Single-factor scoring validation for the Health Assessment Questionnaire-Disability Index (HAQ-DI) in patients with systemic sclerosis and comparison with early rheumatoid arthritis patients |
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| Authors: | Jason C. Cole Dinesh Khanna Philip J. Clements James R. Seibold Donald P. Tashkin Harold E. Paulus Michael R. Irwin Sarosh J. Motivala Daniel E. Furst |
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| Affiliation: | (1) Consulting Measurement Group, Huntington Beach, CA, USA;(2) QualityMetric, Lincoln, RI, USA;(3) Division of Immunology, Department of Medicine, University of Cincinnati, Cincinnati, OH, USA;(4) Institute for the Study of Health, University of Cincinnati, Cincinnati, OH, USA;(5) Veterans Affairs Medical Center, Cincinnati, OH, USA;(6) Division of Rheumatology, Department of Medicine, University of California, Los Angeles – David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;(7) Division of Rheumatology, University of Michigan Scleroderma Program, Ann Arbor, MI, USA;(8) Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, Los Angeles – David Geffen School of Medicine at UCLA, Los Angeles, CA, USA;(9) University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Los Angeles, CA, USA;(10) Consulting Measurement Group, 7071 Warner Ave., #F-400, Huntington Beach, CA 91403, USA |
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| Abstract: | Objective Structural validity for the Health Assessment Questionnaire-Disability Index (HAQ-DI) has recently been provided for patients with rheumatoid arthritis (RA). The goal of the current study was to examine the structural validity of the HAQ-DI in patients with systemic sclerosis (SSc, scleroderma) and to compare its performance with that in patients with RA.Methods The HAQ-DI structural validity was first assessed in a sample of 100 scleroderma patients using confirmatory factor analysis. Second, the similarity of factor structures between SSc patients (n = 291) and RA patients (n = 278) was tested using a multigroup structural validity model to assure that comparison of scores between these two diagnostic groups is appropriate.Results Results yielded a single-factor HAQ-DI score which favored the current scoring system of the HAQ-DI (model fit was CFI = 0.99 and RMSEA = 0.04). Moreover, even the most stringent model of multigroup structural validity affirmed the similarity between SSc and RA patients on the HAQ-DI (model fit was CFI = 0.99 and RMSEA = 0.04) nor was it different from a model without any demands on group similarity: CFI difference = 0.007; χ2 = 4.29, df = 26, p=0.99.Conclusion The current results indicate that a single-factor HAQ-DI is appropriate for future clinical trials in scleroderma and, in addition, HAQ-DI scores among patients with SSc and early RA can be compared legitimately with one another. |
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| Keywords: | Confirmatory factor analysis HAQ-DI Latent analysis Rheumatoid arthritis Systemic sclerosis |
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