scholarly journals EP41 The Multidimensional Health Assessment Questionnaire (MDHAQ) and the Heath Assessment Questionnaire Disability Index (HAQDI): a comparison in patients with psoriatic arthritis

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Weiyu Ye ◽  
Simon Hackett ◽  
Claire Vandevelde ◽  
Sarah Twigg ◽  
Laura C Coates
Keyword(s):  
Health Assessment Questionnaire ◽  
Health Assessment ◽  
Retest Reliability ◽  
Bland Altman Method ◽  
Floor Effects ◽  
The Mean ◽  
Test Retest Reliability ◽  
Multidimensional Health ◽  
Assessment Questionnaire ◽  
Questionnaire Disability

Abstract Background We compared the Health Assessment Questionnaire Disability Index (HAQDI) and the simpler Multidimensional Health Assessment Questionnaire (MDHAQ) in patients with psoriatic arthritis (PsA), and examined whether either questionnaires are less prone to ‘floor effects’, whereby patients report normal scores despite experiencing functional impairment. Methods Data were collected prospectively across three UK hospital trusts from 2018-2019. All patients completed the MDHAQ, HAQDI and PsA Impact of Disease Questionnaire (PsAID) in a single clinic visit. A subset were given an identical pack to complete one week later. The HAQ questionnaires are scored from 0-3, and the PsAID is scored from 0-10. The PsAID has a validated patient acceptable symptom state (PsAID≤4) to stratify high-impact and low-impact disease. Mean with standard deviation (S.D.) was calculated and variability was assessed using the Bland-Altman method. Intraclass correlation coefficients (ICC, two-way mixed model absolute agreement) was used to assess test-retest reliability. Using pilot data, we calculated that 210 patients were required to detect non-inferiority between the HAQ questionnaires, with a 0.125 margin at a two-sided 0.025 significance level with > 90% power. All analyses were performed using R. This study was approved by London-Surrey Research Ethics Committee. Results 210 patients completed the study; one withdrew consent thus 209 were analysed. 62 patients completed the questionnaires one week later. 60.0% were male, mean age was 51.7 years, and median PsA duration was 7.0 years. In clinic, mean (S.D.) scores on the MDHAQ, HAQDI including/excluding aids, and PsAID were 0.58 (0.64), 0.79 (0.78), 0.70 (0.73), and 3.71 (2.70), respectively. The mean HAQDI tends to be higher than the MDHAQ, for both high and low-impact disease. However, the difference between the two mostly lies within 1.96 S.D. of the mean using the Bland-Altman method, suggesting reasonable agreement. Comparing clinic and 1-week scores, the ICCs for the MDHAQ, HAQDI including/excluding aids, and PsAID were 0.97 (95% CI 0.95-0.98), 0.98 (0.97-0.99), 0.98 (0.96-0.99), and 0.96 (0.93-0.97) respectively, suggesting excellent test-retest reliability. Patients scoring ‘0’ in MDHAQ and HAQDI including/excluding aids were similar (48, 47, 49). Using a score of ≤ 0.5 for low functional impairment, 23 patients had a MDHAQ ≤ 0.5 when their HAQDI including aids > 0.5. This reduced to 17 when using HAQDI excluding aids > 0.5. In contrast, 4 patients had a HAQDI including aids ≤ 0.5 when MDHAQ > 0.5. This increased to 5 patients when using HAQDI excluding aids ≤ 5. Collectively, this suggests the HAQDI is less prone to floor effects compared to the MDHAQ, especially when the score incorporates aids. Conclusion The MDHAQ and HAQDI scores show test-retest reliability and reasonable agreement in patients with PsA. Although the MDHAQ is quicker for patients to complete, it appears more prone to floor effects. Disclosures: W. Ye: None. S. Hackett: None. C. Vandevelde: None. S. Twigg: None. L.C. Coates: None.

Measuring physical function in psoriatic arthritis: comparing the Multi-Dimensional Health Assessment Questionnaire to the Health Assessment Questionnaire Disability Index

2021 ◽  
pp. jrheum.200927
Author(s):  
Weiyu Ye ◽  
Simon Hackett ◽  
Claire Vandevelde ◽  
Sarah Twigg ◽  
Philip S. Helliwell ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Physical Function ◽  
Health Assessment Questionnaire ◽  
Health Assessment ◽  
Clinic Visit ◽  
Retest Reliability ◽  
Floor Effects ◽  
Test Retest Reliability ◽  
Assessment Questionnaire ◽  
Questionnaire Disability

Objective To compare physical function scales of the Multi-Dimensional Health Assessment Questionnaire (MDHAQ) to the Health Assessment Questionnaire Disability Index (HAQDI) in patients with psoriatic arthritis (PsA), and examine whether either questionnaire is less prone to ‘floor effects’. Methods Data were collected prospectively from 2018 to 2019 across three UK hospitals. All patients completed physical function scales within the MDHAQ and HAQDI in a single clinic visit. Agreement was assessed using medians and the Bland-Altman method. Intraclass correlation coefficients (ICCs) were used to assess test-retest reliability. Results 210 patients completed the clinic visit; one withdrew consent thus 209 were analysed. 60.0% were male, with mean age of 51.7 years and median disease duration of 7 years. In clinic, median MDHAQ and HAQDI including/excluding aids scores were 0.30, 0.50 and 0.50 respectively. Although the median score for HAQDI is higher than MDHAQ, the difference between the two mostly lies within 1.96 standard deviations from the mean suggesting good agreement. The ICCs demonstrated excellent test-retest reliability for both HAQ questionnaires.Similar numbers of patients scored ‘0’ on the MDHAQ and HAQDI including/excluding aids (48, 47, and 49 respectively). Using a score of ≤0.5 as a cut-off for minor functional impairment, 23 patients had a MDHAQ ≤0.5 when their HAQDI including aids >0.5. Conversely, 4 patients had a MDHAQ > 0.5 when the HAQDI including aids ≤0.5. ConclusionBoth HAQ questionnaires appear to be similar in detecting floor effects in patients with PsA.

