A multidimensional health assessment questionnaire (MDHAQ) for all patients with rheumatic diseases to complete at all visits in standard clinical care.

Rheumatic diseases differ from many chronic diseases in that no single measure provides a gold standard for diagnosis, prognosis, monitoring, and documentation of changes over long periods. Therefore, pooled indices of several measures have been developed, such as the American College of Rheumatology (ACR) Core Data Set and disease activity score (DAS) for rheumatoid arthritis (RA), systemic lupus erythematosus disease activity index (SLEDAI), Bath ankylosing spondylitis disease activity index (BASDAI), and others. Quantitative clinical rheumatology measures and indices are used primarily in clinical trials and other research studies, but generally not in standard clinical care, which usually is conducted without quantitative data, other than laboratory tests, often with noncontributory, false positive, or false negative results. Measures designed for research often are lengthy, not easily scored, and not designed to add to standard patient care. By contrast, measures designed for standard care are short, easily scored, and useful to monitor patient status at each visit. Some research measures have been adapted for standard care, such as the multidimensional health assessment questionnaire (MDHAQ) derived from the HAQ, which includes an index of the three RA core data set measures (physical function, pain, and global estimate), also known as routine assessment of patient index data 3 (RAPID 3). RAPID 3 can be scored in 10 sec, compared to 90 sec for a 28-joint count, and 40 sec for a standard HAQ. The MDHAQ is useful in all rheumatic diseases by saving time, documenting changes in status over long periods, and by improving rheumatology care and outcomes.