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Blog - PRO tools in ankylosing spondylitis

Published: 29-12-2016

The database makes it much faster and easier to identify PRO instruments that have been used in patients with a particular disease and their caregivers. In this blog, we describe the evidence map we generated of PRO instruments that have been used in studies of patients with the musculoskeletal disorder ankylosing spondylitis (AS).

We searched the database for the disease Ankylosing spondylitis and the study type PRO study. We found 128 abstracts that had been indexed by PubMed since 1960, and used these to generate the evidence maps below.

The 128 abstracts cited a total of 64 different PRO instruments. Of these, 22 instruments were specific for AS or other inflammatory arthritis, 27 were general instruments used to evaluate quality of life or utilities, 12 assessed non-disease-specific symptoms, in particular fatigue, or other conditions or diseases that were common comorbidities of people with AS, and three evaluated the impact of the disease on work productivity. The most frequently used tool was the BASDAI, cited in 66 abstracts, followed by the BASFI (54 abstracts), SF-36 (52 abstracts), AS Quality of life questionnaire (34), Health Assessment Questionnaire (20) and the EQ-5D (14).

The Netherlands was the most frequent location for the studies, with 16 abstracts, followed by the United States (14 abstracts), then Germany, Turkey and the United Kingdom (12 abstracts each), then Canada (11 abstracts). Interventions assessed were generally targeted therapies such as TNF inhibitors and physical therapies.

Number of abstracts citing each PRO instrument by geographical location: disease-specific tools




Number of abstracts citing each PRO instrument by geographical location: general tools



Number of abstracts citing each PRO instrument by geographical location:  tools assessing comorbidities


Number of abstracts citing each PRO instrument by geographical location: tools assessing impact on work performance


The evidence map shows that a wide range of PRO tools have been used in studies of ankylosing spondylitis from a wide range of locations, but only nine tools and six countries were cited in more than 10 abstracts.


AQOL: Assessment of Quality of Life

AS-AIMS2: Arthritis Impact Measurement Scale, AS version

AS-WIS: Ankylosing Spondylitis Work Instability Scale

ASAS: Assessment in Ankylosing Spondylitis International Working Group criteria for improvement

ASDAS: Ankylosing Spondylitis Disease Activity Score

ASES: Arthritis Self-Efficacy Scale

ASQOL: Ankylosing Spondylitis Quality of Life Scale

BAS-G: Bath Ankylosing Spondylitis global score

BASDAI: Bath Ankylosing Spondylitis Disease Activity Index

BASFI: Bath Ankylosing Spondylitis Functional Index

BASMI: Bath Ankylosing Spondylitis Metrology Index

BDI: Beck Depression Inventory

BFI: Brief Fatigue Inventory

CASQ: Combined AS questionnaire

DISQ: Dudley Inflammatory Bowel Symptom Questionnaire

EASi-QoL: Evaluation of AS Quality of Life

FACIT-Fatigue: Functional Assessment of Chronic Illness Therapy- Fatigue scale

FIQ: Fibromyalgia impact questionnaire

FIS: Fatigue Impact scale

FSS: Fatigue severity scale

HADS: Hospital Anxiety and Depression Scale

HAQ: Health Assessment Questionnaire

HUI2: Health Utilities Index mark 2

HUI3: Health Utilities Index mark 3

JAQQ: Juvenile Arthritis Quality of Life Questionnaire

JSEQ: Jenkins Sleep Evaluation Questionnaire

LDQ: Leeds Disability Questionnaire

mSASSS: modified Stoke AS Spine Score

NHP: Nottingham Health Profile

NRS: Numerical rating scale

PASS: Patient acceptable symptom state

PGI: Patient Generated Index

PHQ-9: Patient Health Questionnaire

RADAI: Rheumatoid Arthritis Disease Activity Index

RAPID3: Routine Assessment of Patient Index Data

SCQ: Self-administered comorbidity questionnaire

WF-NRS: Worst Fatigue - Numeric Rating Scale

WHODAS-II: World Health Organization Disability Assessment Scale

WPAI: Work Productivity and Activity Impairment

WPS: Work Productivity Survey