Psychometric validation of the celiac disease-specific quality of life survey (CD-QOL) in adults with celiac disease in the United States
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Published:2023-03-16
Issue:8
Volume:32
Page:2195-2208
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ISSN:0962-9343
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Container-title:Quality of Life Research
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language:en
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Short-container-title:Qual Life Res
Author:
Dochat CaraORCID, Afari NiloofarORCID, Arigo DanielleORCID
Abstract
Abstract
Purpose
Celiac disease and its treatment negatively impact quality of life, indicating potential need for measurement of disease-specific quality of life domains to inform interdisciplinary intervention. The Celiac Disease Quality of Life Survey (CD-QOL) has been used in clinical research; however, its factor structure has not been confirmed and psychometric properties have not been evaluated in English-speaking adults in the U.S. Aims: (1) Confirm the factor structure of the 20-item English CD-QOL; (2) assess psychometric properties including internal consistency reliability, convergent validity, known groups validity, and incremental validity.
Methods
453 adults with self-reported Celiac disease (Mage = 40.57; 88% female; 92% White) completed the CD-QOL and validated measures of generic health-related quality of life (SF-36), gluten-free diet adherence (CDAT), anxiety and depression symptoms (PROMIS), and physical symptoms (CSI) as part of the iCureCeliac® patient-powered research network.
Results
Confirmatory factor analysis found superior fit for a bifactor structure with one general factor and four group factors. Ancillary bifactor analyses suggest the CD-QOL can be considered primarily unidimensional. Total and three subscale scores demonstrated acceptable internal consistency reliability. Convergent and known groups validity were supported. The CD-QOL demonstrated some incremental validity over the SF-36.
Conclusion
The English CD-QOL can be used as a measure of disease-specific quality of life among adults with Celiac disease in the U.S. Compared to generic instruments, the CD-QOL appears to better capture specific cognitive and affective aspects of living with Celiac disease. Use of a total score is recommended. Its utility as a screening and outcome measurement tool in clinical settings should be examined.
Funder
National Institute of Diabetes and Digestive and Kidney Diseases National Heart, Lung, and Blood Institute
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
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