Evaluating score distributions in the revised Dutch version of the Childhood Health Assessment Questionnaire

Abstract

Objectives: Evaluating the original, and the revised version of the Dutch Childhood Health Assessment Questionnaire (CHAQ). To explore the effect of different score calculation methods and eight more challenging items as proposed by Lam et al. (2004) on the score distribution in a population of patients with Juvenile Idiopathic Arthritis (JIA). Methods:Two convenience samples of 59 and 31 children with JIA were studied. Box-andwhisker plots and the Kolmogorov-Smirnov (K-S) one-sample test of normality were used, to explore the score distributions. Results:The results of this study confirm a ceiling effect when using the original CHAQ-30 with either score calculation method. The original CHAQ with the added eight more challenging items and the "mean" score calculation method, as well as the revised CHAQ showed less ceiling effect. Conclusion:The original CHAQ-38 with the "mean" score calculation method as well as the revised CHAQ are a possible alternative for future studies. However, there is a need for further prospective studies to improve the CHAQ and to support our findings.

Comparing different revisions of the Childhood Health Assessment Questionnaire to reduce the ceiling effect and improve score distribution: Data from a multi-center European cohort study of children with JIA

“…This finding is in accordance with the study of Ouwerkerk et al [10], Lam et al [7] and Van Dijk et al [11] that both show a reduced number of patients at the ceiling.…”

The relevance of using the Childhood Health Assessment Questionnaire (CHAQ) in revised versions for the assessment of juvenile idiopathic arthritis

“…Overall, values of the CHAQ38 were most improved with the CAT1 in patients and with the CAT2 in controls, even though slightly fewer controls completed this response model. However, unlike the findings of others (11,(15)(16)(17), showing a reduction in the ceiling effect of no less than 15% when using CHAQ38 instead of CHAQ30, we found that the ceiling effect was still present in both CHAQ versions. However, the ceiling effect was most reduced, but not avoided, when using the CAT2 response model in both study groups.…”

“…Others have examined the revised CHAQ versions in children with JIA and shown a significantly improved sensitivity and a diminished ceiling effect using the CHAQ38 (15)(16)(17), but with less convincing results with the CAT2, compared to the CAT1 with a simplified scoring model (15)(16)(17) (Figure 1). …”

Fatigue in patients with Juvenile Idiopathic Arthritis: relationship to perceived health, physical health, self-efficacy, and participation

“…Disability was measured using the Dutch version of the Childhood Health Assessment Questionnaire (C-HAQ38) [28], which measured functional impairment in 9 domains. Scores ranged from 0 to 3, where 0 stands for no impairment and 3 for maximum impairment.…”