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Cross-cultural adaptation and validation of the Chinese version of the Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S)

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Abstract

The Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S) is a commonly used questionnaire to evaluate function and health status of patients with ankylosing spondylitis (AS). The objective of this study was to cross-culturally adapt the HAQ-S into Chinese and then to evaluate its reliability and validity. The Chinese version of the HAQ-S was obtained with a five-step procedure of translation and cross-cultural adaptation. All invited patients met the New York criteria for AS, and a total of 103 patients finally participated in this study. Intraclass correlation coefficient (ICC) was used to evaluate the test-retest and inter-rater reliability of the HAQ-S. Internal consistency of the questionnaire was evaluated by Cronbach’s alpha coefficient. Spearman’s correlation coefficient was calculated to assess the construct validity between the HAQ-S and Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), and the laboratory parameters (erythrocyte sedimentation rate, ESR; C-reactive protein, CRP). Test-retest and inter-rater reliability were excellent with intraclass correlation coefficients of 0.987 (p < 0.05) and 0.982 (p < 0.05), respectively. The overall internal consistency of the HAQ-S was found satisfactory (Cronbach’s alpha = 0.914). The Chinese version of the HAQ-S correlated good with the BASFI (r = 0.749, p < 0.01), and moderate with the BASDAI (r = 0.581, p < 0.01) and the BASMI (r = 0.425, p < 0.01). But, the adapted questionnaire correlated poorly with ESR (r = 0.298, p < 0.01) or CRP (r = 0.283, p < 0.01). The Chinese version of the HAQ-S is reliable and valid for the evaluation of Chinese-speaking patients with AS.

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Acknowledgements

The authors thank all the patients participating in the study.

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Author notes

  1. DeLin Liu, Chen Zhang, and Chen Wang contributed equally to this work as co-first authors

  2. Weidong Xu and Jia Li contributed equally to this work as co-corresponding authors

Authors and Affiliations

  1. Department of Orthopedics, Changhai Hospital, Second Military Medical University, No 168, Changhai Road, Shanghai, 200433, China

    DeLin Liu, Chen Zhang, Chen Wang, Jia Li & Weidong Xu

  2. Department of General Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China

    Jiao Liu

  3. Department of Orthopedics, The Eighty-eighth Military Hospital, Hushan Road 6, Tai’an, China

    DaHe Li

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  1. DeLin Liu
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  2. Chen Zhang
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  3. Chen Wang
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  4. Jiao Liu
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  5. DaHe Li
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  6. Jia Li
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Correspondence to Jia Li or Weidong Xu.

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Written informed consent was obtained from each patient, and the study was approved by the ethics committee of Second Military Medical University.

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Liu, D., Zhang, C., Wang, C. et al. Cross-cultural adaptation and validation of the Chinese version of the Health Assessment Questionnaire for the Spondyloarthropathies (HAQ-S). Clin Rheumatol 36, 2027–2033 (2017). https://doi.org/10.1007/s10067-017-3759-6

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  • DOI: https://doi.org/10.1007/s10067-017-3759-6

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