Assessing disability and quality of life in systemic sclerosis: Construct validities of the Cochin Hand Function Scale,Health Assessment Questionnaire (HAQ), Systemic Sclerosis HAQ,and Medical Outcomes Study 36‐Item Short Form Health Survey |
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| Authors: | François Rannou Serge Poiraudeau Alice Berezné Thierry Baubet Véronique Le‐guern Jean Cabane Loïc Guillevin Michel Revel Jacques Fermanian Luc Mouthon |
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| Affiliation: | 1. Assistance Publique‐H?pitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France;2. Dr. Poiraudeau has received consulting fees (less than $10,000 each) from Sanofi‐Aventis and Pfizer. Dr. Guillevin has received consulting fees (more than $10,000) from Wyeth. Dr. Mouthon has received consulting fees (less than $10,000 each) from Laboratoire Fran?ais du Fractionnement Biologique et des Biotechnologies and Pfizer.;3. Assistance Publique‐H?pitaux de Paris and Avicenne Hospital, Paris 13 University, Bobigny, France;4. Assistance Publique‐H?pitaux de Paris, Saint‐Antoine Hospital, Paris 6 University, Paris, France;5. Assistance Publique‐H?pitaux de Paris, Necker Hospital, Paris 5 University, Paris, France |
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| Abstract: | Objective To assess the construct validity of the Cochin Hand Function Scale (CHFS) and the relevance of using aggregate scores for the scleroderma Health Assessment Questionnaire (sHAQ) and Medical Outcomes Study 36‐Item Short Form Health Survey (SF‐36) in systemic sclerosis (SSc). Methods We evaluated 50 patients with SSc (mean ± SD age and disease duration 54 ± 12 years and 9 ± 8 years, respectively), of which 26 had limited cutaneous SSc (lcSSc) and 23 diffuse SSc (dSSc). Quality of life was assessed by the SF‐36, global disability by the Health Assessment Questionnaire (HAQ) and sHAQ, and hand disability by the CHFS. Construct validity was assessed by convergent and divergent validity (Spearman's rank correlation coefficient) and factor analysis. Results The CHFS had good construct validity and its total score explained 75% of the variance of the HAQ. The HAQ had better construct validity than the aggregate sHAQ and their scores correlated well (r = 0.88). The aggregate sHAQ was no better than the HAQ in discriminating between lcSSc and dSSc. SF‐36 physical and mental components had acceptable convergent and divergent validity. Factor analysis of the 8 subscales extracted 3 factors explaining 72% of the variance, which differed from the a priori stratification with physical and mental subscales extracted in the same factor. Conclusion In patients with SSc, the CHFS has good construct validity, the HAQ should be preferred over the aggregate sHAQ for assessing physical functioning, and use of SF‐36 physical and mental components aggregate scores is questionable. |
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| Keywords: | Systemic sclerosis Quality of life Outcome measures Validity Health assessment Disability |
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