Limited Data on Cross-Cultural Validity of Functional Status Assessment Measures in RA

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Researchers examined translations, cultural adaptation, and cross-cultural validity of Functional Status Assessment Measures for rheumatoid arthritis, finding gaps in translation methods and testing.

There are few data on the cross-cultural validity of Functional Status Assessment Measures, including the Health Assessment Questionnaire (HAQ) and the Patient-Reported Outcomes Measurement Information System (PROMIS), in rheumatoid arthritis (RA), according to results published in Arthritis Care & Research.

The researchers searched 4 electronic medical databases from inception through April 4, 2018, using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) group search strategy. They used the COSMIN tool for cross-cultural validity and scored included studies as excellent, good, fair, or poor.

The study included 39 studies, 29 of which described the translation, cultural adaptation, or cross-cultural validity of the HAQ-DI, 8 other HAQ derivates, and 2 PROMIS measures. The studies represented 22 languages.

Of the 39 included studies, 3 were examined for the cross-cultural validity of translated versions.

In 2 studies that examined cross-cultural validity, the results indicated differential item functioning (DIF) between Dutch and US populations for the HAQ-II and PROMIS measures. Another study found DIF between populations in Turkey and the United Kingdom for the HAQ.

The researchers rated 2 studies as excellent, 3 as good, 13 as fair, and 21 as poor.

“Further investigation should be considered when using these measures for multinational clinical trials and for day-to-day use in practice in settings where cross-cultural validity has not been formally established,” the researchers wrote.

Kulhawy-Wibe SC, Zell J, Michaud K, et al. A systematic review and appraisal of the cross-cultural validity of functional status assessments measures in rheumatoid arthritis [published online April 12, 2019]. Arthritis Care Res. doi:10.1002/acr.23904