Health Assessment Questionnaire (original) (raw)

2013, Encyclopedia of Behavioral Medicine

Questionnaire (HAQ) was originally developed in 1978 by James F. Fries, MD, and colleagues at Stanford University. It was one of the first self-report functional status (disability) measures and has become the dominant instrument in many disease areas, including arthritis. It is widely used throughout the world and has become a mandated outcome measure for clinical trials in rheumatoid arthritis and some other diseases. The initial paper, published in 1980 (see key journal references at end of this document), has been the most cited article in the rheumatology literature. A 1995 review discusses more than 200 publications on the reliability, validity, and its applicability in multiple settings and languages. The present number of citations (see website-to be completed in September, 2000) is in excess of 400. Purpose The HAQ was developed as a comprehensive measure of outcome in patients with a wide variety of rheumatic diseases, including rheumatoid arthritis, osteoarthritis, juvenile rheumatoid arthritis, lupus, scleroderma, ankylosing spondylitis, fibromyalgia, and psoriatic arthritis. It has also been applied to patients with HIV/AIDS and in studies of normal aging. It should be considered a generic rather than a disease-specific instrument. Its focus is on self-reported patient-oriented outcome measures, rather than process measures. User Permission The HAQ is copyrighted only so that it will be used unmodified, thus preserving the validity of results, and so that we retain a record of use. However, we consider the HAQ to be in the public domain, with the request that users cite relevant HAQ articles(s) in their publications (see key journal references at the end of this document and the website for the complete articles). There is no charge for permission. GENERAL QUESTIONNAIRE DESCRIPTION While the HAQ disability and pain scales are often referred to as "The HAQ", long term outcome assessment best includes the Full Five-Dimension HAQ, which is a comprehensive outcome measure that assesses a hierarchy of patient outcomes in four domains: 1) disability, 2) discomfort and pain, 3) drug side effects (toxicity) and 4) dollar costs. Death, while obviously not a self-report outcome, is a requisite part of the conceptual model of patient outcome. In the United States, this is usually accomplished using the National Death Index. Alternatively, the first two domains, which comprise the HAQ Disability Index and Pain Scale can be used independently and frequently are. The drug toxicity sections and the economic impact sections undergo periodic changes; the disability, pain, and patient global areas have been maintained as constant since 1983. The domain of disability is assessed by the eight categories of dressing, arising, eating, walking, hygiene, reach, grip, and common activities. Discomfort is determined by the presence of pain and its severity. Specific drug-associated side effects are classified according to their severity and whether the drug was