Background/Purpose: The Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) is a recently developed patient reported outcome measure (PROM) for use across patients with different musculoskeletal conditions. The initial development included a detailed scoping exercise and qualitative development phase involving both patients and clinicians. This study provides the first validation of the MSK-HQ in inflammatory arthritis.

Methods: 287 adults with an established diagnosis of inflammatory arthritis were recruited from six centres in England. Patients completed the MSK-HQ and other PROMs at baseline and again after 3 months. The MSK-HQ consists of 14 items relating to facets of musculoskeletal health including pain, fatigue, physical function, symptom interference, sleep, self-efficacy and psychological well-being rated using a four point ordinal scale from ‘not at all’ to ‘extremely’. Construct validity was assessed using item response theory (IRT) methods. Specifically, a graded response model examined the functioning of each item with respect to underlying musculoskeletal health. Concurrent validity of the MSK-HQ total score was considered in relation to the Health Assessment Questionnaire (HAQ), as well as Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA) Impact of Disease Scales in disease subgroups (RAID & PsAID). Test-retest reliability was considered over three months.

Results: The MSK-HQ was approximately normally distributed with no evidence of floor or ceiling effects. A unidimensional structure was confirmed though two items (understanding & self-efficacy) were less weakly related to the overall construct. Reliability across the range of responses was high (alpha 0.93). The total scale score correlated highly with the HAQ in all patients (r=-0.81), RAID in those with RA or undifferentiated patients (n=218, r=-0.88), and PsAID in PsA patients (n=43, r=-0.88). Test-retest reliability over three months was good in those with stable disease (intraclass correlation=0.73).

Conclusion: In this study, we have provided further support for the validity and reliability of a new musculoskeletal health PROM in people with inflammatory arthritis. The tool compares well to existing PROMs, with the added advantage of lacking the floor effect of HAQ. The major advantage of the MSK-HQ is it is not disease specific and has high content validity in rheumatological conditions. The MSK-HQ score will be of value in clinical rheumatology practice, providing a measure which can be used across disease areas.

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/psychometric-evaluation-of-the-arthritis-research-uk-musculoskeletal-health-questionnaire-msk-hq-in-inflammatory-arthritis/