Questionnaire Development

Development of the MDHAQ

The lower scores with a greater level of “floor effects” of the MHAQ compared to the HAQ was addressed by the addition of 6 complex activities in a multidimensional multidimensional HAQ (MDHAQ). The term “multi-dimensional” is used in recognition that the questionnaire had been further modified over the years to include not only the queries of 8-10 activities of daily living, and visual analog scales for pain and global status from the ACR Core Data Set, but also scores for fatigue, psychological distress, morning stiffness and change in status on one side of one page, and review of systems and medications on the reverse side of the page. The additional activities reduced the number of patients with floor effects from 16% on the HAQ and 30% on the MHAQ, to less than 3% on the MDHAQ.


  • Pincus, Theodore et. al. TOWARD A MULTIDIMENSIONAL HEALTH ASSESSMENT QUESTIONNAIRE (MDHAQ).  ARTHRITIS & RHEUMATISM.  Vol. 42, No. 10, October 1999, pp 2220–2230

  • Pincus, Theodore et. al. Further Development of a Physical Function Scale on a Multidimensional Health Assessment Questionnaire for Standard Care of Patients with Rheumatic Diseases.  The Journal of Rheumatology 2005; 32:8

  • Pincus, Theodore. A Multidimensional Health Assessment Questionnaire (MDHAQ) for All Patients with Rheumatic Diseases to Complete at All Visits in Standard Clinical Care. Bulletin of the NYU Hospital for Joint Diseases 2007;65(2):150-60

  • Pincus, Theodore et. al. Quantitative measurement of patient status in the regular care of patients with rheumatic diseases over 25 years as a continuous quality improvement activity, rather than traditional research. Clin Exp Rheumatol 2007; 25 (Suppl. 47): S69-S81.


Questionnaire Information

Because the activities chosen for the MHAQ generally were the simplest among the two or three within each HAQ category, as the other activities were not performed by all patients.

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