de Tiedra A G, Mercadal J, Badía X, Mascaró J M, Lozano R
Medical Department, Laboratorios Novag S.A., Barcelona, Spain.
Pharmacoeconomics. 1998 Oct;14(4):405-22. doi: 10.2165/00019053-199814040-00007.
The objective of this study was to develop a process to obtain an instrument to measure dermatology specific health-related quality of life (HR-QOL), and to adapt it into another culture, namely the Spanish-speaking community.
By consensus, a multi-disciplinary team determined the qualities of an 'ideal' questionnaire as follows: need (absence of any such instrument), utility, multi-dimensionality, psychometric development, simplicity, high degree of standardisation, and accessibility. A bibliographic search was conducted on Medline, EMBASE and IME (Spanish Medical Index), using 'dermatology' and 'quality of life' as the key words, from January 1990 through to September 1997, supplemented by a second level reference search, to identify the instruments already in existence. Rather than develop a questionnaire ex novo, it was decided to make a cultural adaptation of an existing one. The questionnaires identified in the literature search were classified according to their generic or specific scope and it was decided to adapt a dermatology specific instrument. To select and compare the instruments, a model was developed which would provide an Adaptation Index (ADAPT), which includes the degree of development of psychometric properties, the formal design and the degree of standardisation at a given moment in time.
Six dermatology specific scales were identified: Impact of Skin Disease Scale (IMPACT), Dermatology Life Quality Index (DLQI), Skindex, Dermatology Quality-of-Life Scales (DQOLS), Dermatology Specific Quality of Life (DSQL) and Qualita di Vita Italiana in Dermatologia (QUAVIDERM). The ADAPT Index for each of the above was determined at the time of the study and the DLQI was chosen for adaptation (ADAPT = 77, October 1997).
The study showed the utility of ADAPT Index to assist in the selection process of the questionnaire to adapt. The results of the analysis indicate that in order to introduce and systematically use dermatology specific HR-QOL instruments, the indices require consolidation and improvement. There is a special need for an effort to be made in developing transculturally equivalent instruments suitable for international research.
本研究的目的是开发一种方法来获得一种用于测量皮肤病特定健康相关生活质量（HR-QOL）的工具，并将其改编应用于另一种文化背景，即说西班牙语的群体。
通过共识，一个多学科团队确定了一份“理想”问卷的特质如下：必要性（缺乏此类工具）、实用性、多维度性、心理测量学发展、简单性、高度标准化以及可及性。从1990年1月至1997年9月，在Medline、EMBASE和IME（西班牙医学索引）上进行了文献检索，使用“皮肤病学”和“生活质量”作为关键词，并辅以二级参考文献检索，以识别已有的工具。决定不对新开发问卷，而是对现有问卷进行文化改编。在文献检索中识别出的问卷根据其通用或特定范围进行分类，并决定改编一份皮肤病学专用工具。为了选择和比较这些工具，开发了一个模型，该模型将提供一个改编指数（ADAPT），其中包括心理测量学特性的发展程度、形式设计以及特定时间点的标准化程度。
识别出六种皮肤病学专用量表：皮肤病影响量表（IMPACT）、皮肤病生活质量指数（DLQI）、皮肤指数（Skindex）、皮肤病生活质量量表（DQOLS）、皮肤病特定生活质量（DSQL）和意大利皮肤病生活质量（QUAVIDERM）。在研究时确定了上述每个量表的ADAPT指数，并选择DLQI进行改编（ADAPT = 77，1997年10月）。
该研究表明ADAPT指数有助于辅助问卷改编的选择过程。分析结果表明，为了引入并系统使用皮肤病特定的HR-QOL工具，这些指数需要巩固和改进。特别需要努力开发适用于国际研究的跨文化等效工具。
