Doeglas D, Krol B, Guillemin F, Suurmeijer T, Sanderman R, Smedstad L M, Briançon S, van den Heuvel W
Northern Centre for Healthcare Research, University of Groningen, The Netherlands.
J Rheumatol. 1995 Oct;22(10):1834-43.
To compare a disease specific measure of functional status, the Health Assessment Questionnaire (HAQ) with a generic measure of functional status, the Groningen Activity Restriction Scale (GARS) in a cross cultural and longitudinal setting. Besides the comparison of psychometric properties, sex differences were also studied.
In a sample of 634 patients with rheumatoid arthritis (RA) (290 from The Netherlands, 116 from France, 228 from Norway), the psychometric properties (Cronbach's alpha and rho) of the GARS and the HAQ were compared among countries. The sensitivity for change between T1 and T2 was tested by means of the standardized response mean for a one year followup; furthermore, the relative efficiency of both instruments was computed. A t test was used to trace sex differences.
The psychometric properties of both the HAQ and the GARS were very good. Both form unidimensional scales of hierarchically ordered items; alpha and rho are > 0.91 for both instruments. For patients who improved between T1 and T2, measured by the Ritchie Articular Index, the standardized response mean of the HAQ and the GARS were moderate, whereas for patients who worsened, the standardized response means were small. The results based on the relative efficiency were ambiguous. Furthermore, the mean score for women on the HAQ was 0.25 higher in contrast to scores for men. The GARS did not yield different scores for women and men.
The internal consistency of the GARS and the HAQ are comparable. The HAQ has yielded different results for women and men. Therefore, when the HAQ is used, sex differences should be taken into account. With respect to sensitivity to change, the GARS and the HAQ obtained much better results for patients who improved in contrast to patients who worsened. The GARS was found to be more sensitive to change for patients who improved.
在跨文化和纵向研究背景下，比较一种针对特定疾病的功能状态测量工具——健康评估问卷（HAQ）与一种通用的功能状态测量工具——格罗宁根活动受限量表（GARS）。除了比较心理测量特性外，还研究了性别差异。
在634例类风湿性关节炎（RA）患者样本中（290例来自荷兰，116例来自法国，228例来自挪威），比较了各国GARS和HAQ的心理测量特性（克朗巴哈系数和相关系数）。通过一年随访的标准化反应均值测试T1和T2之间变化的敏感性；此外，计算了两种工具的相对效率。使用t检验来追踪性别差异。
HAQ和GARS的心理测量特性都非常好。两者都形成了由分层排序项目组成的单维量表；两种工具的克朗巴哈系数和相关系数均>0.91。对于在T1和T2之间病情改善的患者（通过里奇关节指数测量），HAQ和GARS的标准化反应均值适中，而对于病情恶化的患者，标准化反应均值较小。基于相对效率的结果不明确。此外，HAQ上女性的平均得分比男性高0.25。GARS在女性和男性中的得分没有差异。
GARS和HAQ的内部一致性相当。HAQ在女性和男性中产生了不同的结果。因此，使用HAQ时应考虑性别差异。在对变化的敏感性方面，与病情恶化的患者相比，GARS和HAQ在病情改善的患者中获得了更好的结果。发现GARS对病情改善的患者变化更敏感。
