Sensitivity to change of the health assessment questionnaire (HAQ) and other clinical and health status measures in rheumatoid arthritis: results of short-term clinical trials and observational studies versus long-term observational studies

Arthritis Care Res. 1992 Sep;5(3):130-6. doi: 10.1002/art.1790050304.


To obtain evidence concerning short-term and long-term efficacy of clinical and health status measures in rheumatoid arthritis (RA), we conducted two observational studies--a 6-month study of 233 patients receiving methotrexate and a 10-year study of 157 patients receiving multiple treatments in a rheumatic disease clinic. Results of the 6-month study yielded effect sizes for treatment similar to the meta-analyses reported by Felson [corrected] et al. (Arthritis Rheum 33:1449-1461, 1990) and the controlled trials of methotrexate reported by Weinblatt et al. (Arthritis Rheum 33:330-338, 1990), suggesting that observational studies provide valid measurements of treatment effect. The effect size for the Health Assessment Questionnaire (HAQ) was 0.5. By contrast, the 10-year study suggested that standard clinical variables changed little and were not useful in assessing RA outcome, while the effect size of the HAQ was -2.39. These data continue to underscore the differences between short-term trials and the long-term outcome of RA, and suggest an important place for the HAQ or similar instruments in all phases of RA evaluation and assessment.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Arthritis, Rheumatoid* / physiopathology
  • Arthritis, Rheumatoid* / psychology
  • Arthritis, Rheumatoid* / therapy
  • Effect Modifier, Epidemiologic
  • Evaluation Studies as Topic
  • Female
  • Health Status*
  • Humans
  • Kansas
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Research Design / standards
  • Sensitivity and Specificity
  • Surveys and Questionnaires / standards*


  • Methotrexate