Regarding our paper Measuring health related quality of life in patients with rheumatoid arthritis — reliability, validity and responsiveness of a Swedish version of the RAQoL (1). First of all we want to point out that when performing the translation and evaluation of RAQoL we were not aware of any other Swedish translation. Moreover, a Swedish version had not previously been published. Very unfortunately, we did not observe the statement in the original publication of RAQoL that permission to translate and use the instrument was requested. It was really not our intention to violate this rule. We are very sorry for all bother we have caused you. However, we feel in spite of this that we have to comment on some issues related to our scientific approach, which is questioned by McKenna and Hedin. Our translation was performed according to common practice (the back translation did not change the phrasing). Our panel consisted of an experienced rheumatoid arthritis (RA) team and patients were interviewed face-to-face. The psychometric properties regarding reliability and validity were similar to the original version of RAQoL (2), giving evidence that the translation procedure was acceptable — although not exactly as outlined by the developers. In fact, a main finding in our study was that RAQoL had good psychometric properties. The factor analysis was suggested by one of the reviewers and, as pointed out in our paper, it was performed despite the fact that the items were not highly correlated. As could be expected, no useful factor solution was obtained confirming — as also stated by McKenna and Hedin — the satisfactory construct validity of RAQoL. RAQoL is a measure of quality of life (QoL) based on a new concept, the need-based model. In our paper RAQoL was incorrectly classified as a disease-specific health-related quality of life (HQoL) instrument, which was not according the aim of the developers. We do agree with the definition of QoL as a reflection of the way in which patients perceive and react to their health status and to other nonmedical aspects of their lives (3), but do not find this very much divergent from the WHO definition of HQoL (4). We also agree, as stated in our paper, that health status instruments intended to measure HQoL have their shortcomings. However, in our opinion the Nottingham Health Profile (NHP) could not solely be considered a measure of functional impairment and disability, as social and emotional features are also included. In fact, our regression models showed that disease-state factors — mainly disability — explained only about half of the variance. This was also the case for RAQoL. It therefore doesn’t seem to be a confusion of concepts to compare responsiveness of RAQoL and NHP. In the responsiveness analyses we chose to use the total score derived from NHP Part 1. This approach reduces faults caused by multiple comparisons and, furthermore, the total score seems to be more sensitive to changes over time (5, 6). A disadvantage of a summated score is that the clinical relevance of a change is difficult to interpret. However, if the first analysis with total scores yields significant results, a second analysis of changes in different subscales could be performed. In a recent study of treatment effects of etanercept and infliximab, we have used this procedure to evaluate the impact on HQoL of these drugs. NHP total scores decreased significantly, and further analysis showed that all measured dimensions of QoL, including emotional and social aspects, showed remarkable improvement (7). Evaluation of the relation between changes in disease state and possible changes in QoL was performed in a longitudinal observational study over 6‐12 months (1). Many patients had a fairly stable disease course and effect sizes were small. Despite this, we did find a certain responsiveness that was fairly equal for RAQoL and NHP. We concluded that our findings did not support the suggestion that a disease-specific QoL measure should be more sensitive to change than a generic instrument, such as NHP. The results might, of course, have been different in an intervention study. However, one previous study of a small number of patients receiving methotrexate showed no differences in responsiveness between RAQol and NHP (8). Improvement of QoL is the main goal in the management of RA-patient’s, and thus an extremely important outcome measure. A patient’s perceived QoL is a very complex interaction between many