchi MM, Kaffel D, Hamida AB, Zouari B (2009) Validation of the Tunisian versions of bath ankylosing spondylitis functional index (BASFI) and disease activity index (BASDAI). Tunis Med 87(8):527–530

    PubMed  Google Scholar 

  26. Rostom S, Benbouaaza K, Amine B, Bahiri R, Yacoub YI, Alla SAO, Abouqal R, Hajjaj-Hassouni N (2010) Psychometric evaluation of the Moroccan version of the bath ankylosing spondylitis functional index (BASFI) and bath ankylosing spondylitis disease activity index (BASDAI) for use in patients with ankylosing spondylitis. Clin Rheumatol 29(7):781–788

    Article  PubMed  Google Scholar 

  27. Akkoc Y, Karatepe AG, Akar S, Kirazli Y, Akkoc N (2005) A Turkish version of the Bath ankylosing spondylitis disease activity index: reliability and validity. Rheumatol Int 25(4):280–284

    Article  PubMed  Google Scholar 

  28. Ruof J, Stucki G (1999) Validity aspects of erythrocyte sedimentation rate and C-reactive protein in ankylosing spondylitis: a literature review. J Rheumatol 26(4):966–970

    PubMed  CAS  Google Scholar 

  29. Spoorenberg A, van der Heijde D, de Klerk E, Dougados M, de Vlam K, Mielants H, van der Tempel H, van der Linden S (1999) Relative value of erythrocyte sedimentation rate and C-reactive protein in assessment of disease activity in ankylosing spondylitis. J Rheumatol 26(4):980–984

    PubMed  CAS  Google Scholar 

  30. Martindale J, Smith J, Sutton CJ, Grennan D, Goodacre L, Goodacre JA (2006) Disease and psychological status in ankylosing spondylitis. Rheumatology (Oxford) 45(10):1288–1293

    Article  CAS  Google Scholar 

  31. Baysal O, Durmus B, Ersoy Y, Altay Z, Senel K, Nas K, Ugur M, Kaya A, Gur A, Erdal A, Ardicoglu O, Tekeoglu I, Cevik R, Yildirim K, Kamanli A, Sarac AJ, Karatay S, Ozgocmen S (2011) Relationship between psychological status and disease activity and quality of life in ankylosing spondylitis. Rheumatol Int 31(6):795–800

    Google Scholar 

  32. Dougados M, Moore A, Yu S, Gitton X (2007) Evaluation of the patient acceptable symptom state in a pooled analysis of two multicentre, randomised, double-blind, placebo-controlled studies evaluating lumiracoxib and celecoxib in patients with osteoarthritis. Arthr Res Ther 9(1):R11

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported by a grant (89-04-40-11640) from Tehran University of Medical Sciences.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Immunology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Katayoon Bidad, Mahdi Mahmoudi & Mohammad Hossein Nicknam

  2. Molecular Immunology Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Katayoon Bidad, Mahdi Mahmoudi, Elham Farhadi & Mohammad Hossein Nicknam

  3. Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran

    Sasan Fallahi & Ahmadreza Jamshidi

  4. Community and Preventive Medicine Department, Medical Faculty, Tehran University of Medical Sciences, Tehran, Iran

    Alipasha Meysamie

Authors
  1. Katayoon Bidad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sasan Fallahi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mahdi Mahmoudi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ahmadreza Jamshidi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elham Farhadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alipasha Meysamie
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mohammad Hossein Nicknam
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohammad Hossein Nicknam.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 151 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bidad, K., Fallahi, S., Mahmoudi, M. et al. Evaluation of the Iranian versions of the bath ankylosing spondylitis disease activity index (BASDAI), the bath ankylosing spondylitis functional index (BASFI) and the patient acceptable symptom state (PASS) in patients with ankylosing spondylitis. Rheumatol Int 32, 3613–3618 (2012). https://doi.org/10.1007/s00296-011-2186-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-2186-2

Keywords

Search

Navigation