Wilburn J, McKenna SP, Twiss J. Further developments of the rheumatoid arthritis quality of life scale (RAQoL). Poster presented at the 2009 ISPOR 12th Annual European Congress; October 2009. Paris, Spain. [abstract] Value Health. 2009 Oct; 12(7):A447-8. doi: 10.1016/S1098-3015(10)75215-3

OBJECTIVES: The Rheumatoid Arthritis Quality of Life scale (RAQoL) is the first true QoL measure for RA and is widely used in clinical practice and trials. The scale has good psychometric properties and has been shown to be responsive to changes in disease severity. The objective of the study was to adapt the RAQoL for USA, Mexico, Argentina, Belgium (French and Flemish), France, Romania, Czech Republic, Slovakia, Poland and Russia.

METHODS: The adaptation in each country required 3 stages: Translation, cognitive debriefing and a validation survey. The translation process adopted the dual panel (bilingual followed by lay panel) methodology to ensure the ‘naturalness’ of language. Cognitive-debriefing interviews assessed face and content validity with local RA patients. The validation survey tested the psychometric properties of the new scales and included the Nottingham Health Profile (NHP) as a comparator.

RESULTS: The sample size for France was inadequate to test its psychometric properties. Mean scores on the new versions of the RAQoL ranged from 10.7 to 15.7 (maximum possible  30). Internal consistency ranged from 0.90–0.97 and test-retest reliability from 0.85–0.99 with 7 countries above 0.90. Scores were related to selfperceived severity in all countries, reaching significance in 7 out of 10 countries and were significantly related to self-perceived general health in all countries. Mean correlations with NHP sections were highest (as expected) with energy level, pain and physical mobility (average correlations 0.71–0.74) and lowest with emotional reactions, sleep disturbance and social isolation (average correlations 0.50–0.67).

CONCLUSIONS: The present study indicates that (with the exception of France which requires additional validation data) the new language versions of the RAQoL meet the standards of the original UK version and the other 8 existing versions. The new instruments represent valid and reliable tools for measuring QoL in international clinical trials in RA.

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