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Reducing work disability in Ankylosing Spondylitis -development of a work instability scale for AS

Gilworth, G., Emery, P., Barkham, N., Smyth, M.G., Helliwell, P. and Tennant, A. (2009) Reducing work disability in Ankylosing Spondylitis -development of a work instability scale for AS. BMC Musculoskeletal Disorders , 10. ISSN 1471-2474

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Abstract

BACKGROUND The Work Instability Scale for Rheumatoid Arthritis (RA-WIS) is established and is used by physicians to identify patients at risk of job loss for rapid intervention. The study objective was to explore the concept of Work Instability (a mismatch between an individual's abilities and job demands) in Ankylosing Spondylitis (AS) and develop a Work Instability Scale specific to this population.

METHODS New items generated from qualitative interviews were combined with items from the RA-WIS to form a draft AS-WIS. Rasch analysis was used to examine the scaling properties of the AS-WIS using data generated through a postal survey. The scale was validated against a gold standard of expert assessment, a test-retest survey examined reliability.

RESULTS Fifty-seven participants who were in work returned the postal survey. Of the original 55 items 38 were shown to fit the Rasch model (χ2 37.5; df 38; p 0.494) and free of bias for gender and disease duration. Following analysis for discrimination against the gold standard assessments 20 items remained with good fit to the model (χ2 24.8; df 20; p 0.21). Test-retest reliability was 0.94.

CONCLUSION The AS-WIS is a self-administered scale which meets the stringent requirements of modern measurement. Used as a screening tool it can identify those experiencing a mismatch at work who are at risk of job retention problems and work disability. Work instability is emerging as an important indication for the use of biologics, thus the AS-WIS has the potential to become an important outcome measure.

Item Type: Article
Copyright, Publisher and Additional Information: © 2009 Gilworth et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Musculoskeletal Disease (Leeds)
Depositing User: Sherpa Assistant
Date Deposited: 06 May 2010 15:10
Last Modified: 08 Feb 2013 17:06
Published Version: http://dx.doi.org/10.1186/1471-2474-10-68
Status: Published
Publisher: Biomed Central
Refereed: Yes
Identification Number: 10.1186/1471-2474-10-68
Related URLs:
URI: http://eprints.whiterose.ac.uk/id/eprint/10809

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