Conversion of the MDHAQ to the HAQ score: a simple algorithm developed and validated in a cohort of 13 391 real-world patients.

OBJECTIVES: To develop and validate in real-world patients a conversion algorithm from the Multidimensionel Health Assessment Questionnaire physical function scale (MDHAQ) to the Stanford Health Assessment Questionnaire disability index physical function scale (HAQ) score. METHODS: From the DANBIO registry, 13 391 patients with RA (n = 8983), PsA (n = 2649) and axial spondyloarthritis (axSpA, n = 1759) with longitudinal data on HAQ and MDHAQ were included, stratified by diagnosis, and randomized 1:1 into development and validation cohorts. Conversion algorithms were developed by linear regression and applied in validation cohorts. From MDHAQ, the HAQ was calculated (cHAQ) and validated against the observed HAQ for criterion, correlational and construct validity. RESULTS: For RA, we developed the conversion algorithm cHAQ = 0.15+MDHAQ*1.08, and validated it in the RA validation cohort. Criterion validity: HAQ and cHAQ had comparable discriminative power to distinguish between high and low patient global scores (standardized mean difference: HAQ:-1.29, cHAQ:-1.35). Kappa value between HAQ and cHAQ functional states indicated good agreement (0.83). Correlational validity: baseline HAQ and cHAQ, respectively, correlated well with patient global scores (r = 0.65/0.67). Bland-Altman plots showed good agreement across all functional states. Construct validity: HAQ and cHAQ discriminated equally well between patients reporting symptom state as acceptable vs not, and across responses to an external anchor. Aiming for a common algorithm, the RA conversion algorithm was validated for PsA and axSpA with similar results. CONCLUSION: This study suggests that in observational datasets with only the MDHAQ available, a simple algorithm allows valid conversion to HAQ on the group level in RA, PsA and axSpA.

The association between psychosocial work environment, attitudes towards older workers (ageism) and planned retirement.

PURPOSE: The aim of this study was to examine the association between psychosocial factors (in particular ageism) at the workplace and older workers' retirement plans, while taking health and workability of the employee into account. METHODS: In the fall and winter of 2008, self-report data on work environment, health, workability and retirement plans were collected in a representative national sample (n = 3,122) of Danish employees 50 years or older. Ordinal logistic regression was used to analyse associations in a cross-sectional design. Predictor variables were standardized. RESULTS: In analyses adjusted for socio-demography, socio-economy, health, workability and work performance, 4 out of 6 examined psychosocial factors (ageism, lack of recognition, lack of development possibilities, lack of predictability) were significantly associated with plans of early retirement (OR: 1.10-1.13). Stratified on gender, three psychosocial factors (ageism, lack of recognition, lack of development possibilities) remained significant for men (OR: 1.15-1.25) and none for women. In particular was the association between retirement plans and ageism highly significant in the male subgroup, but no association was found in the female subgroup. CONCLUSION: Ageism, lack of recognition and lack of development possibilities are associated with older male workers' retirement plans in our analyses. Workability has the strongest association with retirement plans for both genders.