COSMIN database

Measurement properties of physical function scales validated for use in patients with rheumatoid arthritis: a systematic review of the literature

Oude Voshaar, M. A., ten Klooster, P. M., Taal, E., and van de Laar, M. A.
BACKGROUND: The aim of this study was to systematically review the content validity and measurement properties of all physical function (PF) scales which are currently validated for use with patients with rheumatoid arthritis (RA).

METHODS: Systematic literature searches were performed in the Scopus and PubMed databases to identify articles on the development or psychometric evaluation of PF scales for patients with RA. The content validity of included scales was evaluated by linking their items to the International Classification of Functioning Disability and Health (ICF). Furthermore, available evidence of the reliability, validity, responsiveness, and interpretability of the included scales was rated according to published quality criteria.

RESULTS: The search identified 26 questionnaires with PF scales. Ten questionnaires were rated to have adequate content validity. Construct validity, internal consistency, test-retest reliability and responsiveness was rated favourably for respectively 15, 11, 5, and 6 of the investigated scales. Information about the absolute measurement error and minimal important change scores were rarely reported.

CONCLUSION: Based on this literature review, the disease-specificHAQ and the generic SF-36 can currently be most confidently recommended to measure PF in RA for most research purposes. The HAQ, however, was frequently associated with considerable ceiling effects while the SF-36 has limited content coverage. Alternative scales that might be better suited for specific research purposes are identified along with future directions for research
Health Qual Life Outcomes
Publication year:
Functional status:
Physical functioning
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the musculoskeletal system and connective tissue
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
AIMS2 - Arthritis Impact Measurement Scales 2   
AIMS2-SF - Arthritis Impact Measurement Scales-Short Form
AIMS - Arthritis Impact Measurement Scales (versions; sAIMS; shortened AIMS)
BI - Barthel Index   
CSHQ-RA - Cedars-Sinai Health Related Quality of Life for Rheumatoid Arthritis instrument (Also: CSHQ-RA Revised - Cedars-Sinai Health Related Quality of Life for Rheumatoid Arthritis instrument Revised)
CSSRD-FAS - Cooperative Systematic Studies for Rheumatic Diseases group Functional Assessment Survey,
FFbH (Also FFbH-R) - Funktionsfragenbogen, Hannover [alias: Hannover Functional Ability Questionnaire]
FSI - Functional Status Index   
GARS - Groninger Activity Restriction Scale   
HAQ - Health Assessment Questionnaire (versions:MHAQ - Modified HAQ; HAQ-II)   
HAQ-II - Health Assessment Questionnaire II
IRGL - Impact of Arthritis on Health and Lifestyle / Invloed van Rheuma op Gezondheid en Leefwijze   
MDHAQ - Multidimensional Health Assessment Questionnaire (10-ADL and 14-ADL versions)
MHI (Q) - McMaster Health Index (Questionnaire)
NHP - Nottingham Health Profile   
ROAD - Recent Onset Arthritis Disability Questionnaire,
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
SIP-RA - Sickness Impact Profile for Rheumatoid Arthritis
SIP - Sickness Impact Profile (versions: SIP-8; SIP-68; SIP-136; SIP-SV; UKSIP)   
TFCQ - Toronto Functional Capacity Questionnaire
WHODAS II - World Health Organization Disability Assessment Schedule II (versions: WHODAS-12)