Assessment of functional ability in patients with rheumatoid arthritis; validation of the Czech version of the Stanford Health Assessment Questionnaire (HAQ)


Authors: O. Šléglová 1;  L. Dušek 2;  M. Olejárová 1;  D. Tegzová 1;  J. Vencovský 1;  K. Pavelka 1
Authors‘ workplace: Revmatologický ústav, Praha, 2Centrum biostatistiky a analýz, Brno 1
Published in: Čes. Revmatol., 18, 2010, No. 2, p. 73-83.
Category: Original Papers

Overview

Objective:
Our objective was to translate and adapt the Stanford Health Assessment Questionnaire (HAQ) for use in the Czech Republic and to test reliability and validity of this version.

Methods:
Following a discussion with the authors, modification for local Czech conditions, and retranslation, the Czech version was created, and tested for its reliability and validity. We tested the questionnaire on a cohort of 132 patients with rheumatoid arthritis (RA). The patients were treated with biological therapy, and were tested prior to and after the initiation of therapy.

Results:
Mutual correlation analysis of repeated measurements demonstrated high concurrence - 0.978 in rank correlation (based on the Spearman correlation coefficient), and 0.956 in quantitative correlation based on the Pearson correlation coefficient. The construction validity of HAQ was studied by rank correlation relating the resultant scores of quality of life to important indicators of the clinical state of patients. The quality of life score was statistically significantly correlated to CRP values, DAS score and two of its components: the number of tender joints and the patient’s general health or global disease activity measurement on a visual analogue scale. The internal integrity of the Czech version of the HAQ questionnaire evaluated in terms of the Cronbach coefficient alpha equalled 0.924. Following commencement of biological therapy, the average HAQ value decreased from 1.63 to 1.12. The relative change in HAQ thus equalled 31%.

Conclusion:
The Czech HAQ is a reliable and valid instrument for measuring functional disability of Czech patients with RA.

Key words:
Health Assesment Questionare (HAQ), rheumatoid arthritis, functional ability, translation and adaptation of a questionnaire


Sources

1. Wolfe F, Hampley D. The long term outcomes of rheumatoid arthritis. Work disability: a prospective 18 year study of 823 patients. J Rheumatol 1998; 25: 2108-17.

2. Pincus T, Callahan LF. Taking mortality in rheumatoid arthritis seriously – predictive markers, socioeconomic and co morbidity. J Rheumatol 1986; 13: 841-45.

3. Fries JF, Spitz PW, Kraines RG, Holman HR. Measument of patient outcome in arthritis. Arthritis Rheum 1980; 23: 137-45.

4. Fries JF, Spitz PW, Young DY. The dimensions of health outcomes: the Health Assessment Quuestionnare, disability and pain scales. J Rheumatol 1982; 9: 789–93.

5. Fries JF. The assessment of disability: from first to future principles. British J Rheum 1983; 22: 48-58.

6. Bruhlmann P, Stucki G., Michel BA. Evaluation of German version of the Physical Dimensions of the Health Assessment Questionnaire in patients with rheumatoid arthritis. J Rheumatol 1994 ; 21: 1245–1249.

7. Ekdahl C, Eberhardt K, Andersson SI, Svensson B. Assessing disability in patients with rheumatoid arthritis – Use of Swedish version of the Stanford Health Assessment Questionare. Scand J Rheumatol 1988; 17: 263–271.

8. Ferraz MB, Oliveira LM, Araujo PMP, Atra E, Tuqwell P. Crosscultural reliability of the physical ability dimension of the Health Assassment Questionnaire. J Rheumatol 1990; 17: 813–7.

9. Maini R, St. Clair EW, Breedveld F, et al. Infliximab versus placebo in rheumatoid arrthritis patients receiving concomitant methotrexate: a randomised phase III. trial. ABSTRACT Study Group Lancet 1999; 354: 1932–39.

10. Altman DG. Practical statistics for medical Research. Chapman and Hall, London 1991.

11. Cronbach LJ. Coefficient Alpha and the Internal Structure of Tests. Psychometrika 1951; 16: 297-334.

12. Nunnally J. Psychometric theory. New York: McGraw-Hill Companies. 1978

13. Ranza R, Marchesoni A, Calori G, Bianchi G, Braga M, et al. The Italian version of the Functional Disability Index of the Health Assessment Questionnaire. A reliable instrument for multicenter studies in rheumatoid arthritis. Clinical and Experimental Rheumatology 1993, 11; 123-128.

14. Siegert CE, Vleming LJ, Vandenbroucke JP, Cats A. Measurement of disability in Dutch rheumatoid arthritis patients. Clin Rheumatol 1984; 3: 305-9.

15. Kirwan JR, Reeback JS: Stanford Health Assessment Questionnare modified to assess disability in British patients with rheumatoid arthritis. Br J Rheumatol 1986; 25: 206-9.

16. Perez ER, Mackenzie CR, Ryan C: Development of a Spanish version of the modified Health Assessment Questionare. Arthritis Rheum 1989; 32: 100-8.

17. Bosi Ferraz M, Magalhaes Oliveira L, Araujo PMP, Atra E, Tugwell P. Cross-cultural reliability of the physical ability dimension of the Health Assessment Questionnaire. J Rheumatol 1990; 17: 813-17.

18. Van der Heijde DMFM, van Riel PLCM, van de Putte LBA. Senzitivity of a Dutch Health Assessment Health Assessment Questionare in a trial comparing hydrochloroquine vs. sulphasalazine. Scan J Rheumatol 1990; 19: 407-412.

19. Esteve-Vives J, Battle E. Adaptation of health assessment questionare (HAQ) in the Spanish population. Rev Esp Rheumatol 1991; 18: 258-262.

20. Wolfe F, Pincus T, Standard self-report questionainers in routine clinical and research prastise – an opportunity for patients and rheumatologist. J Rheumatol 1991; 18: 643-44.

21. Maini RN, Breedveld FC, Kalden JR, et. al. Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alfa monoclonal antibody combined with low dose factor alfa monoclonal antibody copmbined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum 1998; 41: 1552-63.

22. Lipsky PE, van der Heide DMFM, St Clair EW, et al. Infliximab and methotrexate in the treatment of rheumatoid artritis Anti Tumor Necrosis Factor Trial in Rheumatoid Arthritis with concomitant therapy study group. N Engl J Med 2000; 343: 1594-602.

Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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