Badia Xavier, Webb Susan M, Prieto Luis, Lara Nuria
Health Outcomes Research Europe Group, Health Outcomes Research Europe C/Plató 6, 1o, 5a, 08021 Barcelona, Spain.
Health Qual Life Outcomes. 2004 Feb 27;2:13. doi: 10.1186/1477-7525-2-13.
Acromegaly is a chronic disease with an important impact on patients, Health Related Quality of Life (HRQoL). The ability to effectively measure Health Related Quality of Life is central to describing the impacts of disease or treatment upon the patient, therefore the importance of having a disease specific questionnaire for acromegaly. For the development of the AcroQoL questionnaire different sources of information were used: first a literature search was performed to identify relevant papers describing the impact of acromegaly in HRQoL, second the main domains of impact on HRQoL were identified by 10 experts endocrinologists, and third ten in-depth semi-structured interviews were conducted in acromegalic patients to identify domains and items related to the self-perceived impact of acromegaly in patients' life. After a proper qualitative analysis a preliminary 38 item questionnaire was obtained. Rasch analysis concluded with a final 22 item questionnaire. The measurement properties (validity and reliability) of the resulting final questionnaire were tested and compared using standard procedures (Cronbach's Alpha and item-total correlation). The evaluation of the item parameters confirmed the construct validity of the new instrument. Responsiveness to change was assessed in a small sample of 32 acromegalic patients with active disease in Spain who were administered the AcroQoL and the generic questionnaire EuroQoL 5-D. The results showed a statistically significant relationship between all the dimensions of AcroQoL and the VAS (visual analogic scale) of EQ-5D. An improvement in the global score of AcroQoL was related to a global improvement in the VAS of the EQ-5D. Following the current recommended standard methodology the Spanish questionnaire was translated into eleven other languages.
肢端肥大症是一种对患者的健康相关生活质量(HRQoL)有重要影响的慢性疾病。有效测量健康相关生活质量的能力对于描述疾病或治疗对患者的影响至关重要,因此拥有一份针对肢端肥大症的特定疾病问卷非常重要。为了开发肢端肥大症生活质量问卷(AcroQoL),使用了不同的信息来源:首先进行文献检索,以确定描述肢端肥大症对健康相关生活质量影响的相关论文;其次,10位内分泌专家确定了对健康相关生活质量产生影响的主要领域;第三,对肢端肥大症患者进行了10次深入的半结构化访谈,以确定与肢端肥大症对患者生活的自我感知影响相关的领域和项目。经过适当的定性分析后,获得了一份初步的38项问卷。拉施分析最终得出了一份22项问卷。使用标准程序(克朗巴哈系数和项目与总分相关性)对最终问卷的测量属性(效度和信度)进行了测试和比较。对项目参数的评估证实了新工具的结构效度。在西班牙的一小群32名患有活动性疾病的肢端肥大症患者中进行了变化反应性评估,这些患者接受了肢端肥大症生活质量问卷和通用问卷欧洲五维度健康量表(EuroQoL 5-D)。结果显示,肢端肥大症生活质量问卷的所有维度与欧洲五维度健康量表的视觉模拟评分(VAS)之间存在统计学上的显著关系。肢端肥大症生活质量问卷的总体得分提高与欧洲五维度健康量表视觉模拟评分的总体改善相关。按照当前推荐的标准方法,将西班牙文问卷翻译成了其他11种语言。