Quality of Life Research

, 15:1383 | Cite as

Single-factor scoring validation for the Health Assessment Questionnaire-Disability Index (HAQ-DI) in patients with systemic sclerosis and comparison with early rheumatoid arthritis patients

  • Jason C. Cole
  • Dinesh Khanna
  • Philip J. Clements
  • James R. Seibold
  • Donald P. Tashkin
  • Harold E. Paulus
  • Michael R. Irwin
  • Sarosh J. Motivala
  • Daniel E. Furst
  • and on behalf of the Scleroderma Lung Study (SLS) and Relaxin Study
Original Paper



Structural validity for the Health Assessment Questionnaire-Disability Index (HAQ-DI) has recently been provided for patients with rheumatoid arthritis (RA). The goal of the current study was to examine the structural validity of the HAQ-DI in patients with systemic sclerosis (SSc, scleroderma) and to compare its performance with that in patients with RA.


The HAQ-DI structural validity was first assessed in a sample of 100 scleroderma patients using confirmatory factor analysis. Second, the similarity of factor structures between SSc patients (n = 291) and RA patients (n = 278) was tested using a multigroup structural validity model to assure that comparison of scores between these two diagnostic groups is appropriate.


Results yielded a single-factor HAQ-DI score which favored the current scoring system of the HAQ-DI (model fit was CFI = 0.99 and RMSEA = 0.04). Moreover, even the most stringent model of multigroup structural validity affirmed the similarity between SSc and RA patients on the HAQ-DI (model fit was CFI = 0.99 and RMSEA = 0.04) nor was it different from a model without any demands on group similarity: CFI difference = 0.007; χ2 = 4.29, df = 26, p=0.99.


The current results indicate that a single-factor HAQ-DI is appropriate for future clinical trials in scleroderma and, in addition, HAQ-DI scores among patients with SSc and early RA can be compared legitimately with one another.

Key words

Confirmatory factor analysis HAQ-DI Latent analysis Rheumatoid arthritis Systemic sclerosis 



Dr. Khanna was supported in part by the Arthritis and Scleroderma Foundations (Physician Scientist Development Award), the Scleroderma Foundation (New Investigator Grant), a National Institutes of Health K12 BIRWCH Scholar Award, the Scleroderma Clinical Trials Consortium, and the Scleroderma Lung Study by Grant No. UO1 HL60587.


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Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Jason C. Cole
    • 1
    • 2
  • Dinesh Khanna
    • 3
    • 4
    • 5
  • Philip J. Clements
    • 6
  • James R. Seibold
    • 7
  • Donald P. Tashkin
    • 8
  • Harold E. Paulus
    • 6
  • Michael R. Irwin
    • 9
  • Sarosh J. Motivala
    • 9
  • Daniel E. Furst
    • 6
  • and on behalf of the Scleroderma Lung Study (SLS) and Relaxin Study
  1. 1.Consulting Measurement GroupHuntington BeachUSA
  2. 2.QualityMetricLincolnUSA
  3. 3.Division of Immunology, Department of MedicineUniversity of CincinnatiCincinnatiUSA
  4. 4.Institute for the Study of HealthUniversity of CincinnatiCincinnatiUSA
  5. 5.Veterans Affairs Medical CenterCincinnatiUSA
  6. 6.Division of Rheumatology, Department of MedicineUniversity of California, Los Angeles – David Geffen School of Medicine at UCLALos AngelesUSA
  7. 7.Division of RheumatologyUniversity of Michigan Scleroderma ProgramAnn ArborUSA
  8. 8.Division of Pulmonary and Critical Care Medicine, Department of MedicineUniversity of California, Los Angeles – David Geffen School of Medicine at UCLALos AngelesUSA
  9. 9.University of California, Los Angeles – Cousins Center for PsychoneuroimmunologyLos AngelesUSA

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