AB0613 VALIDATION OF HINDI VERSION OF RAID SCORE (H-RAID) IN PATIENTS WITH RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY
Authors: M. Gopalakrishnan, K. Shakeel, A. Kumar P H, S. Saurabh, S. Khichar
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Rheumatoid arthritis (RA) affects over 10 million individuals in India. Along with the disease activity scales assessing the severity of the disease, patient-reported outcomes (PRO) are equally important in managing RA. Rheumatoid arthritis impact of disease (RAID) score is a valuable tool for assessing the impact of RA from the patient's perspective. However, validating RAID scores in Hindi is essential to improve the accessibility of patients with RA who face challenges with the English version. This not only enhances accessibility but also streamlines the process, reducing the burden on both the healthcare system and patients in rheumatology clinics across India. <h3>Objectives:</h3> To validate the Hindi version of RAID (H-RAID) score and to determine its relationship with other disease activity scores <h3>Methods:</h3> After Ethics Committee approval, a cross-sectional study was conducted at the rheumatology clinic in our tertiary care teaching hospital, in Jodhpur, India. The translation process included - back translation, expert reviews, pre-testing, face validation, content validation, and cognitive interviews with patients. Demographic details were collected along with an assessment of disease activity score 28 (DAS28), patient global assessment of disease activity (PtGA), pain visual analogue scale (VAS), H-RAID, and Indian health assessment questionnaire (IHAQ). Internal consistency was assessed using Cronbach alpha and correlation with DAS28 and IHAQ was performed. Confirmatory Factor Analysis (CFA) using LaVan and Sem Tools R packages was performed to confirm the factor structure of H-RAID. <h3>Results:</h3> RAID was translated into Hindi with the help of language experts and face and content validation was done with experts in the field and suggested changes were made. The content validation index (n=10 experts) was calculated as 0.96. Cognitive interviews were done in patients with RA. The final version of H-RAID was then administered to the patients enrolled. A total of 238 patients with RA were enrolled with a mean age of 47.6 ± 11.9 years and 88.7% were females. Out of 238 patients, 55 (23.1%) were in remission (DAS28-CRP &lt;2.6) while 41 (17.2%) had low disease activity (DAS28-CRP 2.6-3.2), 116 (48.7%) had moderate disease activity (DAS28-CRP 3.2-5.1), and 26 (10.9%) had high disease activity (DAS28-CRP &gt;5.1). The median H-RAID score was 4.09 (Figure 1). Internal consistency calculated using Cronbach alpha was 0.858. H-RAID correlated positively with disease activity score, DAS28-CRP (r = 0.385, p &lt;0.001), PtGA scores (r = 0.530, p &lt;0.001), pain VAS (r = 0.639, p &lt;0.001), and established PRO - IHAQ (r = 0.532, p &lt;0.001). Confirmatory Factor Analysis resulted in an acceptable model fit after adjustments with non-multicollinear factors and factor loadings exceeding the 0.3 cutoff (CFA value ranging from 0.45 to 0.79) compared to the initial Model 1 (Figure 2). The CFA of the single-factor model of RAID, the model did not fit the data. Modification Indices (MI, sometimes called a LaGrange Multiplier) estimated the amount by which the chi-square would be reduced if a single parameter restriction were to be removed from the model. After the inclusion of 3 correlated residuals (Item 1- Item 2, Item 3- Item 5 and Item 4- Item 6) to the model, the CFA showed an acceptable model fit (Figure 2). The factors were not multicollinear because all r values were less than 0.85, which indicated good discrimination between the factors. The factor loadings for all items exceeded the cut-off value of 0.3 (0.45 to 0.79). <h3>Conclusion:</h3> H-RAID is a valid tool for assessing the impact of RA across various dimensions of individuals' lives in the Indian context. <h3>REFERENCES:</h3> [1] Dougados, M., Brault, Y., Logeart, I. et al. Defining cut-off values for disease activity states and improvement scores for patient-reported outcomes: the example of the Rheumatoid Arthritis Impact of Disease (RAID). Arthritis Res Ther 14, R129 (2012). https://doi.org/10.1186/ar3859 <h3>Acknowledgements:</h3> Prof. Pankaj Bhardwaj, Academic Head School of Public Health and Prof. Mahendra Kumar Garg, Head of Department of Internal Medicine. <h3>Disclosure of Interests:</h3> <b>None declared.</b>