Validation of the HAQ-UP-A (Health Assessment Questionnaire-Upper Limbs-Argentine Version) in patients with rheumatoid arthritis

Abstract

HAQ is considered the gold standard for the evaluation of functional capacity in patients with rheumatoid arthritis (RA), even though it does not focus in any particular anatomical region. With the objective of assessing functional disability of the hand in elderly patients with osteoarthritis, Baron et al. used a modified version of the HAQ which was calculated as the mean value for those categories involving mostly upper extremities and named it ‘HAQ-UP’. This instrument has not been validated in patients with RA. ObjetiveTo valídate HAQ-UP argentine version in patients with RA. MethodsCross-sectional study. Consecutive patients ≥ 18 years with diagnosis of RA (ACR/EULAR 2010) were included. Socio-demographic data and RA characteristics were recorded. Questionnaires were administered: HAQ-A, HAQ-UP-A, FIHOA, Quick DASH. The reproducibility of the questionnaire was assessed. ResultsA total of 100 patients were included, 83% women, mean age 57.9 years (SD 11.6). Cronbach's alpha test was 0.94. The intra-item correlation did not show redundant questions. HAQ-UP-A showed excellent correlation with HAQ-A (r=0.93); FIHOA (r=0.89) and Quick DASH (r=0.91). It also showed good correlation with DAS28-ESR (r=0.68) and other composite disease activity indices as well as with other parameters of the disease. There was no correlation between HAQ-UP-A and disease duration. The reproducibility of the questionnaire was 0.82. Multiple linear regression adjusted for age and sex showed patient global VAS as the main determinant of HAQ-UP-A, followed by the presence of morning stiffness. ConclusionHAQ-UP-A was found to be reliable, valid and reproducible in patients with RA, representing a useful tool for the evaluation of the functional capacity of the upper limbs in these patients.