Clinical Rheumatology

, Volume 14, Issue 1, pp 15–20 | Cite as

Quality of life assessment: a comparison of four questionnaires: for measuring improvements after total hip replacement

  • M. Borstlap
  • J. L. Zant
  • R. M. Van Soesbergen
  • J. K. Van Der Korst


Three experimental questionnaires were compared with the Influence of Rheumatic Diseases on Health and Lifestyle (IRGL) questionnaire, a Dutch version of the Arthritis Impact Measurement Scales. Sixty-two patients with osteoarthritis (OA) and 35 patients with rheumatoid arthritis (RA), all of whom underwent hip arthroplasty, completed the study.

Results showed that visual analogue scales for pain, stiffness, fatigue, and anxiety were strongly correlated with a number of the IRGL scales.

Patient preference scales were sensitive to change and provided additional information on aspects of the patients' quality of life (QOL) that were felt to be important by the patients themselves. The questionnaire on performance in various roles in life was insensitive to change.

In existing questionnaires, there is an attempt to represent the concept of QOL in terms of its most important aspects. Such realizations of the concept of QOL are not entirely suitable for application in clinical trials. The IRGL is overly complex, and its sometimes comprehensive scales do not deal with the possible effects of treatment. Neither of these properties is conducive to sensitivity to change. Visual analogue scales reduce the complexity. A simpler representation of QOL that can evaluate aspects relevant to treatment is recommended.

