| Name of the Instrument/Tool | Health Assessment Questionnaire for the Spondyloarthropaties (HAQ-S) |
| First Description |
Daltroy LH, Larson MG, Roberts NW, Liang MH. A modification of the Health Assessment Questionnaire for the spondyloarthropathies. J Rheumatol 1990;17(7):946–50. |
| Year | 1990 |
| Domains | |
| Concept of constructs | Physical function |
| Population/Disease | Disease specific |
| Originally developed for | Ankylosing spondylitis (AS), Axial Spondyloarthritis |
| Other rheumatic diseases where can be applied (only if validated) |
--- |
| Additional population with no rheumatic diseases |
No |
| Language: Originally published in | English |
| Available in Language | English, Turkish, Spanish, Finnish, Portuguese |
| REFERENCE IDENTIFICATION | |
| Author/s | Daltroy LH |
| Title | A modification of the Health Assessment Questionnaire for the spondyloarthropathies. |
| Journal | J Rheumatol |
| Year | 1990 |
| Vol | 17 |
| Num | 7 |
| Pages | 946-50 |
| Country | United States |
| Language | English |
| Other references of interest | |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/10493677 |
| Brief Description |
Comparative responsiveness of 3 functional indices in ankylosing spondylitis. |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/9918252 |
| Brief Description |
Validity and sensitivity to change of spondylitis specific measures of functional disability. |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/7362664 |
| Brief Description |
Brief description: Measurement of patient outcome in arthritis - HAQ-DI article. |
| Instrument/Tool Translations References | |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/2213762 |
| Brief Description |
A modification of the Health Assessment Questionnaire for the spondyloarthropathies (original English version). |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/7641514 |
| Brief Description |
Factors related to change in global health after group physical therapy in ankylosing spondylitis (Dutch). |
| Link | http://www.ncbi.nlm.nih.gov/pubmed/7857999 |
| Brief Description |
Continuation of group physical therapy is necessary in ankylosing spondylitis: results of a randomized controlled trial (Dutch). |
| DEVELOPER CONTACT INFORMATION | |
| Correspondence to | Professor Mathew Liang |
| mhliang@bics.bwh.harvard.edu | |
| Address | 5 Francis Street, Department of Rheumatology Brigham & Women’s Hospital, Boston, MA 02115 |
| Website | --- |
| Available | --- |
| Links |
The HAQ 20-item disability scale is available at http://patienteducation.stanford.edu/research/haq20.html. The 5 extra questions are outlined in the original HAQ-S manuscript |
| DESCRIPTION OF THE INSTRUMENT | |
| Type Of Measure | Questionnaire |
| Brief Description |
Patient self-administered questionnaire used to assess the physical functioning of an individual with ankylosing spondylitis/axial SpA. The HAQ-S is an adaptation of the Health Assessment Questionnaire (HAQ) that includes five items specific to axSpA |
| Number of Items | 25 items (20 from HAQ-DI and 5 unique to HAQ-S) |
| Range | 0-3 |
| Responses options/scale |
Yes Responses are 0 = able to do with no difficulty; 1 = able to do with some difficulty; 2 = able to do with much difficulty; and 3 = unable to do. |
| Developed for | Both |
| PRACTICAL APPLICATION | |
| Method of administration | Self-administered |
| Recommendations to score |
Score each category by the highest score within that category. Do not score if 25% items are missing. If any "aids or devices" and/or "help from another person" item is checked, upscore to “2” the category to which they apply (unneeded if the score is already "2" or "3"). The total score is = (sum of the categories / number of answered categories). Do not score if >2categories are missing. |
| Score Interpretation | --- |
| Cut-off points | --- |
| Cut-off points applied to | --- |
| Smallest detectable change if described | --- |
| Smallest detectable change applied to | --- |
| Completion time by the patient | - minutes |
| Scoring time by the assessor | - minutes |
| Training to score | Need to get used to the scoring. |
| Strengths | Useful in clinical practice & research, Widely used |
| Limitations | Floor effect |
| MEASUREMENT PROPERTIES | |
| Limitations | >=5 European languages (English) |
| Observations | --- |
| 1. RELIABILITY | |
| A. Internal Consistency | Not Tested |
| Cronbach's (Describe) | --- |
| B. Reliability intraobserver or test-retest | Tested |
| Continuous scores: intraclass correlation coefficient (ICC) Dichotomus: Cohen kappa (Describe) |
Test–retest showed stability between time 1 and time 3, with Pearson’s correlation coefficient given as r = 0.92. ICC not reported. |
| C. Reliability interobserver or Measurement error | Not Tested |
| Standard error of measurement (SEM), smallest detectable change (SDC) or Limits of agreement (LoA) (Describe) |
--- |
| 2. VALIDITY | |
| A. Content validity: face validity | Tested |
| Expert opinion (relevance and comprehensiveness) (Describe) |
The existing HAQ-DI was adapted for use in spondylarthritis patients by adding 5 disease-specific items, determined by the investigators (methods not given).
The original HAQ was felt to show good face validity related to the difficulties with activities of daily living reported by a group of 300 British AS patients. |
| B. Construct Validity: Structural validity |
Not Tested |
| Brief Description | --- |
| Hypotheses-testing | Tested |
| Brief Description |
HAQ-S is highly correlated with the original HAQ-DI (Spearman’s correlation coefficient 0.96), and moderately correlated with other measures of physical functioning, the Dougados Functional Index (r = 0.64) and the generic instrument, Arthritis Impact Measurement Scales (r = 0.80). Correlations are less strong with physical limitations (including cervical rotation, r = -0.50; Schober’s test, r = -0.36). |
| Cross-cultural validity | Not Tested |
| Brief Description | --- |
| C. Criterion validity | Not Tested |
| Comparison with a 'gold standard' Continuous scores: correlations, ROC curves Dichotomus: Sensitivity & Specificity (Describe) |
--- |
| 3. RESPONSIVENESS | |
| Responsiveness | Tested |
| Ability to detect change over time Multiple methods (Describe) |
Responsiveness statistics for the HAQ-S show an effect size (ES) of 0.20 (moderate) and standardized response mean (SRM) of 0.28 for improvement, and an ES of 0.28 and SRM of 0.72 for deterioration in a cohort of AS patients treated with non-steroidal anti-inflammatory drugs. |
| 4. INTERPRETABILITY | |
| Interpretability | Tested |
| of responders with the highest/lowest score Minimal important difference (MID) (Describe) |
There is a floor effect with score clustering at the normal (0) end of the scale described. |
| OTHER COMMENTS | |
| Other Comments |
This measure has been used in some registries to monitor axSpA symptoms |
| OUTCOME MEASURE | |
| Outcome Measure |
For further information, please contact the developers. HAQ-S |
| Document 1 |
HAQ-S_IEnglish in Appendix |