Kocher, Agnes; Ndosi, Mwidimi; Denhaerynck, Kris; Simon, Michael; Dwyer, Andrew A; Distler, Oliver; Hoeper, Kirsten; Künzler-Heule, Patrizia; Redmond, Anthony C; Villiger, Peter M.; Walker, Ulrich A; Nicca, Dunja (2021). A rare disease patient-reported outcome measure: revision and validation of the German version of the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) using the Rasch model. Orphanet journal of rare diseases, 16(1), p. 356. BioMed Central 10.1186/s13023-021-01944-9
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BACKGROUND
Rare disease patient-reported outcome measures (PROMs) require linguistic adaptation to overcome the challenge of geographically dispersed patient populations. Importantly, PROMs such as health-related quality of life (HRQoL) should accurately capture responses to patient-identified concerns. The Systemic Sclerosis Quality of Life Questionnaire (SScQoL) is a 29-item tool validated in six languages. Previous evaluation of the German version revealed problems with dichotomous responses. This study aimed to revise the German SScQoL, extend the response structure, and evaluate content and construct validity, reliability and unidimensionality.
METHODS
The instrument validation study involved revising the German SScQoL response structure, cognitive debriefing with patients and validation using Rasch analysis. The revised SScQoL was completed by Swiss-German-speaking patients with SSc within the Swiss MANagement Of Systemic Sclerosis (MANOSS) study. Rasch analysis was employed to test the validity, reliability and unidimensionality of the revised instrument.
RESULTS
Based on cognitive debriefing with patients (n = 6) dichotomous items were extended to a polytomous 4-point response structure. A total of 78 patients completed the revised SScQoL. Initial analysis of the 29 items suggested the scale lacked fit to the model (χ2 = 51.224, df = 29, p = 0.007). Grouping items into five domains resulted in an adequate fit to the Rasch model (χ2 = 5.343, df = 5, p = 0.376) and unidimensionality (proportion of significant independent t tests: 0.045, 95% CI 0.016-0.114). Overall, the scale was well targeted, had high internal consistency (Person Separation Index, PSI = 0.931) and worked consistently in patients with different demographic and clinical characteristics.
CONCLUSIONS
The revised German SScQoL has a 4-point response structure and is a valid, reliable measure. Rasch analysis is useful for validating continuous response structure of quality of life measures. Further evaluation of measurement equivalence with other German-speaking cultures is required for multinational comparisons and data pooling.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology |
UniBE Contributor: |
Villiger, Peter Matthias |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1750-1172 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Brigitte Isenschmid |
Date Deposited: |
28 Dec 2021 16:09 |
Last Modified: |
05 Dec 2022 15:55 |
Publisher DOI: |
10.1186/s13023-021-01944-9 |
PubMed ID: |
34372892 |
Uncontrolled Keywords: |
Health-related quality of life Item response theory Methodology Patient reported outcome measures Patient-centered care Rare diseases Rasch analysis Rheumatology Scleroderma Systemic sclerosis Validation study |
BORIS DOI: |
10.48350/161670 |
URI: |
https://boris.unibe.ch/id/eprint/161670 |
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