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01-11-2010 | Uitgave 9/2010 Open Access

Quality of Life Research 9/2010

Application of the health assessment questionnaire disability index to various rheumatic diseases

Quality of Life Research > Uitgave 9/2010
Maaike M. van Groen, Peter M. ten Klooster, Erik Taal, Mart A. F. J. van de Laar, Cees A. W. Glas



To investigate whether the Stanford Health Assessment Questionnaire Disability Index (HAQ-DI) can serve as a generic instrument for measuring disability across different rheumatic diseases and to propose a scoring method based on item response theory (IRT) modeling to support this goal.


The HAQ-DI was administered to a cross-sectional sample of patients with confirmed rheumatoid arthritis (n = 619), osteoarthritis (n = 125), or gout (n = 102). The results were analyzed using the generalized partial credit model as an IRT model.


It was found that 4 out of 8 item categories of the HAQ-DI displayed substantial differential item functioning (DIF) over the three diseases. Further, it was shown that this DIF could be modeled using an IRT model with disease-specific item parameters, which produces measures that are comparable for the three diseases.


Although the HAQ-DI partially functioned differently in the three disease groups, the measurement regarding the disability level of the patients can be made comparable using IRT methods.

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