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Development and validation of a vitiligo-specific quality-of-life instrument (VitiQoL) - 14/06/13

Doi : 10.1016/j.jaad.2012.01.038 
Evelyn Lilly, MD a, Phoebe D. Lu, MD, PhD d, Judy H. Borovicka, MD a, David Victorson, PhD b, Mary J. Kwasny, ScD c, Dennis P. West, PhD a, Roopal V. Kundu, MD a, d,
a Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 
b Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois 
c Department of Preventive Medicine, Biostatistics Collaboration Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois 
d Department of Dermatology, New York University School of Medicine, New York, New York 

Reprint requests: Roopal V. Kundu, MD, Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St Clair St, Suite 1600, Chicago, IL 60611.

Abstract

Background

Vitiligo significantly affects a person’s health-related quality of life (HRQL). Although a small number of generic, and disease-specific, dermatologic HRQL measures exist, currently no vitiligo-specific instrument is available to capture disease-targeted concerns and issues.

Objective

We sought to develop and validate a vitiligo-specific self-report instrument for HRQL.

Methods

A pool of vitiligo-specific items was created based on in-depth interviews with patients with vitiligo (n = 16) and their responses to items in several previously validated HRQL measures. These items comprising our new instrument, VitiQoL, along with Skindex-16 and Dermatology Life Quality Index were administered to patients with vitiligo (n = 90) at two academic centers. This new instrument was validated using psychometric analysis.

Results

The VitiQoL items showed high internal consistency (Cronbach alpha = 0.935). Exploratory factor analysis demonstrated 3 factors: participation limitation, stigma, and behavior. Concurrent validity was evidenced by large correlations between self-reported severity and VitiQoL scores (r = 0.51). Known groups validity was demonstrated for the VitiQoL behavior subscale between individuals with exposed and unexposed patches (P = .01). Convergent validity was shown by strong correlations between VitiQoL and outside dermatology scales measuring similar constructs (Skindex-16, r = 0.82; Dermatology Life Quality Index, r = 0.83).

Limitations

Potential selection bias was a limitation as most patients were recruited from academic centers. Reliability of the instrument was tested only with internal consistency and not reproducibility. Responsiveness of the instrument was not tested because of the prolonged time course necessary to observe clinically significant change in vitiligo.

Conclusion

VitiQoL is a reliable and valid HRQL instrument.

Le texte complet de cet article est disponible en PDF.

Key words : health-related quality of life, instrument development, instrument validation, vitiligo

Abbreviations used : DLQI, HRQL, VitiQoL


Plan


 Supported by the Ambi Skin of Color Society Research Award.
 The first two authors contributed equally to this article.
 Conflicts of interest: None declared.


© 2012  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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