Abstract
BackgroundThe Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire is a unidimensional, disease-specific measure developed in the UK and the Netherlands. This study describes its adaptation into other languages.MethodsThe UK English ASQOL was translated into US English; Canadian French and English; French; German; Italian; Spanish; and Swedish (dual-panel methods). Cognitive debriefing interviews were conducted with AS patients. Psychometric/scaling properties were assessed using data from two Phase III studies of adalimumab. Baseline and Week-2 data were used to assess test-retest reliability. Validity was determined by correlation of ASQOL with SF-36 and BASFI and by discriminative ability of ASQOL based on disease severity. Item response theory (Rasch model) was used to test ASQOL's scaling properties.ResultsCognitive debriefing showed the new ASQOL versions to be clear, relevant and comprehensive. Sample sizes varied, but were sufficient for: psychometric/scaling assessment for US English and Canadian English; psychometric but not scaling analyses for German; and preliminary evidence of these properties for the remaining languages. Test-retest reliability and Cronbach's alpha coefficients were high: US English (0.85, 0.85), Canadian English (0.87, 0.86), and German (0.77, 0.79). Correlations of ASQOL with SF-36 and BASFI for US English, Canadian English, and German measures were moderate, but ASQOL discriminated between patients based on perceived disease severities (p < 0.01). Results were comparable for the other languages. US English and Canadian English exhibited fit to the Rasch model (non-significant p-values: 0.54, 0.68), confirming unidimensionality.ConclusionThe ASQOL was successfully translated into all eight languages. Psychometric properties were excellent for US English, Canadian English, and German, and extremely promising for the other languages.
Highlights
The Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire is a unidimensional, disease-specific measure developed in the UK and the Netherlands
Most items in the questionnaire were capable of translation into all eight languages without difficulty
As the emphasis was on conceptual rather than linguistic translations, some of the translated items took a different form from the UK original
Summary
The Ankylosing Spondylitis Quality of Life (ASQOL) questionnaire is a unidimensional, disease-specific measure developed in the UK and the Netherlands. Ankylosing spondylitis (AS) is a chronic rheumatic disease with a worldwide prevalence of up to 0.9% [1] and rates as high as 2.0% reported for some ethnic groups [2]. The disease may involve the peripheral joints and extra-articular structures [1]. Patients commonly experience pain, morning stiffness and disability, all which generally increase with duration of disease [3]. Systemic features, such as anorexia and fatigue may occur. Some patients develop acute anterior uveitis, cardiovascular or pulmonary problems [2]. Men are more commonly affected than women [4] and, as with other sponylarthritides, AS is associated with positivity for the HLA-B27 gene [1]
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