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Disease-specific measure of physical, social, and emotional well-being designed as a measure of outcome in arthritis1.
There are 9 scales: mobility, physical activity (walking, bending, lifting), dexterity, household activity (managing money
and medications, housekeeping), social activities, activities of daily living, pain, depression, and anxiety. AIMS2 includes arm
function, social support, and work.
AIMS were developed by Robert F. Meenan, dean, Boston University School of Public Health, 715 Albany St., T-C-306,
Boston, MA 02118. Email: firstname.lastname@example.org.
There is an original version, shortened version, an expanded version (AIMS2), a short-form of the AIMS2 (AIMS2-SF),
a child version, and a version for the elderly (Geri-AIMS). AIMS has been translated into many languages including Portuguese,
Canadian French, Italian, Spanish, French, Dutch, Swedish, Turkish, and Norwegian.
Number of items in scale: AIMS 45, Shortened AIMS 18, AIMS2 101, and AIMS2-SF 26.
Subscales: AIMS 9 (listed above); shortened AIMS 9; AIMS2 12.
Developmental/target. Developed in patients with rheumatoid arthritis and osteoarthritis to assess the outcome of health care.
AIMS have been used in other conditions including: psoriatic arthritis, ankylosing spondylitis, fibromyalgia,
carpal tunnel syndrome, colles fracture, hemophilia and in patients undergoing joint replacement surgery. A 1-page summary
of results has been developed for use in clinical practice.
WHO ICF Components: Activity limitation, Participation restriction
Method: Self-administered and relatively easy to complete.
Training: None required.
Time to administer/complete: AIMS 15 minutes, Shortened AIMS 6-8 minutes, AIMS2 20-30 minutes, AIMS2-SF 10 minutes.
Equipment needed: None
Availability / Cost: AIMS are available with user manual from Dr. Meenan (contact information above). It is also available at
AIMS2 - free access (Click on free access/disease-specific measures/rheumatology/AIMS2/public domain access/copy of
original AIMS2 question/copy of the user's manual). Dutch and Italian translations are available at the same website.
Responses: Guttman Scale.
Score range: Range is 0-10 for each section. Total health score 0-60.
Interpretation of scores: Zero represents good health status, 10 and 60 represent poor health status.
Method of scoring: Each section contains a Guttman Scale (a series of questions/statements that are graded so that endorsement of one
level of disability automatically indicates disability on all levels below it). In AIMS the number of response options
within the Guttman scales varies across sections. In AIMS2, the response format has been standardized across sections to
5-point scales. For scoring, the Guttman scaling is ignored and each item is scored separately without weights. Higher
scores indicate greater disability. The score for each section is standardized to a 0-10 scale using a standardization
formula. The total health score is calculated by summing the standardized scores for mobility, physical and household
activities, dexterity, pain, and depression.
Time to score: Scoring by hand takes around 10 minutes. Computerized scoring can be completed in seconds.
Training to score: Minimal training is required for scoring, users' guides are available.
Training to interpret: No specific training is required for interpretation of scores but familiarity with the range and
direction of scoring is helpful.
Norms available: None.
Reliability: AIMS: Guttman scale coefficients for scalability >0.6. The Guttman scale coefficients for reproducibility
are >0.9. Internal consistency via Cronbach's alpha >0.60 for each of the 9 sections. The test-retest correlations
between 2 administrations over a 2-week period in several studies are >0.80.
Shortened AIMS: Internal consistency and test-retest reliability are similar to the original AIMS.
AIMS2 internal consistency via Cronbach's alpha over the 9 sections range from 0.72 to 0.91.
Test-retest intraclass correlation coefficients range from 0.65 to 0.90 over a 10-day period and from 0.78
to 0.94 over a 3-week period.
AIMS2-S: Test-retest intraclass correlation coefficients are >0.70 over a 1-week period.
AIMS content validity: Items in AIMS are based on the content of the Rand Health Survey Questionnaires, the Quality of Well-Being
Scale, and Katz's Index of Activities of Daily Living. Items on dexterity and pain were added. Factor analysis
identified 3 factors (physical function, psychological, and pain), which have been replicated in subsequent studies.
AIMS construct: Relevant subscales of AIMS correlate strongly with other measures of the construct (e.g., physical activity AIMS
scale with Health Assessment Questionnaire (HAQ), AIMS pain scale with HAQ pain scale, AIMS and Functional Status
Questionnaire). Physical functioning AIMS scales correlate more strongly with measures of disease activity than AIMS
psychological or social scales; all scales correlate with increasing age (i.e., reduced function with increasing age).
AIMS2 content: Derived from AIMS but expanded to include arm function, social support, and work giving a 5-factor structure
(lower extremity function, upper extremity function, affect, pain, and social interaction).
AIMS2 criterion: Moderate correlations with general health status measures: NHP, SIP and Short Form-36 (SF-36).
AIMS2 construct: Moderate, expected correlations with disease activity (swollen joint count, pain visual analog scale
(VAS) and erythrocyte sedimentation rate).
AIMS2-SF content: Derived from AIMS2 using Delphi and nominal group techniques. Principal components factor
analysis confirmed the same 5-factor structure as AIMS2.
AIMS2-SF criterion: Comparison between AIMS2 and AIMS2-SF using the Bland and Altman method for measuring agreement found almost complete
agreement. Moderate correlations with other general health status measures (MHAQ, SF-36, and SIP) were very similar
to the correlations between these measures and AIMS2.
AIMS2-SF construct: Correlations with clinical and disease factors were moderate and as expected.
Responsiveness/sensitivity to change: Responsiveness of AIMS is better than most other generic and disease-specific measures (SIP, QWB, HAQ,
Functional Status Index, and McMaster Health Index). AIMS2 and AIMS2-SF have similar responsiveness. Standardized
response means for changes in AIMS2-SF scores over 3 months range from 0.36 (small) to 0.8 (high).
The AIMS is a widely used disease-specific measure that has a broad scope, measuring many aspects of health status.
It is more responsive in patients with arthritis than any of the generic measures. The revised version, AIMS2 has good
psychometric properties and the advantage of including measures of satisfaction with health and patients' priorities
for improvement. The full-length versions are quite time consuming to complete, and the short-form (AIMS2-SF) that has
similar psychometric properties to the full-length versions, may be more appropriate for postal surveys, studies where
patients are required to complete several questionnaires, and in clinical practice.
ARHP Research Committee - content last reviewed 2015