Mak Hugo W F, Chan Elsie T S, Yim Jackie S H, Lee Elaine, Lam Dorothy L Y, Chiang Valerie, Li Philip H
Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong.
Asia Pac Allergy. 2023 Mar;13(1):3-9. doi: 10.5415/apallergy.0000000000000020. Epub 2023 Apr 28.
The Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) is not currently available in Chinese. Besides, penicillin allergy (PA) is a worldwide public health challenge, and delabeling inauthentic PA can improve clinical and economic outcomes. However, its effect on health-related quality of life (HRQoL) remains poorly known.
The study objective is to translate and validate a Chinese version of DrHy-Q and investigate the effect of PA delabeling on HRQoL using DrHy-Q.
A Chinese DrHy-Q was translated then completed by patients with drug allergy labels for psychometric validation. Afterwards, another cohort of patients finished the Chinese DrHy-Q before and after their PA workup for pre-post comparison.
A total of 130 patients were studied. Sixty-three patients (79.4% female; median age = 59 ± 15 years) completed the Chinese DrHy-Q for validation (mean score = 38.9 ± 23.5). It demonstrated excellent internal consistency (Cronbach α = 0.956; 95% confidence interval [CI], 0.939-0.971) and test-retest reliability (intraclass correlation coefficient = 0.993 [95% CI, 0.969-0.998]). Construct validity was confirmed by its one-dimensional structure in factor analysis. Divergent validity was established because only 2 (out of 9) SF-36 scales showed weak negative correlations to DrHy-Q. Patients with multiple implicated drugs presented significantly higher DrHy-Q scores than those with only a single drug (42.0 ± 22.5 vs 28.7 ± 24.4; = 0.038), showing discriminant validity. Subsequently, another 67 patients (73.1% female; median age = 56 ± 15 years) underwent PA investigations and completed their pre-post DrHy-Q. A significant drop in DrHy-Q score was shown (40.8 ± 21.7 vs 26.6 ± 22.5; Cohen's = 0.964; < 0.001), reflecting improvement in HRQoL.
The Chinese DrHy-Q is reliable and valid for HRQoL assessment. PA delabeling significantly benefits patients' HRQoL. Future larger-scale studies are warranted to corroborate our findings.
《药物过敏生活质量问卷》（DrHy-Q）目前尚无中文版。此外，青霉素过敏（PA）是一项全球性的公共卫生挑战，去除虚假的PA标签可改善临床和经济结果。然而，其对健康相关生活质量（HRQoL）的影响仍知之甚少。
本研究的目的是翻译并验证中文版的DrHy-Q，并使用DrHy-Q调查PA标签去除对HRQoL的影响。
翻译中文版DrHy-Q，然后由有药物过敏标签的患者完成，以进行心理测量学验证。之后，另一组患者在进行PA检查前后完成中文版DrHy-Q，以进行前后比较。
共研究了130名患者。63名患者（79.4%为女性；中位年龄 = 59±15岁）完成了用于验证的中文版DrHy-Q（平均得分 = 38.9±23.5）。它显示出出色的内部一致性（Cronbach α = 0.956；95%置信区间[CI]，0.939 - 0.971）和重测信度（组内相关系数 = 0.993 [95% CI，0.969 - 0.998]）。在因子分析中，其单维结构证实了结构效度。由于9个SF-36量表中只有2个与DrHy-Q呈弱负相关，因此确立了区分效度。有多种相关药物的患者的DrHy-Q得分显著高于只有单一药物的患者（42.0±22.5对28.7±24.4；P = 0.038），显示出判别效度。随后，另外67名患者（73.1%为女性；中位年龄 = 56±15岁）接受了PA检查，并完成了检查前后的DrHy-Q。DrHy-Q得分显著下降（40.8±21.7对26.6±22.5；Cohen's d = 0.964；P < 0.001），反映了HRQoL的改善。
中文版DrHy-Q在HRQoL评估中可靠且有效。PA标签去除对患者的HRQoL有显著益处。未来需要进行更大规模的研究来证实我们的发现。
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