The Gout Assessment Questionnaire 2.0: cross-cultural translation into Dutch, aspects of validity and linking to the International Classification of Functioning, Disability and Health

Abstract

The Gout Assessment Questionnaire 2.0 (GAQ2.0) is a disease-specific patient-reported outcome measure for gout that distinguishes five different subscales and comprises overall 31 questions. The aims of this study were to translate the GAQ2.0 into Dutch and to test clinimetric properties. Recommendations for translation and cross-cultural adaptation were followed and no cultural adaptations were needed. The resulting Dutch GAQ2.0 was administered to patients registered at the rheumatology outpatient clinic diagnosed with gout. Internal consistency was tested using Cronbach's α, reliability using intraclass correlation coefficient (ICC), content validity by linkage to the International Classification of Functioning, Disability and Health (ICF) and construct validity by correlating the subscales of the GAQ2.0 with the HAQ disability index (HAQ-DI) and 36-item Short Form Health Survey (SF-36). A total of 126 patients [106 (84%) male, mean age 66.6 years (s.d. 10.4), mean disease duration 11.2 years (s.d. 10.6)] completed a number of questionnaires, including the GAQ2.0, HAQ-DI and SF-36, and underwent a clinical examination. Internal consistency was sufficient (Cronbach's α = 0.83-0.94), except for the subscale gout medication side effects (Cronbach's α = 0.51). Test-retest reliability was good (ICCs 0.73-0.86) for all subscales, but moderate for the subscale unmet gout treatment need (ICC 0.56). Gout impact (GI) subscale scores showed only weak to moderate correlations with HAQ-DI and SF-36, but stronger emphasis on the emotional consequences of gout. Also, it correlated better with gout-specific outcomes such as the number of gout flares and pain. The Dutch GAQ2.0 shows sufficient evidence of validity to assess disease-specific functioning and health in patients with gout and seems to capture different aspects than those represented in the HAQ and SF-36.