Development of a new questionnaire for evaluating QOL in adult hypopituitarism: adult hypopituitarism questionnaire (AHQ)
Akira Shimatsu1, Hitoshi Ishii2 & Kazuo Chihara3
Objective: To develop and validate the adult hypopituitarism questionnaire (AHQ) as a disease-specific, self-administered questionnaire for evaluation of QOL in adult patients with hypopituitarism.
Methods: The development and validation of a new questionnaire were performed in a standardized manner: item development, pilot-testing and psychometric validation.
Result: Content validity of the initial questionnaire was evaluated via two pilot-tests. After these tests, we made minor revisions and finalized the initial version of the questionnaire. The questionnaire was constructed with two domains: psycho-social and condition-related domain. For psychometric assessment, analyses were performed on the responses of 196 adult patients with various degrees of hypopituitarism. The intraclass correlations of the respective domains were 0.91 and 0.95, and Cronbachs α coefficients were 0.96 and 0.94, indicating adequate testretest reliability and internal consistency for each domain. For known-group validity, domain scores were closely associated with the investigators assessment of symptom severity; the more severe the symptoms, the lower the QOL. For construct validity, the domain structure was found to be almost the same as that initially hypothesized. Exploratory factor analysis (n=228) demonstrated that each domain consisted of five and seven sub-domains, respectively.
Conclusion: The AHQ showed good reliability and validity for evaluating QOL in adult Japanese patients with hypopituitarism. Further assessments, such as factor validity, responsiveness and translatability into other languages are required to make the questionnaire more robust to meet international standards.