Responsiveness of the ABILHAND questionnaire in measuring changes in rheumatoid arthritis patients

ABILHAND is a Rasch-built questionnaire that measures manual ability in rheumatoid arthritis (RA) patients. This study aimed to examine the test-retest reliability and the responsiveness of ABILHAND in RA patients.

Eighty-eight patients underwent 3 evaluations: the first evaluation was at baseline (time 1), the second was 2 weeks later (time 2), and the third was 1 year later (time 3). Disease activity was assessed using the Disease Activity Score in 28 joints using the C-reactive protein level (DAS28-CRP). Patients rated the intensity of their RA-related pain using a 100-mm visual analog scale for pain and completed questionnaires based on their activity limitations (ABILHAND and the Health Assessment Questionnaire) and quality of life.

The responsiveness analyses were conducted by using global, group, and individual approaches. The global approach showed significant differences between the time 1 and time 3 scores of the DAS28-CRP (P = 0.04) and ABILHAND (P = 0.04). Based on the changes in disease activity scores and the European League Against Rheumatism response criteria, the sample was divided into 3 groups: deteriorated, stable, and improved. The mean ± SD changes in manual ability were higher in the deteriorated (-1.23 ± 1.53 logit) and in the improved (1.22 ± 2.06 logits) groups than in the stable group (0.48 ± 1.09 logit). The effect size and standardized response mean confirmed that observation. The minimal clinically important difference was assessed in each group of patients.

The ABILHAND questionnaire exhibited responsiveness in detecting slight changes in RA patients. Therefore, the ABILHAND tool can be used to evaluate the functional status of RA patients in clinical trials and settings.