Development and validation of a disease-targeted quality of life instrument for chronic diverticular disease: the DV-QOL
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Colonic diverticular disease is typically conceived as acute diverticulitis attacks surrounded by periods of clinical silence. However, evolving data indicate that many patients have persistent symptoms and diminished health-related quality of life (HRQOL) long after acute attacks. We developed a disease-targeted HRQOL measure for symptomatic uncomplicated diverticular disease (SUDD)—the diverticulitis quality of life (DV-QOL) instrument.
We conducted a systematic literature review to craft a conceptual model of SUDD HRQOL. This was complemented by three focus groups including 45 SUDD patients. We developed items based on our literature search, focus groups, and cognitive debriefings. We administered the items to SUDD patients with persistent symptoms following a confirmed diverticulitis event. We created scales based on factor analysis and evaluated the scales for reliability and validity.
Concept elicitation revealed a range of illness experiences attributed to SUDD. Coding of 20,490 transcribed words yielded a 52-code network with four primary, condition-related concepts: (1) physical symptoms (e.g., bloating); (2) behaviors (e.g., restrictions); (3) cognitions and concerns (e.g., fear); and (4) impact and consequences (e.g., absenteeism, anxiety). Based on patient language, we developed the 17-item DV-QOL instrument. In a cross-sectional validation sample of 197 patients, DV-QOL discriminated between patients with recent versus distant diverticulitis events and correlated highly with Short Form 36 and hospital anxiety and depression scores.
Patients with SUDD attribute a wide range of negative psychological, social, and physical symptoms to their condition, both during and after acute attacks; DV-QOL captures these symptoms in a valid, reliable manner.
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- Development and validation of a disease-targeted quality of life instrument for chronic diverticular disease: the DV-QOL
Quality of Life Research
Volume 24, Issue 1 , pp 163-179
- Cover Date
- Print ISSN
- Online ISSN
- Springer International Publishing
- Additional Links
- Patient-reported outcomes
- Health-related quality of life
- Industry Sectors
- Brennan M. R. Spiegel (1) (2) (3) (8)
- Mark W. Reid (1) (8)
- Roger Bolus (2) (8)
- Cynthia B. Whitman (8)
- Jennifer Talley (1) (8)
- Stanley Dea (4)
- Kamyar Shahedi (4)
- Hetal Karsan (5)
- Chassidy Teal (5)
- Gil Y. Melmed (6)
- Erica Cohen (1) (6)
- Garth Fuller (3) (8)
- Linnette Yen (7)
- Paul Hodgkins (7)
- M. Haim Erder (7)
- Author Affiliations
- 1. Department of Gastroenterology, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Building 115, Room 215, Los Angeles, CA, 90073, USA
- 2. Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- 3. Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- 8. Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
- 4. Department of Gastroenterology, UCLA-Olive View Medical Center, Los Angeles, CA, USA
- 5. Atlanta Gastroenterology Associates, Atlanta, GA, USA
- 6. Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- 7. Shire Development LLC, Wayne, PA, USA