Development and validation of the revised Cedars-Sinai Health-Related Quality of Life for Rheumatoid Arthritis Instrument

C. F. Chiou, C. D. Sherbourne, I. Cornelio, D. P. Lubeck, H. E. Paulus, M. Dylan*, C. H. Chang, M. H. Weisman

*Corresponding author for this work

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objective. To improve accuracy and content coverage of the original 33-item Cedars-Sinai Health-Related Quality of Life for Rheumatoid Arthritis Instrument (CSHQ-RA). Methods. A total of 312 RA patients from 55 sites were screened in a 24-week trial. Patients completed an expanded 48-item version of the CSHQ-RA, Medical Outcomes Study Short Form 36 (MOS SF-36), and Stanford Health Assessment Questionnaire (HAQ) Disability Index at 5 visits. The revised CSHQ-RA was created based on response frequencies and distributions, item-to-item correlation, factor and Rasch analysis, and input from experts. Psychometric evaluation included internal consistency, test-retest reliability, convergent and discriminant validity, and responsiveness. Minimum clinically important difference (MCID) was also measured. Results. Response rates were 93% at baseline and 71% at 12 weeks. Eighty-one percent of respondents at baseline were women, mean ± SD age was 52 ± 12 years, and mean ± SD duration of RA was 10.8 ± 10.4 years. The revised CSHQ-RA included 36 items measuring 7 domains (4 original and 3 new). All Cronbach's alpha coefficients were >0.8, indicating good internal consistency. Test-retest reliability measured intraclass correlation coefficients, which ranged from 0.86 to 0.95. All 7 domains correlated significantly with the MOS SF-36 and HAQ, indicating good convergent validity. Analysis of variance of disability group scores showed good discriminant validity (P < 0.0001). The MCIDs ranged from 6.2 for social well-being to 14.8 for pain/discomfort. Conclusion. The revised CSHQ-RA was validated using a broader RA patient population. It captures 3 additional domains (social well-being, pain/discomfort, and fatigue), which allow for measuring all important aspects of health-related quality of life.

Original languageEnglish (US)
Pages (from-to)856-863
Number of pages8
JournalArthritis Care and Research
Volume55
Issue number6
DOIs
StatePublished - Dec 15 2006

Keywords

  • Instrument validation
  • Quality of life
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Rheumatology

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