Correlates of the disability index of the health assessment questionnaire: A measure of functional impairment in systemic sclerosis

Abstract

Objective. To evaluate functional impairment in systemic sclerosis (SSc) patients with diffuse cutaneous scleroderma at the time of entry into a trial of a therapeutic intervention (D-penicillamine).Methods. The 20-item Disability Index of the Health Assessment Questionnaire (HAQ-DI) was administered to 134 patients as they entered a multicenter trial of high-dose versus low-dose D-penicillamine. All patients had diffuse SSc of <18 months' duration. SSc patients who had severe organ system involvement and recent renal crisis and who were receiving prednisone >10 mg/day were excluded from entry. Logistic regression modeling was used to examine the relationship of HAQ-DI scores to SSc skin and organ system involvement. Odds ratios (OR) and 95% confidence intervals (95% CI) were used to estimate effects. Conclusion. Increased HAQ-DI scores at baseline were correlated with reduced fist closure, reduced handspread, elevated platelet count, presence of tender joints, older age, and female sex. The most important contributor to functional impairment was hand dysfunction. Even within the first 18 months after SSc onset, moderate-severe functional impairment (HAQ-DI scores >1.0) was frequent (53%) in this group of diffuse SSc patients. In early diffuse SSc, the self-administered HAQ-DI is therefore a valuable assessment of function that correlates with objective physical and laboratory

A Cross Sectional Study of Cardiopulmonary Complications and Severity of Pulmonary Hypertension and Lung Fibrosis in Patients With Systemic Sclerosis

“…15,28,29 In our study, the median HAQ score was 0.50 (interquartile range 0.25-0.87). Most of the patients (79.1%) had mild to moderate disability, which was different compared to the study of Clements et al, 30 who reported a mean baseline score of 1.04±0.67, which correlates with moderate to severe disability. We demonstrated a significant correlation between HAQ and FEV 1 /FVC (%) (r=0.439, p=0.007), and also between HAQ and DLCO divided by alveolar volume (r= -0.347, p=0.045).…”

Health values of patients with systemic sclerosis

“…The overall HAQ DI score is determined by summing the highest item score in each of the 8 domains and dividing the sum by 8, yielding a score ranging from 0 (no disability) to 3 (severe disability). In the original HAQ DI, an additional grade of difficulty was added for persons using assistive/adaptive devices (such as a cane or walker); however, as in more recent studies (21,22), we did not modify subjects' responses for use of assistive/adaptive devices.…”

High-dose immunosuppressive therapy and autologous hematopoietic cell transplantation for severe systemic sclerosis: long-term follow-up of the US multicenter pilot study

“…These evaluations included a medical history, physical examination, complete blood count, serum chemistries, autoantibodies (Scl-70, ANA), thyroid function tests, validated standard measurements of the mRSS, pulmonary function testing for FVC and DLCO adj , high-resolution computed tomography (HRCT) scans of the chest, multigated acquisition (MUGA) scan of the heart or echocardiogram for left ventricular ejection fraction (LVEF), and a modified Health Assessment Questionnaire Disability Index (mHAQ-DI). 5,[17][18][19][20][21] An ophthalmologic examination was done at the last study evaluation to assess for cataracts. In a subset of consenting patients, skin biopsies were done after HDIT next to the site of the baseline biopsy.…”