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ORIGINAL ARTICLE
Year : 2012  |  Volume : 7  |  Issue : 2  |  Page : 74-82

Validation and usefullness of Indian version (CRD Pune) health assessment questionnaire: Drug trials, community practice and COPCORD Bhigwan population study (1994-2012)


Center for Rheumatic Diseases, Hermes Doctor House, 1988 Convent St., Camp, Pune 411001, India

Correspondence Address:
Arvind Chopra
Center for Rheumatic Diseases, Hermes Doctor House, 1988 Convent St., Camp, Pune 411001
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.1016/j.injr.2012.04.009

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Background: Stanford HAQ (S-HAQ) and several versions are used worldwide to measure physical function. Based on traditions and life style, a maiden Indian version (CRD Pune) was developed and used extensively (1996e2011). We report clinimetric properties and long term use. Methods: The Indian version was finalized in a step wise consensus building process between doctors, community and patients. It remained similar to S-HAQ in basic structure (categories) and score/disability index. Current data was selected from controlled drug trials in active RA, referral community patients (clinic and camps) and WHO ILAR COPCORD (community oriented program for control of rheumatic diseases) Bhigwan. Standard statistics were used; significant p < 0.05. Results: Testeretest and correlation statistics confirmed face and content (Cronbach's index >0.8) and construct validity and reliability at several time points. There was fair to good (0.2e0.6) correlation between Indian HAQ and pain visual analog scale, joint counts for pain/tenderness and swelling, sedimentation rate and radiological score (joint damage). The efficacy variables explained up to 70% variation in HAQ (dependent) regression models. The Indian HAQ scored significantly higher than the S-HAQ but the difference was not clinically relevant. The Indian HAQ was sensitive to change (effect size 0.7) over 24 week treatment with hydroxychloroquin. Generic use in COPCORD survey showed moderately severe HAQ disability in all patient groups including 'ill-defined aches' and soft tissue rheumatism. HAQ improved patient satisfaction. Conclusion: The Indian HAQ (CRD Pune) was a valid and useful patient outcome measure and improved compliance (long term follow up).


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