With the DAS under my belt, I was ready for the next step and would take the plunge that Ted Pincus had been urging on me for years.
For those of you who don’t know him, Theodore Pincus, MD, is a giant of our field, an investigator of vision and passion. No shrinking violet, Ted is always exhorting rheumatologists to use the HAQ and he touts his questionnaires wherever he goes, handing them out like leaflets at a political rally.
Ted was once a basic scientist and knows the value of numbers. He has told me many times that the HAQ gives as much information as the ACR20, 50, or 70 and can match the DAS in its power to illuminate patient outcome. While the data on this point are clear, I was somewhat reluctant to use the HAQ because of the number of questions and their nature—the HAQ Disability Index comprises 20 questions on various activities of daily living. I had perused the questions several times but never really studied their content—a big mistake, as we shall see in next month’s column.
Dr. Pisetsky is physician editor of The Rheumatologist and professor of medicine and immunology at Duke University Medical Center in Durham, N.C.