Development of a multi-dimensional health assessment questionnaire (MDHAQ) for the infrastructure of standard clinical care

T. Pincus¹, Y. Yazici², M. Bergman³

¹Vanderbilt University, Nashville, Tennessee; ²New York University Medical Center, Hospital for Joint Diseases, New York, New York; ³Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.

ABSTRACT
The HAQ has become the pre-eminent patient questionnaire used in rheumatology. It is easily completed by patients, but not easily reviewed and scored in standard clinical care and has some minor psychometric limitations, as do all questionnaires. Modifications of the HAQ been made to facilitate use in standard care, particularly to include 8-10 activities of daily living, along with scores for pain and global status and other information on one side of one page for rapid review by the clinician. A patient questionnaire for standard care should be limited to 2 sides of 1 page, in a format amenable to “eyeball” review by the clinician in 5 seconds or less. It can be scored formally in 15-20 seconds or less, and is useful in patients with all rheumatic diseases.
The current version of a multi-dimensional HAQ (MDHAQ) includes scoring templates on the questionnaire to allow formal scoring in less than 15 seconds by a rheumatologist or an assistant, for possible entry onto a paper and/or computerized flow sheet. Various versions of the MDHAQ may also include a "constant" region of physical function, pain and patient global status, and "variable" regions of fatigue, morning stiffness, psychological distress, change in status, a review of systems, a rheumatoid arthritis disease activity self-report joint count (RADAI), review of recent health events, and review of medications. The MDHAQ can be used in the infrastructure of rheumatology care to include quantitative data in standard care of all patients with all rheumatic diseases.

Key words
MDHAQ, HAQ, activities of daily living.

Supported in part by grants from the Arthritis Foundation, the Jack C. Massey Foundation and Abbott Immunology.
Theodore Pincus, MD; Yusuf Yazici, MD; Martin Bergman, MD.
Please address correspondence to: Theodore Pincus, MD, Professor of Medicine, Division of Rheumatology and Immunology, Vanderbilt University School of Medicine, 203 Oxford House, Box 5, Nashville, TN 37232-4500, USA.
E-mail: t.pincus@vanderbilt.edu

Clin Exp Rheumatol 2005; 23 (suppl. 39): S19-S28.
© CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2005.