Key words

Total Hip AIMS Visual Analogue Scales Rheumatoid Arthritis Osteoarthritis 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Bergner, M. Measurement of health status. Med Care 1985, 23, 696–704.Google Scholar
  2. 2.
    Bell, M.J., Bombardier, C., Tugwell, P. Measurement of functional status, quality of life, and utility in rheumatoid arthritis. Arthritis Rheum 1990, 33, 591–601.Google Scholar
  3. 3.
    Bergner, M., Bobbitt, R.A., Carter, W.B. The Sickness Impact Profile: development and final revision of a health status measure. Med Care 1981, 19, 787–805.Google Scholar
  4. 4.
    Hunt, S., McKenna, S., McEwen, J., Williams, J., Papp, E. The Nottingham Health Profile: subjective health status and medical consultations, Soc Sci Med 1981, 15A, 221–229.Google Scholar
  5. 5.
    Chambers, L.W., MacDonald, L.A., Tugwell, P., Buchanan, W.W., Kraag, G. The McMaster Health Index questionnaire as a measure of quality of life for patients with rheumatoid arthritis. J. Rheumatol, 1982, 9, 780–784.Google Scholar
  6. 6.
    Walker, S.R., Rosser, R.M. Quality of Life: Assessment and Application. London, MTP press 1988, 205–222.Google Scholar
  7. 7.
    Mason, J.H., Weener, J.L., Gertman, P.M., Meenan, R.F. Health status in chronic disease: A comparative study of rheumatoid arthritis. J. Rheumatol 1983, 10, 763–768.Google Scholar
  8. 8.
    Ahlmen, E.M., Bengtsson, C.B., Sullivan, B.M., Bjelle, A. A comparison of overall health between patients with rheumatoid arthritis and a population with and without rheumatoid arthritis. Scand J Rheumatol 1990, 19, 413–421.Google Scholar
  9. 9.
    Meenan, R.F., Anderson, J.J., Kazis, L.E., Egger, M.J., Altz-Smith, M., Samuelson, C.O., Willkens, R.F., Solsky, M.A., Hayes, S.P., Blocka, K.L., Weinstein, A., Guttadauria, M., Kaplan, S.B., Klippel, J. Outcome assessment in clinical trials; Evidence for the sensitivity of health status measure. Arthritis Rheum 1984, 27, 1344–1352.Google Scholar
  10. 10.
    Kazis, L.E., Meenan, R.F., Anderson, J.J. Pain in the rheumatic diseases; investigation of a key health status component. Arthritis Rheum 1983, 26, 1017–1022.Google Scholar
  11. 11.
    Meenan, R.F., Gertman, P.M., Mason, J.H., Dunaif, R. The arthritis impact measurement scales; further investigations of a health status measure. Arthritis Rheum 1982, 25, 1048–1053.Google Scholar
  12. 12.
    Feinstein, A.R., Josephy, B.R., Wells, C.K. Scientific and clinical problems in indexes of functional disability. Ann Intern Med 1986, 105, 413–420.Google Scholar
  13. 13.
    Huiskes, C.J.A.E., Kraaimaat, F.W., Bijksma, J.W.J. Development of a self-report questionnaire to assess the impact of rheumatic diseases on health and lifestyle. J Rehabilitation Sciences 1990, 3, 65–70.Google Scholar
  14. 14.
    de Witte, L.P., Tilli, D.J.P., Ticheler, A.J.G., Winants, B.A.C., van der Horst, F.G., van der Linden, Sj. Leven met een reumatische aandoening. Hoensbroek, 1989.Google Scholar
  15. 15.
    Tugwell, P., Bombardier, C., Buchanan, W.W., Goldsmith, C., Grace, E., Hanna, B. The MACTAR patient preference disability questionnaire: an individualized functional priority approach for assessing improvement in physical disability in clinical trials in rheumatoid arthritis. J Rheumatol 1987, 14, 446–451.Google Scholar
  16. 16.
    Tugwell, P., Bombardier, C., Buchanan, W.W., Goldsmith, C., Grace, E., Benneth, K.J., Williams, H.J., Egger, M., Alarcon, G.S., Guttadauria, M., Yarboro, C., Polisson, R.P., Szydlo, L., Luggen, M.E., Billingsley, L.M., Ward, J.R., Marks, C. Methotrexate in rheumatoid arthritis, impact on quality of life assessed by traditional standard-item and individualized patient preference health status questionnaires. Arch Intern Med 1990, 150, 59–62.Google Scholar
  17. 17.
    Wiersma, D., de Jong, A., Ormel, J., Kraaijkamp, H.J.M. De Groningse sociale beperkingenschaal; manual (handleiding). Rijksuniversiteit Groningen 1986.Google Scholar
  18. 18.
    de Jonge, H., Rumke, C.L., van Strik, R. Medische Statistiek (medical statistics). Free University of Amsterdam 1981.Google Scholar
  19. 19.
    Siegel, S., Castellan, N.J. Jr. Nonparametric statistics for the behavioral sciences, 1988.Google Scholar
  20. 20.
    Borstlap, M., Zant, J.L., van Soesbergen, R.M., van der Korst, J.K. Effects of total hip replacement on quality of life in patients with osteoarthrosis and patients with rheumatoid arthritis. Clin Rheumatol 1994, 13, 45–50.Google Scholar
  21. 21.
    de Neeling, J.N.D. Quality of Life: Het onderzoek naar welzijnseffecten van medische behandelingen. Utrecht, Bunge, 1991.Google Scholar
  22. 22.
    Kazis, L.E., Callahan, L.F., Meenan, R.F., Pincus, T. Health status reports in the care of patients with rheumatoid arthritis. J Clin Epidemiol 1990, 43, 1243–1253.Google Scholar
  23. 23.
    Huskisson, E.C. Measurement of pain. J Rheumatol 1982, 9, 768–769.Google Scholar
  24. 24.
    Hekert, J. Semi-structured interviews in 10 patients with rheumatoid arthritis. (not published).Google Scholar
  25. 25.
    Burckhardt, C.S. The impact of arthritis on quality of life. Nurs Res 1985, 34, 11–16.Google Scholar
  26. 26.
    Meenan, R.F., Mason, J.H., Anderson, J.J., Guccione, A.A., Kazis, L.E. AIMS 2: The content and properties of a revised and expanded arthritis impact measurement scales health status questionnaire. Arthritis Rheum 1992, 35, 1–10.Google Scholar
  27. 27.
    Liang, M.H., Larson, M.G., Cullen, K.E., Schwartz, J.A. Comparative measurement efficiency and sensitivity of five health status instruments for arthritis research. Arthritis Rheum 1985, 28, 542–547.Google Scholar

Copyright information

© Acta Medica Belgica 1995

Authors and Affiliations

  • M. Borstlap
    • 1
  • J. L. Zant
    • 1
  • R. M. Van Soesbergen
    • 1
  • J. K. Van Der Korst
    • 1
  1. 1.Centre for Rheumatology and RelabilitationJan van Breemen InstituteAmsterdamThe Netherlands

Personalised recommendations