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The ASAS Health Index has been developed as a composite index based on the International Classification of Functioning (ICF) to measure the impact of SpA on patients’ lives 15. The translation and cross-cultural adaptation of the English version of ASAS-HI was performed and presented in chapter 6 using a standardized operating procedure in Colombian patients with SpA 16. The adapted version of the ASAS-HI maintained the good psychometric properties of the original English- language version of the questionnaire in terms of reliability, sensitivity to change, construct validity and discriminative capacity regarding thresholds of disease activity. This validated ASAS-HI in Spanish-speaking patients with SpA may be used in clinical practice and research studies. This instrument is complementary to other validated tools that assess disease activity, physical function and quality of life in Spanish-language, thus completing the toolkit for the assessment of Colombian patients with SpA 17 18.
The definition of core sets and the choice of appropriate instruments are relevant in order to incorporate important elements from both the patient’s and the physician’s perspective in clinical research. This is particularly important when considering AS and SpA with regard to treatment
comparisons and when considering which measures and outcomes to report in clinical trials 19. In order to evaluate the implementation of the ASAS/OMERACT core sets 20, a systematic literature
review has been performed to analyse and compare the usage of domains, instruments and ASAS response criteria. The findings are presented in chapter 7 and confirm the implementation of the core set in randomized clinical trials after the original publication of the core set in 1999. Overall, the utilization of the disease controlling anti-rheumatic therapy (DC-ART) core set was better than that of the symptom modifying anti-rheumatic drugs SMARD core set. With respect to the ASAS response criteria, as expected, the best implementation was seen evaluating biological therapies.
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