Development and predictive validity of the cirrhosis-associated ascites symptom scale: A cohort study of 103 patients

TY - JOUR

T1 - Development and predictive validity of the cirrhosis-associated ascites symptom scale

T2 - A cohort study of 103 patients

AU - Riedel, Agnete Nordheim

AU - Kimer, Nina

AU - Jensen, Anne-Sofie Houlberg

AU - Dahl, Emilie Kristine

AU - Israelsen, Mads

AU - Aamann, Luise

AU - Gluud, Lise Lotte

PY - 2018/4/21

Y1 - 2018/4/21

N2 - AIM: To develop a scale of domains associated with the health-related quality-of-life (HRQOL) in patients with cirrhosis-related ascites. METHODS: We initially undertook literature searches and a qualitative study in order to design a cirrhosis-associated ascites symptom (CAS) scale describing symptoms with a potential detrimental impact on health related quality of life (HRQL) (the higher the score, the worse the symptoms). Discriminatory validity was assessed in a validation cohort including cirrhotic patients with (1) tense/severe; (2) moderate/mild; or (3) no ascites (controls). Patients also completed chronic liver disease questionnaire (CLDQ) and the EuroQoL 5-Dimensions 5-Level (EQ-5D-5L) questionnaire evaluating HRQL. The relation between scale scores was analysed using Spearman correlations. RESULTS: The final CAS scale included 14 items. The equivalent reliability was high (Chronbach's alpha 0.88). The validation cohort included 103 patients (72% men, mean age 62.4 years). The mean scores for each question in the CAS scale were higher for patients with severe/tense ascites than for mild/moderate ascites and controls. Compared with controls (mean = 9.9 points), the total CAS scale score was higher for severe/tense ascites (mean = 23.8 points) as well as moderate/mild ascites (mean = 18.6 points) (P < 0.001 both groups). We found a strong correlation between the total CAS and CLDQ score (rho = 0.82, P < 0.001) and a moderate correlation between the CAS and the EQ-5D-5L score (0.67, P < 0.001). CONCLUSION: The CAS is a valid tool, which reflects HRQOL in patients with ascites.

AB - AIM: To develop a scale of domains associated with the health-related quality-of-life (HRQOL) in patients with cirrhosis-related ascites. METHODS: We initially undertook literature searches and a qualitative study in order to design a cirrhosis-associated ascites symptom (CAS) scale describing symptoms with a potential detrimental impact on health related quality of life (HRQL) (the higher the score, the worse the symptoms). Discriminatory validity was assessed in a validation cohort including cirrhotic patients with (1) tense/severe; (2) moderate/mild; or (3) no ascites (controls). Patients also completed chronic liver disease questionnaire (CLDQ) and the EuroQoL 5-Dimensions 5-Level (EQ-5D-5L) questionnaire evaluating HRQL. The relation between scale scores was analysed using Spearman correlations. RESULTS: The final CAS scale included 14 items. The equivalent reliability was high (Chronbach's alpha 0.88). The validation cohort included 103 patients (72% men, mean age 62.4 years). The mean scores for each question in the CAS scale were higher for patients with severe/tense ascites than for mild/moderate ascites and controls. Compared with controls (mean = 9.9 points), the total CAS scale score was higher for severe/tense ascites (mean = 23.8 points) as well as moderate/mild ascites (mean = 18.6 points) (P < 0.001 both groups). We found a strong correlation between the total CAS and CLDQ score (rho = 0.82, P < 0.001) and a moderate correlation between the CAS and the EQ-5D-5L score (0.67, P < 0.001). CONCLUSION: The CAS is a valid tool, which reflects HRQOL in patients with ascites.

KW - Aged

KW - Ascites/diagnosis

KW - Cohort Studies

KW - Cross-Sectional Studies

KW - Denmark

KW - Female

KW - Humans

KW - Liver Cirrhosis/complications

KW - Male

KW - Middle Aged

KW - Quality of Life

KW - Reproducibility of Results

KW - Surveys and Questionnaires

U2 - 10.3748/wjg.v24.i15.1650

DO - 10.3748/wjg.v24.i15.1650

M3 - Journal article

C2 - 29686472

SN - 1007-9327

VL - 24

SP - 1650

EP - 1657

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

IS - 15

ER -