Assessing disability and quality of life in systemic sclerosis: Construct validities of the Cochin Hand Function Scale, Health Assessment Questionnaire (HAQ), Systemic Sclerosis HAQ, and Medical Outcomes Study 36-Item Short Form Health Survey†
François Rannou
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Search for more papers by this authorSerge Poiraudeau
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Dr. Poiraudeau has received consulting fees (less than $10,000 each) from Sanofi-Aventis and Pfizer. Dr. Guillevin has received consulting fees (more than $10,000) from Wyeth. Dr. Mouthon has received consulting fees (less than $10,000 each) from Laboratoire Français du Fractionnement Biologique et des Biotechnologies and Pfizer.
Search for more papers by this authorAlice Berezné
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Search for more papers by this authorThierry Baubet
Assistance Publique-Hôpitaux de Paris and Avicenne Hospital, Paris 13 University, Bobigny, France
Search for more papers by this authorVéronique Le-guern
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Search for more papers by this authorJean Cabane
Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris 6 University, Paris, France
Search for more papers by this authorLoïc Guillevin
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Dr. Poiraudeau has received consulting fees (less than $10,000 each) from Sanofi-Aventis and Pfizer. Dr. Guillevin has received consulting fees (more than $10,000) from Wyeth. Dr. Mouthon has received consulting fees (less than $10,000 each) from Laboratoire Français du Fractionnement Biologique et des Biotechnologies and Pfizer.
Search for more papers by this authorMichel Revel
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Search for more papers by this authorJacques Fermanian
Assistance Publique-Hôpitaux de Paris, Necker Hospital, Paris 5 University, Paris, France
Search for more papers by this authorCorresponding Author
Luc Mouthon
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Dr. Poiraudeau has received consulting fees (less than $10,000 each) from Sanofi-Aventis and Pfizer. Dr. Guillevin has received consulting fees (more than $10,000) from Wyeth. Dr. Mouthon has received consulting fees (less than $10,000 each) from Laboratoire Français du Fractionnement Biologique et des Biotechnologies and Pfizer.
Department of Internal Medicine, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, FranceSearch for more papers by this authorFrançois Rannou
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Search for more papers by this authorSerge Poiraudeau
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Dr. Poiraudeau has received consulting fees (less than $10,000 each) from Sanofi-Aventis and Pfizer. Dr. Guillevin has received consulting fees (more than $10,000) from Wyeth. Dr. Mouthon has received consulting fees (less than $10,000 each) from Laboratoire Français du Fractionnement Biologique et des Biotechnologies and Pfizer.
Search for more papers by this authorAlice Berezné
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Search for more papers by this authorThierry Baubet
Assistance Publique-Hôpitaux de Paris and Avicenne Hospital, Paris 13 University, Bobigny, France
Search for more papers by this authorVéronique Le-guern
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Search for more papers by this authorJean Cabane
Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, Paris 6 University, Paris, France
Search for more papers by this authorLoïc Guillevin
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Dr. Poiraudeau has received consulting fees (less than $10,000 each) from Sanofi-Aventis and Pfizer. Dr. Guillevin has received consulting fees (more than $10,000) from Wyeth. Dr. Mouthon has received consulting fees (less than $10,000 each) from Laboratoire Français du Fractionnement Biologique et des Biotechnologies and Pfizer.
Search for more papers by this authorMichel Revel
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Search for more papers by this authorJacques Fermanian
Assistance Publique-Hôpitaux de Paris, Necker Hospital, Paris 5 University, Paris, France
Search for more papers by this authorCorresponding Author
Luc Mouthon
Assistance Publique-Hôpitaux de Paris, Cochin Hospital, Paris 5 University, Paris, France
Dr. Poiraudeau has received consulting fees (less than $10,000 each) from Sanofi-Aventis and Pfizer. Dr. Guillevin has received consulting fees (more than $10,000) from Wyeth. Dr. Mouthon has received consulting fees (less than $10,000 each) from Laboratoire Français du Fractionnement Biologique et des Biotechnologies and Pfizer.
Department of Internal Medicine, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, FranceSearch for more papers by this authorPresented at the 68th Annual Scientific Meeting of the American College of Rheumatology, San Antonio, TX, October 2004.
Abstract
Objective
To assess the construct validity of the Cochin Hand Function Scale (CHFS) and the relevance of using aggregate scores for the scleroderma Health Assessment Questionnaire (sHAQ) and Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) in systemic sclerosis (SSc).
Methods
We evaluated 50 patients with SSc (mean ± SD age and disease duration 54 ± 12 years and 9 ± 8 years, respectively), of which 26 had limited cutaneous SSc (lcSSc) and 23 diffuse SSc (dSSc). Quality of life was assessed by the SF-36, global disability by the Health Assessment Questionnaire (HAQ) and sHAQ, and hand disability by the CHFS. Construct validity was assessed by convergent and divergent validity (Spearman's rank correlation coefficient) and factor analysis.
Results
The CHFS had good construct validity and its total score explained 75% of the variance of the HAQ. The HAQ had better construct validity than the aggregate sHAQ and their scores correlated well (r = 0.88). The aggregate sHAQ was no better than the HAQ in discriminating between lcSSc and dSSc. SF-36 physical and mental components had acceptable convergent and divergent validity. Factor analysis of the 8 subscales extracted 3 factors explaining 72% of the variance, which differed from the a priori stratification with physical and mental subscales extracted in the same factor.
Conclusion
In patients with SSc, the CHFS has good construct validity, the HAQ should be preferred over the aggregate sHAQ for assessing physical functioning, and use of SF-36 physical and mental components aggregate scores is questionable.
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