Evaluation of smoking-specific and generic quality of life measures in current and former smokers in Germany and the United States

Health and Quality of Life Outcomes

Rick Guyer¹  Anuradha Kulasekaran³  Barbara Gandek²  John E. Ware² 

[1] John Ware Research Group, 10 Wheeler Court, Watertown 02472, MA, USA;Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester 01655, MA, USA;British American Tobacco (Investments) Ltd., Group Research & Development, Regents Park Road, Southampton SO15 8TL, UK

关键词: Validity;    Reliability;    Smoking-specific measures;    Health-related quality of life;    Biomarkers of exposure;    Smoking;   

Others  :  1224710
DOI  :  10.1186/s12955-015-0316-3

 received in 2014-12-02, accepted in 2015-07-27,  发布年份 2015

【 摘 要 】

Background

Health-related quality of life (QOL) surveys include generic measures that enable comparisons across conditions and measures that focus more specifically on one disease or condition. We evaluated the psychometric properties of German- and English-language versions of survey scales representing both types of measures in samples of current and former smokers.

Methods

TQOLIT™v1 integrates new measures of smoking-specific symptoms and QOL impact attributed to smoking with generic SF-36 Health Survey measures. For purposes of evaluation, cross-sectional data were analyzed for two independent samples. Disease-free (otherwise healthy) adults ages 23–55 used a tablet to complete surveys in a clinical trial in Germany (125 current and 54 former smokers). Online general population surveys were completed in the US by otherwise healthy current and former smokers (N = 149 and 110, respectively). Evaluations included psychometric tests of assumptions underlying scale construction and scoring, score distributions, and reliability. Tests of validity included cross-sectional correlations and analyses of variance based on a conceptual framework and hypotheses for groups differing in self-reported smoking behavior (current versus former smoker, cigarettes per day (CPD)) and severity of smoking symptoms in both samples and, in the German trial only, clinical parameters of biomarkers of exposure.

Results

Tests of scaling assumptions and internal consistency reliability (alpha = 0.71–0.79) of the smoking-specific measures were satisfactory, although ceiling effects attenuated correlations for former smokers in both samples. Correlational evidence supporting validity of smoking-specific symptom and impact measures included their substantial inter-correlation and higher correlations (than generic measures) with smoking behavior (favoring former over current groups) and CPD in both samples. In the German trial, both smoking-specific measures correlated significantly (p < 0.05) with all four biomarkers. QOL impact attributed to smoking correlated with the SF-36 mental but not physical summary measures in both samples.

Conclusions

German- and English-language TQOLITv1 surveys have comparable and satisfactory psychometric properties. Cross-sectional tests, including correlations with four biomarkers, support the validity of the new smoking-specific measures for use in studies of otherwise healthy smokers. Smoking-specific measures consistently performed better than generic QOL measures in all tests of validity.

【 授权许可】

   
2015 Ware et al.

【 图 表 】

Figure 1.

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