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Reliability and validity of the Chinese version of chronic liver disease questionnaire-nonalcoholic fatty liver disease in patients with nonalcoholic fatty liver disease: a multicenter cross-sectional survey in China

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Abstract

Purpose

The Chronic Liver Disease Questionnaire (CLDQ)-Nonalcoholic Fatty Liver Disease (NAFLD) is a disease-specific instrument to assess the health-related quality of life (HRQL) of patients with NAFLD. In order to provide further evidence for the cross-cultural utility of this instrument in the Chinese population, we translated the CLDQ-NAFLD into Chinese and examined its reliability and validity.

Methods

Patients with NAFLD in 90 hospitals across China were enrolled in this multicenter cross-sectional survey. Eligible patients completed the Chinese version of CLDQ-NAFLD at enrollment to assess HRQL. Internal consistency of the questionnaire was assessed using Cronbach’s alpha coefficient and split-half reliability. Convergent and discriminant validity were assessed using Spearman correlation coefficient. Factor analysis was used to test the construct validity.

Results

Between March and August 2019, 5181 patients with a mean age of 43.8 ± 13.3 years were enrolled. All domains exhibited good internal consistency, with Cronbach’s alpha and split-half reliability greater than 0.70. The scaling success rate of all domains was 100% for convergent validity and 99.4% (179/180) for discriminant validity. The inter-scale correlations indicated a significant correlation between all CLDQ-NAFLD domains (r = 0.608 to 0.832, all p < 0.001). Factor analysis of 36 items extracted 6 factors, which explained 69.14% of the total variance.

Conclusion

The Chinese version of CLDQ-NAFLD is a reliable and valid instrument for assessing the HRQL of Chinese patients with NAFLD.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Code availability

Not Applicable.

Abbreviations

NAFLD:

Non-alcoholic fatty liver disease

HRQL:

Health-related quality of life

CLDQ:

Chronic liver disease questionnaire

SD:

Standard deviations

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Acknowledgements

Language editing services provided by Meg.Tang of MIMS Shanghai Limited., funded by Sanofi (China) Investment Co., Ltd.

Funding

This work was supported by National Natural Science Foundation of China [Grant No. 81870406], and National Natural Science Foundation of China [Grant no. 81870407].

Author information

Authors and Affiliations

  1. Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing International Cooperation Base for Science and Technology On NAFLD Diagnosis, Peking University People’s Hospital, Peking University Hepatology Institute, No.11 Xizhimen South Street, Beijing, 100044, China

    Rui Huang & Hui-Ying Rao

  2. Department of Digestive, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Jian-Gao Fan

  3. Department of Hepatology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China

    Jun-Ping Shi

  4. Department of Digestive, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Yi-Min Mao

  5. Department of Digestive, The First Hospital of China Medical University, Shenyang, China

    Bing-Yuan Wang

  6. Department of Pathology, The Fifth Medical Center of PLA General Hospital, Beijing, China

    Jing-Min Zhao & Zheng-Sheng Zou

  7. Department of Digestive, The First People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Lun-Gen Lu

  8. Department of Digestive, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

    Bi-Hui Zhong

  9. Department of Digestive, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    You-Qing Xu

  10. Department of Infectious Disease, The First Hospital of Fushan, Fushan, China

    Yi-Nong Ye

  11. Department of Hepatology, The Third People’s Hospital, Changzhou, China

    Long-Gen Liu

  12. Department of Digestive, Shengjing Hospital of China Medical University, Shenyang, China

    Lian-Jie Lin

  13. Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, No.168, Litang Road, Changping District, Beijing, 102218, China

    Lai Wei

Authors
  1. Rui Huang
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  2. Jian-Gao Fan
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  14. Hui-Ying Rao
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  15. Lai Wei
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Contributions

R.H., H.R. and L.W: conception and design. All authors: data collection. R.H., H.R. and L.W: data analysis and interpretation. All authors: providing materials and samples. R.H: drafting article. All the authors have read and approved the final manuscript.

Corresponding authors

Correspondence to Hui-Ying Rao or Lai Wei.

Ethics declarations

Conflict of interest

H Rao has received speaking fees from Bristol-Myers Squibb, Gilead, and AbbVie. L Wei has received research support and/or consulting fees from Abbvie, Bristol-Myers Squibb, Gilead, Roche, and Novartis. R Huang, J Fan, J Shi, Y Mao, B Wang, J Zhao, L Lu, B Zhong, Z Zou, Y Xu, Y Ye, L Liu and L Lin certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

This study was approved by the Institutional Review Board of Peking University People’s Hospital (2018PHB259-01). Written informed consent was obtained from each patient.

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Not applicable.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Huang, R., Fan, JG., Shi, JP. et al. Reliability and validity of the Chinese version of chronic liver disease questionnaire-nonalcoholic fatty liver disease in patients with nonalcoholic fatty liver disease: a multicenter cross-sectional survey in China. Qual Life Res 32, 915–922 (2023). https://doi.org/10.1007/s11136-022-03305-w

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