title: Development of a new instrument for rheumatoid arthritis: the Cedars-Sinai Health-Related Quality of Life instrument (CSHQ-RA).
abstract: OBJECTIVE
  To update and complement existing instruments, we developed a multidimensional disease-specific instrument, intended to reflect the impact of rheumatoid arthritis (RA) with modern treatment options on patient's Health-Related Quality of Life (HRQOL).
  
  
  METHODS
  Items were developed from a systematic review of published HRQOL measures and transcripts of RA patient focus groups. Items were refined by an expert panel and administered to 350 patients for psychometric testing.
  
  
  RESULTS
  The systematic review identified 228 potential items, and the focus group transcripts identified 96 additional items. Expert review and pilot testing resulted in an initial 58-item instrument. Twenty-six items were excluded due to floor/ceiling effects, poor response rates, or high item-item correlations. Factor analysis identified a 5-factor structure (eigenvalues >or=1). Multi-trait scaling performed on both completed surveys confirmed the 5 sub-scale structure (Cronbach's > 0.87).
  
  
  CONCLUSIONS
  The CSHQ-RA consists of 33 items that address 5 HRQOL domains, each with high internal consistency. Additional testing will assess the instrument's validity and responsiveness.
authors.affiliation: Cedars-Sinai Health System, Los Angeles, California 90048, USA. weisman@cshs.org
authors.forename: Michael H
authors.initials: MH
authors.lastname: Weisman
authors.forename: Harold E
authors.initials: HE
authors.lastname: Paulus
authors.forename: Simcha M
authors.initials: SM
authors.lastname: Russak
authors.forename: Deborah P
authors.initials: DP
authors.lastname: Lubeck
authors.forename: Chiun-Fang
authors.initials: CF
authors.lastname: Chiou
authors.forename: Nishan
authors.initials: N
authors.lastname: Sengupta
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Ofman
authors.forename: Jeff
authors.initials: J
authors.lastname: Borenstein
authors.forename: Alyson B
authors.initials: AB
authors.lastname: Moadel
authors.forename: Cathy D
authors.initials: CD
authors.lastname: Sherbourne
authors.forename: H D
authors.initials: HD
authors.lastname: Paulus
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards