Subjective well-being in patients with pemphigus: a path analysis

Mitev, Ariel Zoltán; Rencz, Fanni; Tamási, Béla; Hajdu, K.; Péntek, Márta; Gulàcsi, László; Szegedi, Andrea; Bata‐Csörgő, Zsuzsanna; Kinyó, Ágnes; Sárdy, Miklós; Brodszky, Valentin

doi:10.1007/s10198-019-01067-w

Cited by 7 publications

(12 citation statements)

References 38 publications

(49 reference statements)

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“…The correlation coefficient ( r s ) was interpreted as follows: very weak (< 0·20), weak (0·20–0·39), moderate (0·40–0·59), strong (0·60–0·79) and very strong (0·80–1) 37 . We hypothesized that there would be at least a strong correlation between DLQI, DLQI‐R and Skindex‐16 and a moderate correlation of these measures with WHO‐5 and PG‐VAS 20,38,39 …”

Section: Methodsmentioning

confidence: 99%

A comparative study on the measurement properties of Dermatology Life Quality Index (DLQI), DLQI‐Relevant and Skindex‐16*

2021

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Background Dermatology Life Quality Index (DLQI) and Skindex-16 are among the most commonly used dermatology-specific health-related quality-of-life (HRQoL) instruments. DLQI has two common scoring methods, the original and the DLQI-Relevant (DLQI-R) modification. Head-to-head comparisons of the measurement properties of the DLQI, DLQI-R and Skindex-16 are currently lacking. Objectives We aim to compare the measurement properties of the DLQI, DLQI-R and Skindex-16. Methods We analysed data from 618 patients with self-reported physiciandiagnosed dermatological conditions from a cross-sectional survey carried out in Hungary in early 2020. DLQI, DLQI-R and Skindex-16 were compared in terms of ceiling and floor effects, informativity, convergent validity and known-group validity.Results Mean DLQI, DLQI-R and Skindex-16 total scores were 3Á76 AE 5Á03, 4Á11 AE 5Á34 and 29Á36 AE 26Á62, respectively. Among patients with a DLQI/ DLQI-R total score of zero, 64% reported problems on Skindex-16. Overall, 23-38% of patients with 'not relevant' responses on DLQI items 3 (shopping/ home/gardening), 7 (working/studying), 8 (interpersonal problems) and 9 (sexual difficulties) reported problems on their corresponding Skindex-16 items. Average relative informativity (Shannon's evenness index) was the highest for Skindex-16 (0Á85), followed by DLQI-R (0Á66) and DLQI (0Á54). DLQI, DLQI-R and Skindex-16 demonstrated similar convergent validity. DLQI was able to better discriminate between known groups of patients based on overall skin-related HRQoL impairment, whereas DLQI-R and Skindex-16 performed better with respect to self-perceived health status. Conclusions Skindex-16 seems to be more sensitive than DLQI/DLQI-R in capturing mild impairment in HRQoL. Our findings help to provide a fuller understanding of the difference between DLQI, DLQI-R and Skindex-16 and support the informed choice of instrument for clinical and research purposes.What is already known about this topic?• Dermatology Life Quality Index (DLQI) and Skindex-16 are among the most commonly used dermatology-specific instruments to measure health-related quality of life (HRQoL). DLQI has an alternative scoring, DLQI-Relevant (DLQI-R), developed in 2018. • So far, no studies have provided a comprehensive head-to-head comparison of the measurement properties of the DLQI, DLQI-R and Skindex-16.

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Section: Methodsmentioning

confidence: 99%

A comparative study on the measurement properties of Dermatology Life Quality Index (DLQI), DLQI‐Relevant and Skindex‐16*

2021

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“…A large dataset containing DLQI data from four earlier cross‐sectional surveys in three diagnoses (morphea, pemphigus and psoriasis) were used for the analyses . All these surveys were carried out between 2012 and 2017 at four university dermatology clinics in Hungary.…”

Section: Methodsmentioning

confidence: 99%

DLQI‐R scoring improves the discriminatory power of the Dermatology Life Quality Index in patients with psoriasis, pemphigus and morphea

