Longitudinal comparison of the Health Assessment Questionnaire (HAQ) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

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Abstract
Objective: To compare the measurement properties of the generic Health Assessment Questionnaire (HAQ) and the disease‐specific Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Methods: Physical function, pain, and radiographic progression were assessed in knee or hip osteoarthritis patients (n = 271) who had 2 radiographs that were at least 6 months apart from 6 ARAMIS (Arthritis, Rheumatism, and Aging Medical Information System) databanks. Data were compared at baseline and after a mean of 3.2 (SE 0.10) years. Correlation coefficients and standardized effect sizes (SES) were used to assess their relationship and responsiveness.Results: The majority of items in the 2 function and pain scales overlapped and were highly and significantly correlated with each other at baseline and last assessments (function at baseline rs = 0.71 and function at last assessment rs = 0.79, P < 0.0001; pain at baseline rs = 0.70 and pain at last assessment rs = 0.76, P < 0.0001). The HAQ disability index and total knee score were more sensitive to detection of disease progression than the WOMAC (SES for HAQ = 0.27; SES for WOMAC = −0.05).Conclusion: Both instruments showed favorable measurement properties, with the HAQ having the advantages of being more sensitive to change and adaptable to a wide variety of diseases and conditions, which contribute to the generalizability of findings.