Background/Purpose: With the growing development of new technologies in clinical research, an electronic version of the OsteoArthritis Knee and Hip Quality Of Life (OAKHQOL), the e-OAKHQOL, has been formulated. This study aims to assess the validity of the e-OAKHQOL questionnaire and analyze whether the answers were affected by the form of administration (electronic versus paper).

Methods:

Two samples of patients with knee osteoarthritis (ACR criteria) were constituted. The first was composed of subjects, recruited by their general practitioner and who could choose to respond to the electronic or paper version. The second included subjects who responded to the paper version and were matched with respondents to the electronic version in the first sample. The OAKHQOL questionnaire contains 43 items, 3 of them are independent, and describes health-related quality of life (HRQoL) in 5 dimensions: physical activity, mental health, pain, social functioning and social support. A total score is normalized to a score from 0 (worst HRQoL) to 100 (best HRQoL). Two complementary analytical methods were used, the classical test theory (CTT) and a Rasch measurement model for item response theory (partial credit model).

Results: The electronic form was preferred by 471 (89.7%) patients. Among them, 345 were matched to the respondents of the paper version. The percentage of missing responses was lower in electronic than paper form (1.6% versus 2.0%, p = 0.01). The confirmatory factor analysis showed that the 4 or 5-factor models best fit with the data, although the CFI value was slightly below 0.9 (RMSEA value was below 0.08 as expected for model with good fit). Discrimination was good for the physical activity, mental health and pain dimensions. Rasch analysis revealed four items with underfitting. Internal consistency was excellent for dimensions Physical Activities (PSI = 0.96) and mental health (PSI = 0.93) but were slightly less than 0.85 for the other dimensions. No meaningful differential item functioning was detected for the mode of instrument administration, gender, age, educational level, low-back pain and BMI.

Conclusion:

Analysis with CTT and Rasch measurement of the e-OAKHQOL questionnaire revealed the good measurement properties of the five dimensions, so it may be a valuable alternative to the paper form. The instrument may offer many advantages in research and routine clinical practice such as immediate availability of the patient’s score and better collection of data.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-electronic-osteoarthritis-knee-and-hip-quality-of-life-oakhqol-questionnaire-a-useful-and-valid-alternative-to-measure-health-related-quality-of-life-in-knee-osteoarthritis/