Validation of the Chinese drug hypersensitivity quality of life questionnaire: Role of delabeling

Abstract

Background: 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. Objective: 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. Methods: 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. Results: 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; P = 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 d = 0.964; P < 0.001), reflecting improvement in HRQoL. Conclusion: 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.

Clinical utility of and correlation between Sniffin' Sticks and TIB smell identification test (TIBSIT) among Hong Kong Chinese with or without chronic rhinosinusitis

“…Correlations of scores of different olfactory tests (and subtests) were assessed by Spearman correlation. We defined weak, moderate, and strong correlations as 0 < ρ ≤ 0.39, 0.40 ≤ ρ ≤ 0.59 and ρ ≥ 0.60 respectively ( 29 , 30 ). We also examined the effect, if any, of age and sex on olfactory test scores.…”