Evaluation of Measurement Properties of Health Assessment Questionnaire Disability Index (HAQ-DI) among Gout Populations in China
Author(s)
Nuoming Xu, Master candidate1, Tianqi Hong, PhD2, Shitong Xie, PhD1, Jing Wu, PhD1.
1School of Pharmaceutical Science and Technology, Faculty of Medicine, Tianjin University, Tianjin, China, 2School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada.
1School of Pharmaceutical Science and Technology, Faculty of Medicine, Tianjin University, Tianjin, China, 2School of Biomedical Engineering, McMaster University, Hamilton, ON, Canada.
Presentation Documents
OBJECTIVES: Gout is a typical inflammatory arthritis, leading to functional impairments in both the upper and lower limbs of patients. HAQ-DI is a commonly used instrument in gout populations worldwide. The study aimed to evaluate the measurement properties of Health Assessment Questionnaire Disability Index (HAQ-DI) among Chinese gout populations.
METHODS: A representative sample of Chinese gout patients were recruited with stratification based on age, sex, area of residence, and education level. Sociodemographic characteristics, health-related information, and self-reported EQ-5D-5L and HAQ-DI responses were collected through an online survey. Ceiling and floor effects were firstly evaluated. Reliability was assessed by internal consistency (Cronbach’s α). Structural validity was verified by confirmatory factor analysis (CFA). Convergent validity was assessed using Spearman's rank coefficient, examining the correlation between HAQ-DI and EQ-5D-5L. All patients were grouped by the number of chronic diseases (0, 1, 2, ≥3), presence of tophi (yes, no), and other health indicators. Known-group validity was evaluated by determining HAQ-DI score differences between subgroups of each indicator. Effect sizes were then used to assess sensitivity of subgroup differences.
RESULTS: A total of 1,000 patients were included in the study, with 69.7% male and average age of 54.47. 99.4% of patients were on medication. Floor effects were present (14.4%), while no ceiling effects were observed. Cronbach’s α was 0.95. The factor loadings of CFA were above 0.6 and the model fit indices were acceptable (X2/df=5.97, RMSEA=0.071, RFI=0.906, CFI=0.940, TLI=0.920), suggesting that the eight-factor model had well structural validity. The HAQ-DI correlated in predictable ways with five EQ-5D-5L dimensions, with Spearman’s rank coefficient ranging from 0.30 to 0.61. The HAQ-DI can discriminate between subgroups of each indicator, with the mean effect size (0.73) at a medium level.
CONCLUSIONS: The HAQ-DI was verified to have satisfactory reliability, validity, and sensitivity in measuring HRQoL of Chinese gout populations.
METHODS: A representative sample of Chinese gout patients were recruited with stratification based on age, sex, area of residence, and education level. Sociodemographic characteristics, health-related information, and self-reported EQ-5D-5L and HAQ-DI responses were collected through an online survey. Ceiling and floor effects were firstly evaluated. Reliability was assessed by internal consistency (Cronbach’s α). Structural validity was verified by confirmatory factor analysis (CFA). Convergent validity was assessed using Spearman's rank coefficient, examining the correlation between HAQ-DI and EQ-5D-5L. All patients were grouped by the number of chronic diseases (0, 1, 2, ≥3), presence of tophi (yes, no), and other health indicators. Known-group validity was evaluated by determining HAQ-DI score differences between subgroups of each indicator. Effect sizes were then used to assess sensitivity of subgroup differences.
RESULTS: A total of 1,000 patients were included in the study, with 69.7% male and average age of 54.47. 99.4% of patients were on medication. Floor effects were present (14.4%), while no ceiling effects were observed. Cronbach’s α was 0.95. The factor loadings of CFA were above 0.6 and the model fit indices were acceptable (X2/df=5.97, RMSEA=0.071, RFI=0.906, CFI=0.940, TLI=0.920), suggesting that the eight-factor model had well structural validity. The HAQ-DI correlated in predictable ways with five EQ-5D-5L dimensions, with Spearman’s rank coefficient ranging from 0.30 to 0.61. The HAQ-DI can discriminate between subgroups of each indicator, with the mean effect size (0.73) at a medium level.
CONCLUSIONS: The HAQ-DI was verified to have satisfactory reliability, validity, and sensitivity in measuring HRQoL of Chinese gout populations.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PT28
Topic
Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)