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FRI0748-HPR Cross-cultural validation of the portuguese “rheumatoid arthritis impact of disease” score: cross-sectional study
  1. RJO Ferreira1,2,
  2. L Gossec3,
  3. S Hewlett4,
  4. C Duarte1,5,
  5. JK Nicklin4,
  6. JAP da Silva1,5,
  7. M Ndosi4
  1. 1Centro Hospitalar e Universitário de Coimbra
  2. 2UICiSA:E, Escola Superior Enfermagem de Coimbra, Coimbra, Portugal
  3. 3Paris 06 University, Paris, France
  4. 4University of the West of England, Bristol, United Kingdom
  5. 5Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal


Background The Rheumatoid Arthritis Impact of Disease (RAID) score1 assesses 7 impact domains of interest for people with rheumatoid arthritis (RA). Its use in research and clinical practice has been growing, and it is already translated into over 70 languages2 but the cross-cultural validity of the Portuguese RAID has not been well established.

Objectives To validate the Portuguese RAID for use in Portugal.

Methods This was a single centre, cross-sectional validation study involving 2 phases: (i) cognitive debriefing with 38 patients to determine comprehension of the existing2 Portuguese RAID (ii) cross-cultural validation using data from adult patients who were willing and able to complete the Portuguese RAID unaided. Analyses included fit to the Rasch model (implying construct validity, reliability and statistical sufficiency), tests for unidimensionality and invariance across different patient subgroups i.e. age, gender, education background, disease duration, function and culture. To test invariance to culture, the Portugal dataset was compared with datasets from France (n=195) and the UK (n=205).3 RUMM2030 software was used in all analyses.

Results Phase I led to minor changes in phrasing 3 items to enhance understanding and conceptual equivalence between the original RAID and the Portuguese version. In Phase II, 288 patients were included: mean (SD) age=60 (12) years, 82% females, 76% with disease duration ≥5 years, 30% on biologics. The Portuguese RAID was shown to have adequate fit to the Rasch model and high internal consistency (Table 1). Unidimensionality and invariance to age, gender, disease duration and function were confirmed (data not shown). The scale was well targeted for patients with different levels of disease impact (Figure 1). Pooling the datasets from Portugal, France and the UK revealed no cultural response bias (Table 1). RAID was then calibrated into logit-based scores to enable parametric analyses and bias-free cross-cultural comparisons if desired (data not shown).

Table 1.

Results of Rasch analysis from pooled data

Conclusions This study confirms the Portuguese RAID as a robust unidimensional tool for use in Portugal. The raw scores of the 7-item RAID can be used with confidence in clinical practice. Conversion charts are available to enable accurate cross-cultural comparisons across Portugal, France and the UK.


  1. Gossec L, et al. Ann Rheum Dis, 2011;70:935–42.

  2. EULAR RAID and PsAID Questionnaires. Available from Accessed 25th Jan. 2017.

  3. Hewlett S, et al. Ann Rheum Dis, 2015;74:Suppl 2:559.


Disclosure of Interest None declared

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