Brief Article
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World J Gastroenterol. Jun 14, 2013; 19(22): 3494-3501
Published online Jun 14, 2013. doi: 10.3748/wjg.v19.i22.3494
Psychometrics of chronic liver disease questionnaire in Chinese chronic hepatitis B patients
Kai-Na Zhou, Min Zhang, Qian Wu, Zhen-Hao Ji, Xiao-Mei Zhang, Gui-Hua Zhuang
Kai-Na Zhou, Min Zhang, Qian Wu, Zhen-Hao Ji, Xiao-Mei Zhang, Gui-Hua Zhuang, Department of Epidemiology and Biostatistics, Xi’an Jiaotong University College of Medicine, Xi’an 710061, Shaanxi Province, China
Author contributions: All authors participated in the design of the study; Zhou KN, Zhang M, Ji ZH and Zhang XM collected data; Zhou KN, Zhang M and Zhuang GH were involved in data analysis and interpretation; Zhou KN and Zhuang GH drafted the manuscript; all authors have read and approved the final manuscript.
Supported by The National TS Major Project of China, No. 2008ZX10002-001 and No. 2012ZX10002001
Correspondence to: Gui-Hua Zhuang, PhD, Department of Epidemiology and Biostatistics, Xi’an Jiaotong University College of Medicine, No. 76 Yanta Western Road, Xi’an 710061, Shaanxi Province, China.
Telephone: +86-29-82655108 Fax: +86-29-82655032
Received: January 8, 2013
Revised: March 25, 2013
Accepted: March 28, 2013
Published online: June 14, 2013

AIM: To evaluate psychometrics of the Chinese (mainland) chronic liver disease questionnaire (CLDQ) in patients with chronic hepatitis B (CHB).

METHODS: A cross-sectional sample of 460 Chinese patients with CHB was selected from the Outpatient Department of the Eighth Hospital of Xi’an, including CHB (CHB without cirrhosis) (n = 323) and CHB-related cirrhosis (n = 137). The psychometrics includes reliability, validity and sensitivity. Internal consistency reliability was measured using Cronbach’s α. Convergent and discriminant validity was evaluated by item-scale correlation. Factorial validity was explored by principal component analysis with varimax rotation. Sensitivity was assessed using Cohen’s effect size (ES), and independent sample t test between CHB and CHB-related cirrhosis groups and between alanine aminotransferase (ALT) normal and abnormal groups after stratifying the disease (CHB and CHB-related cirrhosis).

RESULTS: Internal consistency reliability of the CLDQ was 0.83 (range: 0.65-0.90). Most of the hypothesized item-scale correlations were 0.40 or over, and all of such hypothesized correlations were higher than the alternative ones, indicating satisfactory convergent and discriminant validity. Six factors were extracted after varimax rotation from the 29 items of CLDQ. The eligible Cohen’s ES with statistically significant independent sample t test was found in the overall CLDQ and abdominal, systematic, activity scales (CHB vs CHB-related cirrhosis), and in the overall CLDQ and abdominal scale in the stratification of patients with CHB (ALT normal vs abnormal).

CONCLUSION: The CLDQ has acceptable reliability, validity and sensitivity in Chinese (mainland) patients with CHB.

Keywords: Chronic hepatitis B, Chronic liver disease questionnaire, Reliability, Validity, Sensitivity

Core tip: Chronic hepatitis B (CHB) is a common chronic liver disease in mainland China, and its adverse prognosis might impair the patients’ health-related quality of life (HRQoL). The chronic liver disease questionnaire (CLDQ) is the first liver specific HRQoL instrument, however, few studies have examined psychometrics of the Chinese (mainland) CLDQ in CHB patients. This study tested psychometrics of the Chinese (mainland) CLDQ in patients with CHB (including CHB without cirrhosis and CHB-related cirrhosis). The findings will help find suitable disease-specific questionnaire in the management of CHB in mainland China and provide evidence for expanding the use of the CLDQ.