Reliability and validity of the Chronic Liver Disease Questionnaire (CLDQ) in adults with non-alcoholic steatohepatitis (NASH)

Abstract

IntroductionSignificant impairments in health-related quality of life (HRQL) in patients with non-alcoholic fatty liver disease have been previously described. The disease-specific HRQL among patients with non-alcoholic steatohepatitis (NASH), however, remains unknown.AimTo determine the degree of construct validity of the Chronic Liver Disease Questionnaire (CLDQ) in adults with NASH.MethodsParticipants referred for the evaluation of histology-proven NASH at Mayo Clinic, Rochester, between 1996 and 2000, were evaluated. HRQL assessment by the Short-Form 36 (SF-36) Health Survey and CLD) was performed. The primary outcome was to determine the level of correlation between overall and subscale scores for the CLDQ and SF-36 instruments.ResultsAmong 79 participants (70%) with NASH completing both questionnaires (mean age, 51.2 years with 64% female gender), excellent reliability was noted for the CLDQ instrument. Significant reductions in all SF-36 domains (p<0.05 for all) including PCS and MCS scores (p<0.02 for both) among participants with NASH compared with normative data from an age-matched and sex-matched US general population sample was observed. Highly significant correlations were observed between overall CLDQ score with SF-36 PCS (r=0.82, p<0.0001) and SF-36 MCS (r=0.67, p<0.0001) scores. Similar degrees of correlation were observed between relevant subscales of the CLDQ and SF-36 as well.DiscussionThe CLDQ has excellent reliability and validity of construct for HRQL assessment in adults with NASH when compared with the SF-36. Future investigations among participants with NASH require assessing the responsiveness of the CLDQ to medical therapies and disease progression.

Reduced brain activity in female patients with non-alcoholic fatty liver disease as measured by near-infrared spectroscopy

“…On the other hand, patients with NAFLD have impaired health-related quality of life. The scores of physical and mental domains in the 36-item Short Form Health Survey (SF-36) questionnaire and Chronic Liver Disease Questionnaire have been observed to be low in patients with NAFLD, including patients with non-alcoholic steatohepatitis (NASH), compared to the general population or to patients with hepatitis B [7–9]. These results imply that NAFLD patients have depressive state even without apparent depression.…”

The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe

“…In addition to its clinical impact, NAFLD has an impact on patient‐reported outcomes . In fact, recent data suggest that NAFLD patients may have significant impairment of their physical health as measured by two patient‐reported quality‐of‐life measurement tools, the Short Form‐36 and the Chronic Liver Disease Questionnaire . Finally, NAFLD has been shown to have an important economic impact on health care use .…”

“…(16) In fact, recent data suggest that NAFLD patients may have significant impairment of their physical health as measured by two patient-reported quality-of-life measurement tools, the Short Form-36 and the Chronic Liver Disease Questionnaire. (17) Finally, NAFLD has been shown to have an important economic impact on health care use. (16) In a recent study of Medicare NAFLD patients, the mean yearly inflation-adjusted charges from the outpatient setting increased from $2,624 6 $3,308 in 2005 to $3,608 6 $5,132 in 2010, in dollars of 2010.…”

Patient‐Reported Outcomes and the Economic Effects of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis: The Value Proposition

“…In addition to CLDQ for patients with liver disease, there are now fully validated HRQL instruments for patients with HCV (CLDQ‐HCV), primary sclerosing cholangitis, or NASH (CLDQ NAFLD‐NASH) . For patients with NAFLD and NASH, the recently developed and validated CLDQ NAFLD‐NASH scoring system contains 36 items divided into four domains with good psychometric properties . CLDQ NAFLD‐NASH was developed using a systematic approach with exhaustive item selection through literature search, patient interviews, focus groups and experts' input.…”

“…(27,(34)(35)(36) For patients with NAFLD and NASH, the recently developed and validated CLDQ NAFLD-NASH scoring system contains 36 items divided into four domains with good psychometric properties. (35,44) CLDQ NAFLD-NASH was developed using a systematic approach with exhaustive item selection through literature search, patient interviews, focus groups and experts' input. This scoring system then underwent systematic item reduction and factor analysis and has been shown to have excellent reliability, validity and responsiveness.…”