Development and validation of the health assessment questionnaire II - A revised version of the Health Assessment Questionnaire
Development and validation of the health assessment questionnaire II - A revised version of the Health Assessment Questionnaire
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DOI：
10.1002/art.20549
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发表时间：
2004-10-01
影响因子：
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通讯作者：
Pincus, T
中科院分区：
文献类型：
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作者：
Wolfe, F;Michaud, K;Pincus, T
Objective.健康评估问卷（HAQ）已成为测量风湿病学功能状态的最常用工具。然而，HAQ很长（34个问题，包括20个关于日常生活活动的问题和14个关于使用辅助工具和设备的问题），评分有些繁琐，有一些地板效应，并且有线性和混淆项目相关的心理测量问题。我们进行了这项研究，以开发和验证修订版的HAQ（HAQ-II）。使用Rasch分析和31个问题的条目库，包括20个HAQ项目，10个项目的HAQ-II。HAQ的五个原始项目被保留。我们对14，038例风湿性疾病患者进行了为期2年的HAQ-II研究，以确定其有效性和可靠性。HAQ-II是可靠的（可靠性为0.88，相比之下，HAQ为0.83），在比HAQ更长的量表上测量残疾，没有不合适的项目，也没有差距。与HAQ、改良HAQ和医学结局研究简表36身体功能量表相比，HAQ-II与临床和结局变量相关性良好或更好。HAQ-II在临床试验和预测死亡率和工作残疾方面表现良好。HAQ和HAQ-II评分之间的平均差异为0.02个单位。HAQ-II是一种可靠有效的10项问卷，其表现至少与HAQ一样好，并且更易于管理和评分。从HAQ转换为HAQ-II和从HAQ-II转换为HAQ用于研究目的简单可靠。HAQ-II可用于目前使用HAQ的所有地方，并且可能证明在临床上更容易使用。
Objective. The Health Assessment Questionnaire (HAQ) has become the most common tool for measuring functional status in rheumatology. However, the HAQ is long (34 questions, including 20 concerning activities of daily living and 14 relating to the use of aids and devices) and somewhat burdensome to score, has some floor effects, and has psychometric problems relating to linearity and confusing items. We undertook this study to develop and validate a revised version of the HAQ (the HAQ-II).Methods. Using Rasch analysis and a 31-question item bank, including 20 HAQ items, the 10-item HAQ-II was developed. Five original items from the HAQ were retained. We studied the HAQ-II in 14,038 patients with rheumatic disease over a 2-year period to determine its validity and reliability.Results. The HAQ-II was reliable (reliability of 0.88, compared with 0.83 for the HAQ), measured disability over a longer scale than the HAQ, and had no nonfitting items and no gaps. Compared with the HAQ, modified HAQ, and Medical Outcomes Study Short Form 36 physical function scale, the HAQ-II was as well correlated or better correlated with clinical and outcome variables. The HAQ-II performed as well as the HAQ in a clinical trial and in prediction of mortality and work disability. The mean difference between the HAQ and HAQ-II scores was 0.02 units.Conclusion. The HAQ-II is a reliable and valid 10-item questionnaire that performs at least as well as the HAQ and is simpler to administer and score. Conversion from HAQ to HAQ-II and from HAQ-II to HAQ for research purposes is simple and reliable. The HAQ-II can be used in all places where the HAQ is now used, and it may prove to be easier to use in the clinic.