Evaluation of Daily Activity Questionnaire (UK): User Manual v4 2023

The Evaluation of Daily Activity Questionnaire (EDAQ) User Manual: Version 4 2023 explains how to use and score the EDAQ (UK version). There are two Manual Supplements for Rasch transforming EDAQ data if researchers wish to use parametric analyses in research. Supplement 1 (Individual condition analyses: DOI: 10.13140/RG.2.2.13699.27685) and Supplement 2 (Cross Condition analyses DOI: 10.13140/RG.2.2.25443.32805).The latest UK version of the EDAQ is available at: EDAQ (parts 1 and 2 DOI: 10.13140/RG.2.2.13856.56327) and EDAQ parts 1,2 and 3 DOI: 10.13140/RG.2.2.27278.33608. Normally parts 1 and 2 only are used. The EDAQ was developed and tested in eight rheumatic and musculoskeletal conditions. It is reliable and valid in these conditions and suitable for use in clinical practice and research. See manual for details. and publication list

Linguistic validation and cultural adaptation of an English version of the Evaluation of Daily Activity Questionnaire in rheumatoid arthritis

Background: To linguistically validate and culturally adapt the Evaluation of Daily Activity Questionnaire (EDAQ) for use in rheumatoid arthritis (RA) from Swedish to British English. The EDAQ is a patient reported outcome measure of daily activity ability. It includes 11 activity domains (Eating and Drinking; Personal Care; Dressing; Bathing; Cooking; Moving Indoors; House Cleaning; Laundry; Moving and Transfers; Communication; Moving Outdoors) and was developed for use in rheumatoid arthritis (RA). Methods: The EDAQ was translated from Swedish to English using standard methods. Activity diaries, cognitive debriefing interviews and focus groups were completed with people with RA to: generate new culturally applicable items; identify important items in the Swedish version to retain in the English version; and develop the English EDAQ based on their views of content and layout. Content validity was established by linking the EDAQ to the International Classification of Functioning RA Core Set. Results: The English EDAQ translation was harmonised with the Swedish version to ensure equivalence of meaning. Sixty-one people with RA participated. 156 activities were identified from 31 activity diaries and included in a draft English EDAQ. Following interviews (n=20) and four focus groups, 138 activities were retained and three additional domains added (Gardening/Household Maintenance; Caring; and Leisure/ Social Activities). Most ICF RA Core Set activities are in the EDAQ. Conclusions: The English EDAQ is a detailed self-report measure of ability in RA. with good content validity

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Development of the United Kingdom Evaluation of Daily Activities Questionnaire in Rheumatoid Arthritis using Rasch Analysis

Background/Purpose: The Evaluation of Daily Activity Questionnaire (EDAQ) is a patient reported measure of activity/activity limitations in Rheumatoid Arthritis (RA) (Nordenskiold et al 1996). The UK version includes 138 items in 14 activity of daily living and participation domains (Eating/Drinking; Personal Care; Dressing; Bathing; Cooking; Moving Indoors; House Cleaning; Laundry; Moving and Transfers; Communication; Moving Outdoors; Gardening/Household Maintenance; Caring; and Hobbies/Leisure/ Social Activities). Each domain is split into two sections: one (A) which scores without aids, alternate methods or help; and another (B) which scores items with aids or alternate methods. All items are scored on a 0–3 scale (no difficulty to unable to do). Our aim was to identify if the UK-EDAQ fits the Rasch model in an RA cohort.Methods: Participants were recruited from Rheumatology clinics. Data from each domain were assessed for initial unidimensionality by a Confirmatory Factor Analysis (CFA). Each domain was analysed separately for sections A and B (where section B overrides section A when applicable). A Root Mean Square Error of Approximation (RMSEA) of 0.10 and below (mediocre fit) was considered adequate as prepepartion for Rasch analysis. Rasch analysis involved testing stochastic ordering (fit); local independence (response dependency and unidimensionality) and properties of invariance across groups (gender, age and employment status: differential item functioning (DIF). RUMM2030 software was used.Results: 383 people with RA participated: 286 women and 97 men; average age 60.38 (SD 11.18) years; RA duration 13.2 years SD 10.72; 118 (31%) were employed. Average pain (10 point VAS) = 4.99 (SD 2.59) and fatigue 5.61 (SD 2.53). CFA of the 14 domain sections (A&B) indicated unidimensionality after adjustment for local dependency (correlated errors) within each domain. All domains achieved RMSEA 0.05). Virtually all items had ordered thresholds, and where this was not the case, the disordering was often marginal. Differential Item Functioning (DIF) by age, gender and employment status was also largely absent, with a few notable exceptions. For example, in the domain 'gardening and household maintenance' the item 'climbing ladders' showed significant DIF by age, with older people showing greater problems with this at any given level of the trait (ANOVA p<0.05). Most domains showed a Person Separation Index reliability (PSI) consistent with individual use, even after adjustment for local dependency (PSI range 0.75–0.94). Where values were lower, this was largely a consequence of skewed data and the presence of a substantive floor effect which affects the PSI; whereas classical alpha values remained high. All domains supported strict unidimensionality.Conclusion: Analysis of the UK- EDAQ support a 14 domain, two component structure (self care and mobility) where each domain, and both components, (independently for sections A and B) satisfy Rasch model requirements after adjustment for local dependency