Cross-cultural validation and reliability of the Korean version of the Haemophilia Activities List

PURPOSE: To translate, culturally adapt, and evaluate the reliability and construct validity of the Korean version of the Haemophilia Activities List (HAL) in adult patients with hemophilia. METHODS: This cross-sectional validation study included adult patients with hemophilia A and B. The HAL was translated into Korean using a standardized forward-backward translation process according to international guidelines. The participants completed the Korean HAL, the EuroQol Five-Dimension Five-Level Questionnaire (EQ-5D-5L), and the Routine Assessment of Patient Index Data 3 (RAPID3) questionnaire. Internal consistency was assessed using Cronbach's alpha, test-retest reliability was assessed using intraclass correlation coefficients (ICCs), and construct validity was assessed using Spearman's correlation analysis. RESULTS: A total of 87 adult patients completed the questionnaire. The mean age was 37 years (range, 18-62 years), and most participants had severe hemophilia. The Korean HAL demonstrated high internal consistency, with a Cronbach's alpha coefficient of 0.97 for the total score and domain-specific values ranging from 0.78 to 0.95. The test-retest reliability was excellent, with an overall ICC of 0.95. Construct validity was supported by strong correlations between the HAL and EQ-5D-5L overall scores (r = 0.78, p < 0.01) and strong correlations with RAPID3 physical function scores (r = -0.82, p < 0.01). CONCLUSIONS: The Korean version of the HAL demonstrated excellent reliability and good construct validity in adult patients with hemophilia. These findings support the use of the Korean HAL as a reliable and culturally appropriate patient-reported outcome measure to assess functional limitations in clinical practice and research.