scholarly journals PNS53 Population Normative DATA for the Health Assessment Questionnaire Disability INDEX in Hungary

2020 ◽  
Vol 23 ◽  
pp. S652
Author(s):  
M. Péntek ◽  
G. Poór ◽  
V. Brodszky ◽  
Z. Zrubka ◽  
L. Gulácsi ◽  
...  
Keyword(s):  
Health Assessment Questionnaire ◽  
Normative Data ◽  
Health Assessment ◽  
Assessment Questionnaire ◽  
Questionnaire Disability

scholarly journals Fibromyalgia Assessment Screening Tool: Clues to Fibromyalgia on a Multidimensional Health Assessment Questionnaire for Routine Care

2019 ◽  
Vol 47 (5) ◽  
pp. 761-769 ◽  
Author(s):  
Kathryn A. Gibson ◽  
Isabel Castrejon ◽  
Joseph Descallar ◽  
Theodore Pincus
Keyword(s):  
Health Assessment Questionnaire ◽  
Health Assessment ◽  
Area Under The Curve ◽  
Routine Care ◽  
Self Report ◽  
Screening Tools ◽  
Symptom Checklist ◽  
Painful Joint ◽  
Multidimensional Health ◽  
Assessment Questionnaire

Objective.To develop feasible indices as clues to comorbid fibromyalgia (FM) in routine care of patients with various rheumatic diseases based only on self-report multidimensional Health Assessment Questionnaire (MDHAQ) scores, which are informative in all rheumatic diagnoses studied.Methods.All patients with all diagnoses complete an MDHAQ at each visit; the 2011 FM criteria questionnaire was added to the standard MDHAQ between February 2013 and August 2016. The proportion of patients who met 2011 FM criteria or had a clinical diagnosis of FM was calculated. Individual candidate MDHAQ measures were compared to 2011 FM criteria using receiver-operating characteristic (ROC) curves; cutpoints to recognize FM were selected from the area under the curve (AUC) for optimal tradeoff between sensitivity and specificity. Cumulative indices of 3 or 4 MDHAQ measures were analyzed as fibromyalgia assessment screening tools (FAST).Results.In 148 patients, the highest AUC in ROC analyses versus 2011 FM criteria were seen for MDHAQ symptom checklist, self-report painful joint count, pain visual analog scale (VAS), and fatigue VAS. The optimal cutpoints were ≥ 16/60 for symptom checklist, ≥ 16/48 for self-report painful joint count, and ≥ 6/10 for both pain and fatigue VAS. Cumulative FAST indices of 2/3 or 3/4 MDHAQ measures correctly classified 89.4–91.7% of patients who met 2011 FM criteria.Conclusion.FAST3 and FAST4 cumulative indices from only MDHAQ scores correctly identify most patients who meet 2011 FM criteria. FAST indices can assist clinicians in routine care as clues to FM with a general rheumatology rather than FM-specific questionnaire.

scholarly journals Validating and Assessing the Sensitivity of the Health Assessment Questionnaire-Disability Index-derived Short Form-6D in Patients with Early Aggressive Rheumatoid Arthritis

2009 ◽  
Vol 36 (6) ◽  
pp. 1150-1157 ◽  
Author(s):  
SOGOL S. AMJADI ◽  
PAUL M. MARANIAN ◽  
HAROLD E. PAULUS ◽  
ROBERT M. KAPLAN ◽  
VEENA K. RANGANATH ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Construct Validity ◽  
Health Assessment Questionnaire ◽  
Short Form ◽  
Health Assessment ◽  
Correlation Coefficients ◽  
Patient Reported ◽  
Clinical Measures ◽  
Assessment Questionnaire ◽  
Questionnaire Disability

Objective.New methodologies allow the scores for the Health Assessment Questionnaire-Disability Index (HAQ-DI) to be translated into preferences/utility scores. We evaluated the construct validity of the HAQ-DI-derived Short Form-6D (SF-6D) score and assessed its responsiveness to change over 6- and 12-month followup periods in patients with early aggressive rheumatoid arthritis (RA).Methods.Patients (n = 277) participating in an RA observational study completed self-reported measures of symptoms and the HAQ-DI at baseline and at 6 and 12 months. Total Sharp scores, C-reactive protein, and erythrocyte sedimentation rate were assessed along with clinical data. Construct validity was assessed by examining the association between SF-6D score and patient-reported and clinical measures using Spearman correlation coefficients. The responsiveness of SF-6D to change was assessed using patient and physician assessments of the disease as clinical anchors. The magnitude of responsiveness was calculated using SF-6D effect size (ES).Result.Mean SF-6D scores were 0.690, 0.720, and 0.723 at baseline and 6 and 12-month followup, respectively. Baseline patient-reported measures had moderate to high correlations with baseline SF-6D (r = 0.43 to 0.52); whereas clinical measures had negligible to low correlations with SF-6D (r = 0.001 to 0.32). ES was moderate for the groups that were deemed to have improved (ES 0.63–0.75) but negligible to small for those that did not (ES 0.13–0.46).Conclusion.Our data support the validity and responsiveness of the HAQ-DI derived SF-6D score in an early RA cohort. These results support the use of the HAQ-DI derived SF-6D in RA cohorts and clinical trials lacking preference-based measures.

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