Title

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

UMMS Affiliation

Division of Epidemiology, Department of Population and Quantitative Health Sciences; Clinical and Population Health Research Program, Morningside Graduate School of Biomedical Sciences; Division of Rheumatology, Department of Medicine

Publication Date

2022-01-21

Document Type

Article

Disciplines

Diagnosis | Epidemiology | Health Services Administration | Health Services Research | Musculoskeletal Diseases | Rheumatology

Abstract

OBJECTIVE: To further refine the wording of screening questions and examine their face validity through cognitive interviews with axial spondyloarthritis (axSpA) and chronic mechanical back pain patients.

METHODS: In-depth, semi-structured cognitive interviews were conducted with 30 patients (10 axSpA; 20 chronic mechanical back pain patients) to assess the face validity and comprehensibility of the screening questions. The interview protocol focused on 12 questions/domains including participants' feedback/thoughts on the duration of suffering from back pain, age at onset of back pain, pace of back pain development, improvement of pain with movement or rest, nocturnal back pain improving upon awakening, pain in other parts of the body, responsiveness of pain to nonsteroidal anti-inflammatory drug (NSAID) use, history of autoimmune conditions, and domains such as sleep, sitting, and stiffness. The Flesch-Kincaid grade level and Flesch reading ease scores were then analyzed for the revised versions of screening questions.

RESULTS: Participants preferred questions that allowed them to provide more details regarding the frequency of their symptoms. Questions were refined for clarity and eliminated if participants considered them to be irrelevant (e.g., NSAIDs). Two sample screeners were derived from twelve questions each with an overall reading grade of 7.5 and reading ease of 65.7%.

CONCLUSIONS: It is feasible to design a screening tool that is accessible to most (e.g., reading level) and clear to individuals with back pain. An evidence-based approach to demonstrate the validity of the screening tool will be critical for it to be implemented widely into clinical practice. Key Points * Our study developed two sample screeners that are clear to individuals with back pain and accessible to most with an overall Flesch-Kincaid reading grade of 7.5 and Flesch reading ease of 65.7%. * Questions that were considered irrelevant to participants were eliminated such as responsiveness of pain to nonsteroidal anti-inflammatory drug (NSAID). * It is feasible to design a screening tool that is accessible to most (e.g., reading level) and clear to individuals with back pain.

Keywords

Axial spondyloarthritis, Back pain, Health Assessment Questionnaire, Spondyloarthropathy

DOI of Published Version

10.1007/s10067-022-06072-8

Source

Shridharmurthy D, Khan S, Lapane KL, Yi E, Kay J, Liu SH. Development of a screening tool to identify patients with axial spondyloarthritis: a cognitive interview study. Clin Rheumatol. 2022 Jan 21. doi: 10.1007/s10067-022-06072-8. Epub ahead of print. PMID: 35059882. Link to article on publisher's site

Journal/Book/Conference Title

Clinical rheumatology

PubMed ID

35059882

Related Resources

Link to Article in PubMed

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