Crosscultural Measurement Equivalence of the Health Assessment Questionnaire II
Article first published online: 30 MAY 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 6, pages 1000–1004, June 2013
How to Cite
Oude Voshaar, M. A. H., Glas, C. A. W., ten Klooster, P. M., Taal, E., Wolfe, F. and van de Laar, M. A. F. J. (2013), Crosscultural Measurement Equivalence of the Health Assessment Questionnaire II. Arthritis Care Res, 65: 1000–1004. doi: 10.1002/acr.21919
- Issue published online: 30 MAY 2013
- Article first published online: 30 MAY 2013
- Accepted manuscript online: 6 DEC 2012 12:00AM EST
- Manuscript Accepted: 16 NOV 2012
- Manuscript Received: 17 APR 2012
- Dutch Arthritis Association. Grant Number: project number 11-1-203
To evaluate the crosscultural measurement equivalence of the US and Dutch Health Assessment Questionnaire II (HAQ-II) in rheumatoid arthritis (RA).
Item response theory (IRT) analyses were performed on US (n = 18,747) and Dutch (n = 1,022) HAQ-II data to evaluate the equivalence of crosscultural item performance. The observed inconsistencies were modeled by assigning country-specific item parameters to biased items. The impact of crosscultural item bias on the comparability of the Dutch and US total scores was analyzed by evaluating the agreement between physical function levels estimated from an IRT model with country-specific item parameters for biased items and physical function levels estimated from the original model that did not account for cultural bias.
Two items showed significant crosscultural bias. However, the agreement in physical function estimates between the respecified and original models was very high, with an intraclass correlation coefficient >0.99 and Bland-Altman limits of agreement ranging from −0.08 to −0.01 on a latent scale with a mean of 0 and an SD of 1.
This study suggests that the Dutch and US HAQ-II produce total scores that can be interpreted interchangeably across countries in RA studies, despite some minor bias at the item level.