A Self-Report Multidimensional Health Assessment Questionnaire (MDHAQ) for Face-To-Face or Telemedicine Encounters to Assess Clinical Severity (RAPID3) and Screen for Fibromyalgia (FAST) and Depression (DEP)

Abstract

Purpose of Review To update the clinical value of a patient self-report multidimensional health assessment questionnaire (MDHAQ). Recent Findings The MDHAQ includes 10 individual quantitative scores for physical function, pain, patient global assessment, fatigue, sleep, anxiety, depression, morning stiffness, change in status, and exercise status, and 5 indices, RAPID3 (routine assessment of patient index data) to assess clinical status in all diseases studied, FAST3 (fibromyalgia assessment screening tool) and MDHAQ-Dep (depression) to screen for fibromyalgia and/or depression, RADAI self-report of specific painful joints and joint count, and a symptom checklist for review of systems, and recognition of flares and medication adverse events. The MDHAQ also uniquely queries traditional “medical” information concerning comorbidities, falls, trauma, new symptoms, illnesses, surgeries, hospitalizations, emergencies, medication changes, and medication side effects. Three MDHAQ versions include long for new patients, short for new and return patients, and telemedicine. An electronic MDHAQ (eMDHAQ) has been developed with software that can interface with any electronic medical record (EMR) through the HL7 FHIR standard. However, EMR collaboration and implementation have proven difficult. Summary An MDHAQ provides a quantitative overview of patient status with far more information and documentation than an interview, involving minimal extra work for the physician.

Further Simplified Clinimetry Using a Multidimensional Health Assessment Questionnaire

“…FM often is easily recognized but underdiagnosed, and may be associated with poor responses to therapies, information that is helpful to the rheumatologist.The MDHAQ is informative in patients with all rheumatic diseases studied. 10 The patient does 95% of the work, and the rheumatologist or an assistant can calculate RAPID3 and FAST4 scores in 20 to 30 seconds.We suggest that any routine care can be enhanced in any setting by asking all patients to complete an MDHAQ in the waiting area, to provide quantitative data for better clinical decisions and patient outcomes.…”

“…The MDHAQ is informative in patients with all rheumatic diseases studied. 10 The patient does 95% of the work, and the rheumatologist or an assistant can calculate RAPID3 and FAST4 scores in 20 to 30 seconds.…”

Diagnostic value of salivary gland ultrasonography for secondary Sjögren syndrome in patients with systemic lupus erythematosus

“…11 Functional status was assessed with a self-report multidimensional Health Assessment Questionnaire (MDHAQ). 22,23 MDHAQ includes 10 activities of daily living, four items to assess psychological distress, duration of morning stiffness as well as visual analogue scales for pain, global status, and fatigue, review of the systems, falls and cardiovascular risk assessment, the rheumatology attitudes index and self-report of joint counts. Specific laboratory investigations were examined.…”

HAQ and DAS28 for clinical trials over months and MDHAQ, RheuMetric and psycho-socio-economic measures for long-term observations over years?

“…In this issue of Rheumatology [ 1 ], investigators from DANBIO (Danish Biologics registry) report an algorithm for converting multidimensional HAQ physical function (MDHAQ-FN) [ 2 ] scores to equivalent values of prototypic HAQ-FN scores [ 3 ]. HAQ-FN includes 20 activities in eight categories of two or three items, scored 0–3; the highest scores within the eight categories are totalled 0–24 and divided by eight for a mean 0–3 HAQ-FN score [ 3 ].…”

“…HAQ-FN includes 20 activities in eight categories of two or three items, scored 0–3; the highest scores within the eight categories are totalled 0–24 and divided by eight for a mean 0–3 HAQ-FN score [ 3 ]. MDHAQ-FN includes 10 activities, eight verbatim from each of the eight HAQ categories, and two complex activities, ‘walk 3 km or 2 miles’ and ‘participate in recreation and sports as one would like’, also scored 0–3, totalled 0–30 and divided by 3 for a 0–10 score [ 2 ].…”