Guerra-Tapia A, Buendía-Eisman A, Ferrando J
Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Facultad de Medicina, Universidad Complutense, Madrid, España.
Facultad de Medicina, Universidad de Granada, Granada, España.
Actas Dermosifiliogr (Engl Ed). 2018 Jun;109(5):424-431. doi: 10.1016/j.ad.2018.02.007. Epub 2018 Mar 13.
Female androgenetic alopecia (FAA) has considerable impact on quality of life. Our analysis of the clinical scales available in the literature to measure the impact of FAA led us to choose the Hair Specific Skindex 29 (HSS29) as the most appropriate for adaptation to Spanish as a tool for following patients in treatment for FAA. This tool assesses disease impact on quality of life over time so that treatments can be tailored to patients' needs. The HSS29 score reflects impact in 3 domains (emotions, symptoms, and functioning) on a scale of 0 (no effect) to 100 (maximum effect). The scale is useful in routine clinical practice, and patients can respond to all items in 5minutes.
We followed recommended procedures to produce a cross-cultural adaptation of the scale. The process involved forward translation of the questionnaire to Spanish followed by back translation by 2 native speakers of the original language (English) and revision as needed after discussion and consensus by a committee of 3 expert dermatologists. The comprehensibility of the resulting translation was assessed in a test-retest step. Next, the psychometric properties, reliability, and construct validity were assessed. Sensitivity and specificity were evaluated with the area under the receiver operating characteristic (ROC) curve, reliability with Cronbach's α, and construct validity by factor analysis using a Varimax rotation. Face validity was also assessed during the process. The intraclass correlation coefficient (ICC) was calculated in the test-retest step.
A total of 170 women with FAA and 30 control subjects completed the cross-culturally adapted Spanish questionnaire. A subgroup of 15 subjects responded a second time between 1 and 2 days after their first session (test-retest). Sensitivity and specificity were excellent according to the area under the ROC curve (0.98; 95% CI, 0.97-0.99), and high reliability was reflected by a Cronbach's α of 0.96. Factor analysis showed that the items were grouped in the same 3 domains (functioning, emotions, and symptoms) as in the original version of the scale. There were no significant differences in the mean (SD) scores on the test and the retest (23.05 [16.42] vs. 22.01 [17.72], respectively). The ICC of over 0.9 indicated excellent correlation between responses to the adapted Spanish version.
The psychometric properties of the Spanish version of the HSS29 are similar to those of the original scale. The Spanish HSS29 is a useful tool for assessing quality of life in FAA.
女性雄激素性脱发（FAA）对生活质量有相当大的影响。我们对文献中可用于衡量FAA影响的临床量表进行分析后，选择了毛发特异性皮肤指数29（HSS29）作为最适合改编为西班牙语的量表，作为FAA治疗中跟踪患者的工具。该工具可评估疾病随时间对生活质量的影响，以便根据患者需求调整治疗方案。HSS29评分反映了在0（无影响）至100（最大影响）范围内3个领域（情绪、症状和功能）的影响程度。该量表在常规临床实践中很有用，患者可在5分钟内回答所有问题。
我们遵循推荐程序对该量表进行跨文化改编。过程包括将问卷正向翻译成西班牙语，然后由2名以英语为母语的人进行反向翻译，并在3名皮肤科专家组成的委员会进行讨论并达成共识后根据需要进行修订。在重测步骤中评估最终翻译的可理解性。接下来，评估心理测量特性、信度和结构效度。使用受试者工作特征（ROC）曲线下面积评估敏感性和特异性，使用Cronbach's α评估信度，使用Varimax旋转的因子分析评估结构效度。在此过程中也评估了表面效度。在重测步骤中计算组内相关系数（ICC）。
共有170名FAA女性和30名对照受试者完成了跨文化改编的西班牙语问卷。15名受试者组成的一个亚组在第一次测试后1至2天再次作答（重测）。根据ROC曲线下面积，敏感性和特异性极佳（0.98；95%CI，0.97 - 0.
