Health Assessment Questionnaire Disability Index (HAD-QI)

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Introduction

The Health Assessment Questionnaire - Disability Index (HAQ-DI) measures health related quality of life factors in various parts of a illness or injury process, and is not focused towards a single disease or disorder. It was designed to measured patient centered and patient assessed outcomes, and can be useful in conditions or life stages such as normal ageing, therapy of rheumatoid arthritis, developing risk factor models of osteoarthritis, and examination of mortality risk in rheumatoid arthritis. It is a self-assessment tool used to measure functional ability in eight different areas: rising, dressing and grooming, hygiene, eating, walking, reach, grip, and activities of independent living.

It was developed in the 1980s, addressing general patient centered outcomes. It was It has been administered by the Stanford Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) many times to assess clinical status, deem the effectiveness in clinical and observational trials, and outline health qualifiers. It has been adopted by the American College of Rheumatology for measuring physical function in rheumatoid arthritis studies.

What is the HAQ-DI & Why use it

The HAD-QI is a quantitative tool used to assess health related quality of life assessments related to many types of injuries or illnesses. Since it was adopted through rheumatology, it can be known to only classify diseases, but as mentioned it is used across varies. Instead of being classified as 'disease specific', it should be classified as 'generic', since it it assesses the dimensions of death, disability, drug side effects, discomfort, and economic costs.

Measuring or assessing Health related quality of life is important at any stage of any condition or or injury. A valid and reliable tool, which can measure and assess over long periods greater than 6 weeks, is needed for such a measurement.

What it measures

The full version of the HAQ collects information of five patient-centered categories, to:

• Avoid Disability
• Be free of Pain and Discomfort
• Avoid adverse Treatment Effects
• Keep dollar costs of treatments low
• Prevent the likelihood of Death

The questionnaire also includes sections on drug side effects, medical costs, and other sections on demographics, lifestyle, and health behaviors.

The most commonly used version is the HAQ, which is the 'short' or 22-page version. This version includes the HAQ Disability Index (HAQ-DI), the HAQ Visual Analog Scale (VAS) for pain, and the VAS patient global health scale.

The disability assessment component of the HAQ, making it the HAQ-DI, measures the patient's capacity for functional tasks. This collects information on fine motor skills of the upper limb, locomotion of the lower limb, and activities that jointly involve movement of the upper and lower limbs.

There are 20 questions which span eight categories, and account for different functional activities. These eight categories include rising, dressing and grooming, hygiene, eating, walking, reach, grip, and activities of independent living. These items are asked in terms of a span over the previous week. The patient responds on a scale of 0 (no disability) to 3 (completely disabled). There are at least two questions from each category.

HAQ VAS Pain Scale

This scale was developed to assess the presence and severity of arthritis related pain. The intention is to gather information from the patient on their experience of the pain over the previous week, although this pain may vary between days. There are two VAS scales which are scored from 0 (no pain) to 3 (intense pain) or 0 (no pain) to 100 (intense pain). THis is generally used in experimental, observational, and clinical settings.

Other Dimensions of the full

THe full HAQ also collects information on Drug Toxicity. Such information includes the name or type of drug, dosage and frequency taken, period of time drug was in use, specific side effects experienced, degree of severity of these side effects, the importance of the drug to the patient, and drug course as a result of the side effect.

Limitations

There are a few limitations noted in regards to the HAQ-DI.

It does not account for non-visible disabilities such as sensory organ dysfunctions, and psychiatric dysfunctions. It also does not collect information about patient or personal satisfaction and social activity.

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