Validation of the pedHAL(short) and HAL(short) in Dutch children and adults with haemophilia

INTRODUCTION: The Haemophilia Activities List (HAL) and paediatric HAL assess self‐reported limitations in various daily activities. To reduce patient burden, shorter versions of the pedHAL (22 items) and HAL (18 items) have been developed. AIM: This study aimed to determine the agreement between the pedHAL/HAL(full) and pedHAL/HAL(short) and construct validity and internal consistency of the pedHAL(/)HAL(short) in persons with haemophilia (PWH). METHODS: A cross‐sectional secondary analysis of the Hemophilia in the Netherlands‐6 national survey was performed. Adult and paediatric PWH completed the original pedHAL/HAL(full), from which pedHAL(/)HAL(short) were derived. Score differences between the original and short versions were calculated. Construct validity was studied by testing hypotheses regarding the relationship of the pedHAL/HAL(short) with the pedHAL/HAL(full), Haemophilia & Exercise Project Test‐Questionnaire (HEP‐Test‐Q), Canadian Haemophilia Outcomes‐Kids’ Life Assessment Tool (CHO‐KLAT) and RAND 36‐item Health Survey (RAND‐36) (convergent/discriminant validity) as well as its ability to discriminate between subgroups (known‐group validity). Internal consistency was assessed with Cronbach's α. RESULTS: We included 113 children (median 10y [range 4–17], 53% severe haemophilia) and 691 adults (median 51y [range 18–88], 35% severe). Scores of the pedHAL/HAL(full) and pedHAL/HAL(short) were similar with high correlations (>0.9). Construct validity was confirmed for the pedHAL/HAL(short). The HAL(short) was able to discriminate between different disease severities and ages. Cronbach's α of the pedHAL/HAL(short) was 0.95–0.97. CONCLUSION: This study confirmed the agreement between the pedHAL/HAL(full) and the pedHAL/HAL(short) and the construct validity of the pedHAL/HAL(short). The next step is to study construct validity of the pedHAL/HAL(short) when administered as short forms.