Validity of EQ‐5D‐5L, Skindex‐16, DLQI and DLQI‐R in patients with hidradenitis suppurativa

Gergely, L; Gáspár, Krisztián; Brodszky, Valentin; Kinyó, Ágnes; Szegedi, Andrea; Remenyik, Éva; Kiss, Norbert; Bató, Alex; Péntek, Márta; Gulàcsi, László; Sárdy, Miklós; Bánvölgyi, András; Wikonkál, Norbert; Rencz, Fanni

doi:10.1111/jdv.16642

Cited by 33 publications

(39 citation statements)

References 59 publications

(132 reference statements)

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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][55][56][57][58][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: Discussionsupporting

confidence: 52%

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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Section: Discussionsupporting

confidence: 52%

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

et al. 2021

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“…Additionally, it is used as a primary endpoint in ongoing clinical studies with an interleukin-23 blocker, tildrakizumab for the treatment of psoriasis [ 54 , 55 ]. Although the DLQI-R is equally good or even better in many aspects of measurement properties than the DLQI [ 12 , 52 , 53 ], it cannot settle all issues around the underlying construct of the original questionnaire (e.g. DIF).…”

Section: Discussionmentioning

confidence: 99%

A Rasch model analysis of two interpretations of ‘not relevant’ responses on the Dermatology Life Quality Index (DLQI)

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Purpose Eight of the ten items of the Dermatology Life Quality Index (DLQI) have a ‘not relevant’ response (NRR) option. There are two possible ways to interpret NRRs: they may be considered ‘not at all’ or missing responses. We aim to compare the measurement performance of the DLQI in psoriasis patients when NRRs are scored as ‘0’ (hereafter zero-scoring) and ‘missing’ (hereafter missing-scoring) using Rasch model analysis. Methods Data of 425 patients with psoriasis from two earlier cross-sectional surveys were re-analysed. All patients completed the paper-based Hungarian version of the DLQI. A partial credit model was applied. The following model assumptions and measurement properties were tested: dimensionality, item fit, person reliability, order of response options and differential item functioning (DIF). Results Principal component analysis of the residuals of the Rasch model confirmed the unidimensional structure of the DLQI. Person separation reliability indices were similar with zero-scoring (0.910) and missing-scoring (0.914) NRRs. With zero-scoring, items 6 (sport), 7 (working/studying) and 9 (sexual difficulties) suffered from item misfit and item-level disordering. With missing-scoring, no misfit was observed and only item 7 was illogically ordered. Six and three items showed DIF for gender and age, respectively, that were reduced to four and three by missing-scoring. Conclusions Missing-scoring NRRs resulted in an improved measurement performance of the scale. DLQI scores of patients with at least one vs. no NRRs cannot be directly compared. Our findings provide further empirical support to the DLQI-R scoring modification that treats NRRs as missing and replaces them with the average score of the relevant items.

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“…Between September 2017 and October 2019, we carried out a cross-sectional survey at three academic dermatology clinics in Hungary [40]. The inclusion criteria to this study were as follows: (i) ≥ 18 years of age; (ii) cognitive ability to understand the questionnaire; (iii) diagnosis of HS by a dermatologist; and (iv) signing a consent form prior to the data collection.…”

Section: Study Design and Patient Populationmentioning

confidence: 99%

The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa

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Purpose Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects up to 1% of the population in Europe. The EQ-5D is the most commonly used generic instrument for measuring health-related quality of life among HS patients. This study aims to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with HS. Methods We recruited 200 consecutive patients with HS (mean age 37 years, 38% severe or very severe HS) to participate in a multicentre cross-sectional survey. Patients completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16 questionnaires. Results More than twice as many different health state profiles occurred in the EQ-5D-5L compared to the EQ-5D-3L (101 vs. 43). A significant reduction in ceiling effect was found for the mobility, self-care and usual activities dimensions. A good agreement was established between the EQ-5D-3L and EQ-5D-5L with an intraclass correlation coefficient of 0.872 (95% CI 0.830–0.903; p < 0.001) that was confirmed by a Bland-Altman plot. EQ-5D-5L improved both the absolute and relative informativity in all dimensions except for anxiety/depression. EQ-5D-3L and EQ-5D-5L demonstrated similar convergent validity with DLQI and Skindex-16. EQ-5D-5L was able to better discriminate between known groups of patients based on the number of comorbidities and disease severity (HS-Physician's Global Assessment). Conclusion In patients with HS, the EQ-5D-5L outperformed the EQ-5D-3L in feasibility, ceiling effects, informativity and known-groups validity for many important clinical characteristics. We recommend using the EQ-5D-5L in HS patients across various settings, including clinical care, research and economic evaluations.

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Validity of EQ‐5D‐5L, Skindex‐16, DLQI and DLQI‐R in patients with hidradenitis suppurativa

Cited by 33 publications

References 59 publications

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

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

A Rasch model analysis of two interpretations of ‘not relevant’ responses on the Dermatology Life Quality Index (DLQI)

The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa

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