Validation of French version of the Scleroderma Health Assessment Questionnaire (SSc HAQ)

Abstract

The modified Scleroderma Health Assessment Questionnaire (SSc HAQ) is a functional score to assess systemic sclerosis (SSc) comprising the HAQ disease index (HAQ-DI) plus five specific visual analogue scales (VAS). Since it was validated in English-speaking patients only, its general use in any other language necessitates prior cross-cultural adaptation and validation. We designed this study to assess its value in French-speaking patients and to validate the French version according to international recommendations. We elaborated a French version using the "forward-backward" method. We then validated its psychometric properties with 100 consecutive SSc French-speaking patients who had undergone simultaneous clinical and paraclinical examination. In addition, we calculated the SSc HAQ score, a new outcome measure, which is obtained by pooling the eight domains from the HAQ-DI with the five organ VAS. Our study confirmed the psychometric properties of the SSc HAQ in non-English-speaking patients with (a) structural validity: the major component analysis, performed on the HAQ-DI and the five VAS, yielding a two-factor structure; (b) convergent validity: with high correlation coefficients between the SSc HAQ score and the physical component score of the SF-36 (r=-0.74, p<0.0001); (c) discriminant validity: the SSc HAQ score was better in patients with limited than with diffuse SSc (0.5+/-0.5 vs 1.1+/-0.7, respectively, p<0.0001) in relation to the number of clinical involvements; (d) reproducibility was high using the test-retest procedure (r=0.98). This study showed the value of the SSc HAQ, which is a simple, discriminant, reproducible self-administered questionnaire to evaluate French-speaking SSc patients. In addition, we suggest the use of a new outcome measure, the SSc HAQ score, to assess this systemic disease more accurately.

Assessing disability and quality of life in systemic sclerosis: Construct validities of the Cochin Hand Function Scale, Health Assessment Questionnaire (HAQ), Systemic Sclerosis HAQ, and Medical Outcomes Study 36‐Item Short Form Health Survey

“…The HAQ and sHAQ both comprise 20 items divided into 8 domains, and the sHAQ has 5 additional domains (scored on a visual analog scale [VAS]) assessing disability induced by SSc symptoms. The aggregate score of the sHAQ is calculated as follows: the 5 VAS scores are converted to a continuous scale from 0 to 3, and the aggregate score is obtained by adding the 8 HAQ domain scores with the 5 VAS converted scores and the sum is divided by 13 (15).…”

Translation and cross-cultural adaptation of the Scleroderma Health Assessment Questionnaire to Brazilian Portuguese

“…In the study by Georges et al, 10 the mean age was 50 years; 76% of the participants were women and 24% were men. The female gender predominates because this disease affects women more.…”

“…This method has also been used in previous studies. 7,14,15 In the study by Steen et al, 9 who created SHAQ, and 10 The addition of these five VASs addressing the symptoms of systemic scleroderma makes SHAQ a specific questionnaire that assesses function in patients with this disease. 18 The VAS relating to Raynaud's phenomenon was not validated in the original questionnaire, but was administered in the study by Georges et al 10 in order to validate the French version of SHAQ.…”

“…In contrast, no changes had to be made to the French version of the SHAQ. 10 In characterizing the sample, the mean age of the 20 participants was 43.7 years; 90% were women and 10% were men.…”

“…[8][9][10] Like HAQ, SHAQ is made up of 20 items distributed among eight domains and has five additional domains that assess dysfunctions caused by the symptoms of systemic scleroderma. For this, five visual analogue scales (VASs) are used.…”