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01-04-2015 | Uitgave 4/2015 Open Access

Quality of Life Research 4/2015

The development and validation of a disease-specific quality of life measure in hyperhidrosis: the Hyperhidrosis Quality of Life Index (HidroQOL©)

Tijdschrift:
Quality of Life Research > Uitgave 4/2015
Auteurs:
P. Kamudoni, B. Mueller, M. S. Salek
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11136-014-0825-2) contains supplementary material, which is available to authorized users.

Abstract

Purpose

To develop and validate a new disease-specific quality of life measure in hyperhidrosis for use in both routine clinical practice and clinical research.

Methods

Interviews and focus group discussions with hyperhidrosis patients, reported elsewhere, provided the content for the measure validated in this study (n = 71). A panel of dermatologists (n = 5) and patients (n = 7) carried out content validation. Further, item reduction and the initial construct validation were carried out in a cross-sectional study (n = 595), using the unidimensional Rasch analysis and exploratory factor analysis. Subsequently, the construct validity, reliability and responsiveness of the revised measure were assessed in a longitudinal study (n = 260). Data collection for the item reduction and the final validation phases was entirely carried out online.

Results

The expert panels judged the HidroQoL as content valid. Rasch analysis supported the revision of response options from five to three. Following removal of misfitting items, a set of 15 items showed optimal fit to the model (chi-squared statistic = 159.64, p = 0.07). Three additional items were retained on consideration of their importance to patients, resulting in an 18-item instrument. The items were grouped into two subscales, daily life activities and psychosocial life domains, based on results of the factor analysis. In subsequent construct validation, the HidroQoL correlated with the DLQI (r s = 0.6, p < 0.01). Reliability was high (internal consistency, Cronbach’s alpha: overall scale = 0.9; test–retest reliability, Intra-class correlation = 0.9). The HidroQoL scores were sensitive to change in patients’ disease severity (score change from baseline to follow-up after 15–35 days, Cohen’s ES = 0.47).

Conclusion

This study has provided the initial evidence supporting measurement properties and the use of the HidroQoL instrument in both routine clinical practice and in research, for assessing quality of life impacts in hyperhidrosis.

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Extra materiaal
Scree plot showing optimal number of factors for the 21 items of the HidroQoL following item reduction using exploratory factor analysis. The optimal number of factors for extraction is identified by counting the factors lying to the left of the curve’s elbow. Factors to the right represent random rather than meaningful co-variation among the items (TIFF 17 kb)
11136_2014_825_MOESM1_ESM.tif
Test characteristic curves of the HidroQoL total score and the latent QoL variable, by age groups. The relationship between the HidroQoL total raw score and the latent QoL variable was similar for the different age groups, indicating absence of bias for the total score in spite of DIF observed in some items (JPEG 28 kb)
11136_2014_825_MOESM2_ESM.jpg
Test characteristic curves of the HidroQoL total score and the latent QoL variable, by body area affected. The relationship between the HidroQoL total raw score and the latent QoL variable was similar for patients with different sites of hyperhidrosis (JPEG 39 kb)
11136_2014_825_MOESM3_ESM.jpg
Test characteristic curves of the HidroQoL total score and the latent QoL variable, by HDSS score (disease severity). The relationship between the HidroQoL total raw score and the latent QoL variable was similar for patients with different levels of disease severity (JPEG 31 kb)
11136_2014_825_MOESM4_ESM.jpg
Test characteristic curves of the HidroQoL total score and the latent QoL variable, by comorbidity. The relationship between the HidroQoL total raw score and the latent QoL variable was similar for patients with different levels of disease severity (JPEG 22 kb)
11136_2014_825_MOESM5_ESM.jpg
Supplementary material 6 (DOCX 19 kb)
11136_2014_825_MOESM6_ESM.docx
Literatuur
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