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Measures to assess ankylosing spondylitis: taxonomy, review and recommendations
C Bakker1, M Boers, S van der Linden
1Department of Internal Medicine, University of Limburg, Maastricht, The Netherlands.
Objective:
To critically review the current use and scope of measures to assess patients with ankylosing spondylitis (AS).
Methods:
Studies in English reported between January, 1986 and August, 1991 were identified both through computer searches of Index Medicus and manual searches of bibliographies. Only studies where assessment of patients with AS was a main topic were included. Information was extracted to classify measures as (1) physician assessed, (2) patient reported or (3) other assessments.
Results:
Physician assessed measures prevailed in 34 (79%) of the 43 studies included. Patient reported measures were mentioned in 29 (67%). Most physician assessed measures (67%) focussed on mobility, most patient reported measures (65%) focussed on discomfort. Single item global assessment by physician or patient, the most generic measure, was reported in 7 (16%) and in 17 (40%) studies, respectively. One study reported a measure which specifically addressed the patient's priorities regarding treatment risks. Other measures were reported in 22 (51%) studies, i.e., laboratory tests in all 22, and additionally radiographs in 2, and various measures in 6 studies. Side effects (by reports or otherwise) were noted in 26 (60%) studies.
Conclusion:
Current assessment in AS incompletely encompasses the spectrum of relevant health status outcomes. Specifically, more attention should be paid to the patient's point of view.
