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Measurement bias in different versions of the Dutch Health Assessment Questionnaire Disability Index
  1. Martijn A H Oude Voshaar1,
  2. Peter M ten Klooster1,
  3. Harald E Vonkeman2,
  4. Wietske Kievit3,
  5. Piet L C M van Riel3,
  6. Mart A F J van de Laar2
  1. 1 Department of Psychology, Health and Technology, Arthritis Centre Twente, University of Twente, Enschede, The Netherlands
  2. 2 Department of Rheumatology and Clinical Immunology, Arthritis Centre Twente, Medical Spectrum Twente, Enschede, The Netherlands
  3. 3 Department of Rheumatic Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands

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The Health Assessment Questionnaire (HAQ) Disability Index is the most frequently used and validated measure of physical function for patients with rheumatoid arthritis (RA).1 Various translated versions of this questionnaire have been used in clinical research in the Netherlands. In 2007, a standardised translation, the Dutch consensus HAQ, was introduced and a letter detailing its development appeared in this journal.2 The Dutch DREAM registry,3 a multicentre observational cohort study that monitors RA patients undergoing different treatment regimens, soon adopted the consensus HAQ.

The consensus HAQ differs in a number of ways from the previously used version that was developed in Nijmegen.4 Differences include the handling and number of aids and the translation of item 13: ‘are you able to reach and get down a 5-pound object (such as …

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