Further Development of a Physical Function Scale on a Multidimensional Health Assessment Questionnaire for Standard Care of Patients with Rheumatic Diseases

THEODORE PINCUS, TUULIKKI SOKKA, and HANNU KAUTIAINEN

ABSTRACT.

Objective. To analyze a further version of the Multidimensional Health Assessment Questionnaire (MDHAQ) with 10 activities of daily living (ADL), which is more easily completed by patients and scored by health professionals than a 14-ADL MDHAQ; and to determine if the 10-ADL MDHAQ would be as informative as the 14-ADL MDHAQ, the 20-ADL HAQ, and the 8-ADL modified HAQ (MHAQ), which is more easily reviewed and scored than the HAQ, but scores are routinely 0.3–0.5 units lower than HAQ scores.

Methods. In standard care, 144 consecutive patients completed a HAQ, which includes a MHAQ, and 14-ADL MDHAQ, which includes a 10-ADL MDHAQ subscale, all scored 0–3. These scales were analyzed for mean and median scores, Cronbach's alpha to estimate internal consistency, factor analysis to estimate construct validity, and cumulative percentile scores.

Results. Mean (median) scores for the HAQ, MHAQ, 14-ADL MDHAQ, and 10-ADL MDHAQ physical function scales were 0.80 (0.75), 0.48 (0.38), 0.83 (0.79), and 0.73 (0.70), respectively. Internal consistency of each scale was very good. The lowest 25 percentile score was 0.16 on the HAQ, 0.0 on the MHAQ, 0.36 on the 14-ADL MDHAQ, and 0.20 on the 10-ADL MDHAQ.

Conclusion. The MDHAQ physical function scale of 10 ADL is more easily completed and scored than the 14-ADL MDHAQ or 20-ADL HAQ, while providing similar information. (J Rheumatol 2005;32:1432-9)

Key Indexing Terms:

MULTIDIMENSIONAL HEALTH ASSESSMENT QUESTIONNAIRE
ASSESSMENT
VALIDITY
RELIABILITY
RHEUMATOID ARTHRITIS
ACTIVITIES OF DAILY LIVING

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From the Division of Rheumatology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; Jyväskylä Central Hospital, Jyväskylä, Finland; and the Rheumatism Foundation Hospital, Heinola, Finland.

Supported in part by grants from the Arthritis Foundation, Aventis, Amgen, Pfizer, and the Jack C. Massey Foundation.

T. Pincus, MD, Vanderbilt University; T. Sokka, MD, PhD, Vanderbilt University and Jyväskylä Central Hospital; H. Kautiainen, BA, Rheumatism Foundation Hospital.

Address reprint requests to Dr. T. Pincus, Division of Rheumatology and Immunology, Vanderbilt University School of Medicine, 203 Oxford House, Box 5, Nashville, TN 37232-4500. E-mail: t.pincus@vanderbilt.edu

Accepted for publication April 5, 2005.

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