et al. 2019

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Background The Dermatology Life Quality Index (DLQI) rates 'not relevant' responses (NRRs) as the item on the questionnaire having no impact on the patients' lives at all. The DLQI-Relevant (DLQI-R) is a recently developed scoring that adjusts the total score of the questionnaire for the number of NRRs indicated by a patient. Objectives To compare the discriminatory power of the original and DLQI-R scoring approaches in terms of absolute and relative informativity. Methods Cross-sectional data from 637 patients with morphea, pemphigus and psoriasis were used for the analyses. To assess absolute and relative informativity, Shannon's index and Shannon's evenness index were calculated for the 10 items on the questionnaire and for DLQI and DLQI-R total scores. Results Mean DLQI and DLQI-R scores of patients were 6Á13 vs. 6Á91. In the subset of patients with NRRs (n = 261, 41%), absolute informativity was higher with the DLQI-R scoring for all eight items with NRR options in all three conditions. The DLQI-R exhibited a better relative informativity in 8, 8 and 6 items in pemphigus, morphea and psoriasis, respectively. The DLQI-R led to an improvement in average item-level informativity in all DLQI score bands up to 20 points. Regarding total scores, the DLQI-R produced both a higher absolute and relative informativity in all three conditions. Conclusions In patients with morphea, pemphigus and psoriasis, DLQI-R scoring improves the discriminatory power of the questionnaire by benefiting from the additional information in NRRs. DLQI-R scoring may be useful both in clinical practice and research. A scoring chart has been developed to aid physicians with scoring.What's already known about this topic?• The original scoring of the Dermatology Life Quality Index (DLQI) rates 'not relevant' responses as the item of the questionnaire having no impact on the patients' lives at all.• DLQI-Relevant (DLQI-R) is a new scoring developed in 2018 that adjusts the total score of the questionnaire for the number of 'not relevant' responses indicated by patients.• The discriminatory power of the DLQI-R compared with the DLQI has not yet been investigated.

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“…Furthermore, we did not have any information on the treatment history of these patients. Several earlier studies from Hungary confirmed that successful treatment and management of skin diseases improve health-related quality of life and well-being of patients [ 9 , 54 – 59 ]. Fourthly, in absence of a Hungarian value set for the ICECAP-A, our analyses relied on the ICECAP-A value set for the UK and not that of the Hungarian population, whose values may differ across attributes and levels.…”

Section: Discussionmentioning

confidence: 93%

“…In prior studies, patients with chronic skin diseases, such as psoriasis, pemphigus and morphea, were more likely to be associated with decreased subjective well-being, happiness and life satisfaction [ 7 – 9 , 42 – 44 ]. Yet this is the first study to validate a capability well-being instrument in dermatological patients.…”

Section: Discussionmentioning

confidence: 99%

“…HRQoL measures may not be able to capture the wellbeing burden of living with a dermatological disease. Relatively few studies have so far examined the subjective well-being of dermatological patients [7][8][9][10], and none of them have investigated capability well-being. The capability approach, drawing on the work of Nobel Laureate economist Amartya Sen, addresses well-being in terms of people's capabilities that reflect what people are able to do rather than what they actually do (i.e.…”

Section: Introductionmentioning

confidence: 99%

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Measurement properties of the ICECAP-A capability well-being instrument among dermatological patients

et al. 2021

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Background Capability well-being captures well-being based on people’s ability to do the things they value in life. So far, no capability well-being measures have been validated in dermatological patients. Objectives To validate the adult version of the ICEpop CAPability measure (ICECAP-A) in patients with dermatological conditions. We aimed to test floor and ceiling effects, structural, convergent and known-group validity, and measurement invariance. Methods In 2020, an online, cross-sectional survey was carried out in Hungary. Respondents with self-reported physician-diagnosed dermatological conditions completed the ICECAP-A, Satisfaction with Life Scale (SWLS), WHO-5 Well-Being Index and two dermatology-specific measures, Dermatology Life Quality Index (DLQI) and Skindex-16. Results 618 respondents (mean age 51 years) self-reported a physician-diagnosed dermatological condition, with warts, eczema, onychomycosis, acne and psoriasis being the most common. ICECAP-A performed well with no floor and mild ceiling effects. The violation of local independence assumption was found between the attributes of ‘attachment’ and ‘enjoyment’. ICECAP-A index scores correlated strongly with SWLS and WHO-5 (rs = 0.597–0.644) and weakly with DLQI and Skindex-16 (rs = − 0.233 to − 0.292). ICECAP-A was able to distinguish between subsets of patients defined by education and income level, marital, employment and health status. Multigroup confirmatory factor analysis indicated measurement invariance across most of these subgroups. Conclusions This is the first study to validate a capability well-being measure in patients with dermatological conditions. The ICECAP-A was found to be a valid tool to assess capability well-being in dermatological patients. Future work is recommended to test measurement properties of ICECAP-A in chronic inflammatory skin conditions.

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Subjective well-being in patients with pemphigus: a path analysis

Cited by 7 publications

References 38 publications

A comparative study on the measurement properties of Dermatology Life Quality Index (DLQI), DLQI‐Relevant and Skindex‐16*

A comparative study on the measurement properties of Dermatology Life Quality Index (DLQI), DLQI‐Relevant and Skindex‐16*

DLQI‐R scoring improves the discriminatory power of the Dermatology Life Quality Index in patients with psoriasis, pemphigus and morphea

Measurement properties of the ICECAP-A capability well-being instrument among dermatological patients

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