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Validity and reliability of the Health Assessment Questionnaire among patients with spondyloarthritis in Singapore
Author(s) -
Kwan Yu Heng,
Fong Warren,
Lui Nai Lee,
Yong Si Ting,
Cheung Yin Bun,
Malhotra Rahul,
Thumboo Julian,
Østbye Truls
Publication year - 2018
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12989
Subject(s) - medicine , reliability (semiconductor) , axial spondyloarthritis , validity , physical therapy , family medicine , ankylosing spondylitis , psychometrics , clinical psychology , sacroiliitis , power (physics) , physics , quantum mechanics
Aim The Health Assessment Questionnaire ( HAQ ) is a popular tool used to measure disability. Few studies have assessed its psychometric properties in patients with spondyloarthritis (SpA). We therefore aimed to assess the reliability and validity of the HAQ in patients with SpA in Singapore. Method Cross‐sectional data from a registry of 196 patients with SpA recruited from a dedicated tertiary referral clinic in Singapore from 2011 to 2014 was used. Analyses were guided by the CO nsensus‐based Standards for the selection of health Measurement IN struments ( COSMIN ) framework. Internal consistency reliability was assessed using Cronbach's alpha. Convergent construct validity was assessed by 30 a priori hypotheses through correlation of the summary score and the eight domain scores of the HAQ with other health outcome measures: Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ), Bath Ankylosing Spondylitis Functional Index ( BASFI ), Bath Ankylosing Spondylitis Global Score ( BASG ), pain, Patient's Global Assessment ( PGA ) and Short Form‐36 Health Survey ( SF ‐36). Divergent construct validity was assessed by poor correlation of HAQ with SF ‐36 Mental component score ( MCS ). Results Among 196 patients (155 males [79.1%] median [range] age: 36 [17–70]; 166 Chinese [84.7%]), the HAQ showed a high internal consistency of 0.78–0.84. Convergent validity was supported by achieving 26 out of the 30 a priori hypotheses. Divergent validity was also established‐ correlation of SF ‐36 MCS with seven domains and summary scores of the HAQ were not statistically significant. Conclusion This study supports the HAQ as a valid and reliable measure of disability for use in patients with SpA.