Abstract
BackgroundHealth assessment measurements for patients with Rheumatoid arthritis (RA) have to be meaningful, valid and relevant. A commonly used questionnaire for patients with RA is the Stanford Health Assessment Questionnaire Disability Index (HAQ), which has been available in Swedish since 1988. The HAQ has been revised and improved several times and the latest version is the Multi Dimensional Health Assessment Questionnaire (MDHAQ). The aim of this study was to translate the MDHAQ to Swedish conditions and to test the validity and reliability of this version for persons with RA.MethodsTranslation and adaption of the MDHAQ were performed according to guidelines by Guillemin et al. The translated version was tested for face validity and test-retest in a group of 30 patients with RA. Content validity, criterion validity and internal consistency were tested in a larger study group of 83 patients with RA. Reliability was tested with test-retest and Cronbach´s alpha for internal consistency. Two aspects of validity were explored: content and criterion validity. Content validity was tested with a content validity index.Criterion validity was tested with concurrent validity by exploring the correlation between the MDHAQ-S and the AIMS2-SF. Floor and ceiling effects were explored.ResultsTest-retest with intra-class correlation coefficient (ICC) gave a coefficient of 0.85 for physical function and 0.79 for psychological properties. Reliability test with Cronbach´s alpha gave an alpha of 0.65 for the psychological dimension and an alpha of 0.88 for the physical dimension of the MDHAQ-S.The average sum of the content validity index for each item was of the MDHAQ-S was 0.94. The MDHAQ-S had mainly a moderate correlation with the AIMS2-SF, except for the social dimension of the AIMS2-SF, which had a very low correlation with the MDHAQ-S.ConclusionsThe MDHAQ-S was considered to be reliable and valid, but further research is needed concerning sensitivity to change.
Highlights
Health assessment measurements for patients with Rheumatoid arthritis (RA) have to be meaningful, valid and relevant
These differences between the Health Assessment Questionnaire Disability Index (HAQ) and the Multi Dimensional Health Assessment Questionnaire (MDHAQ) are of major importance, and it is necessary to follow the development of improved health assessment and make the MDHAQ available in different contexts, in order to be able to assess the impact of RA
The criterion validity of the activities of daily living questions included in the MDHAQ, that derive from the original HAQ, has been tested under Swedish conditions showing that the correlation between the patient’s evaluation of the activity and the therapist’s measure of that activity was 0.91 with a significance of p < 0.0001 [1]
Summary
Health assessment measurements for patients with Rheumatoid arthritis (RA) have to be meaningful, valid and relevant. The importance of physical activity has increased for patients with RA, and this valuable item is included in the MDHAQ These differences between the HAQ and the MDHAQ are of major importance, and it is necessary to follow the development of improved health assessment and make the MDHAQ available in different contexts, in order to be able to assess the impact of RA. The choice to translate and psychometrically test the MDHAQ under Swedish conditions is due to the increased scope of the MDHAQ and its usefulness in clinical practice in comparison with other outcome measurements [9]. The criterion validity of the activities of daily living questions included in the MDHAQ, that derive from the original HAQ, has been tested under Swedish conditions showing that the correlation between the patient’s evaluation of the activity and the therapist’s measure of that activity was 0.91 with a significance of p < 0.0001 [1]. The MDHAQ [6] is to the best of our knowledge not used in Sweden, since it has not been tested under Swedish conditions and/or translated into Swedish
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