Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
J Am Acad Dermatol. 2013 Jul;69(1):e11-8. doi: 10.1016/j.jaad.2012.01.038. Epub 2012 Feb 25.
Vitiligo significantly affects a person's health-related quality of life (HRQL). Although a small number of generic, and disease-specific, dermatologic HRQL measures exist, currently no vitiligo-specific instrument is available to capture disease-targeted concerns and issues.
We sought to develop and validate a vitiligo-specific self-report instrument for HRQL.
A pool of vitiligo-specific items was created based on in-depth interviews with patients with vitiligo (n = 16) and their responses to items in several previously validated HRQL measures. These items comprising our new instrument, VitiQoL, along with Skindex-16 and Dermatology Life Quality Index were administered to patients with vitiligo (n = 90) at two academic centers. This new instrument was validated using psychometric analysis.
The VitiQoL items showed high internal consistency (Cronbach alpha = 0.935). Exploratory factor analysis demonstrated 3 factors: participation limitation, stigma, and behavior. Concurrent validity was evidenced by large correlations between self-reported severity and VitiQoL scores (r = 0.51). Known groups validity was demonstrated for the VitiQoL behavior subscale between individuals with exposed and unexposed patches (P = .01). Convergent validity was shown by strong correlations between VitiQoL and outside dermatology scales measuring similar constructs (Skindex-16, r = 0.82; Dermatology Life Quality Index, r = 0.83).
Potential selection bias was a limitation as most patients were recruited from academic centers. Reliability of the instrument was tested only with internal consistency and not reproducibility. Responsiveness of the instrument was not tested because of the prolonged time course necessary to observe clinically significant change in vitiligo.
VitiQoL is a reliable and valid HRQL instrument.
白癜风显著影响患者的健康相关生活质量（HRQL）。尽管存在少量通用和特定于疾病的皮肤科 HRQL 测量方法，但目前尚无专门针对白癜风的工具来捕捉针对疾病的关注点和问题。
我们旨在开发和验证一种专门用于评估白癜风患者 HRQL 的自我报告工具。
根据对 16 名白癜风患者的深入访谈以及他们对几种先前验证的 HRQL 测量工具中项目的反应，创建了一个包含白癜风特异性项目的池。这些项目组成了我们的新工具，VitiQoL，以及 Skindex-16 和皮肤病生活质量指数（Dermatology Life Quality Index）。在两个学术中心，将这些新工具与 Skindex-16 和皮肤病生活质量指数一起用于白癜风患者（n=90）。使用心理测量分析对新工具进行了验证。
VitiQoL 项目表现出较高的内部一致性（Cronbach alpha=0.935）。探索性因子分析显示有 3 个因子：参与受限、耻辱感和行为。自我报告的严重程度与 VitiQoL 评分之间存在较大的相关性（r=0.51），这表明具有同时效度。在暴露和未暴露斑块的个体之间，VitiQoL 行为子量表具有已知组别的有效性（P=0.01）。VitiQoL 与测量相似结构的外部皮肤科量表之间存在较强的相关性（Skindex-16，r=0.82；皮肤病生活质量指数，r=0.83），这表明具有收敛效度。
由于大多数患者是从学术中心招募的，因此存在潜在的选择偏倚。该工具的可靠性仅通过内部一致性进行了测试，而未通过可重复性进行测试。由于观察到白癜风的临床显著变化需要较长的时间，因此未测试该工具的反应性。
VitiQoL 是一种可靠且有效的 HRQL 工具。
