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Cross-cultural validity of the thyroid-specific quality-of-life patient-reported outcome measure, ThyPRO

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Abstract

Background and purpose

Thyroid diseases are common and often affect quality of life (QoL). No cross-culturally validated patient-reported outcome measuring thyroid-related QoL is available. The purpose of the present study was to test the cross-cultural validity of the newly developed thyroid-related patient-reported outcome ThyPRO, using tests for differential item functioning (DIF) according to language version.

Methods

The ThyPRO consists of 85 items summarized in 13 multi-item scales and one single item. Scales cover physical and mental symptoms, well-being and function as well as social and daily function and cosmetic concerns. Translation applied standard forward–backward methodology with subsequent cognitive interviews and reviews. Responses (N = 1,810) to the ThyPRO were collected in seven countries: UK (n = 166), The Netherlands (n = 147), Serbia (n = 150), Italy (n = 110), India (n = 148), Denmark (n = 902) and Sweden (n = 187). Translated versions were compared pairwise to the English version by examining uniform and nonuniform DIF, i.e., whether patients from different countries respond differently to a particular item, although they have identical level of the concept measured by the item. Analyses were controlled for thyroid diagnosis. DIF was investigated by ordinal logistic regression, testing for both statistical significance and magnitude (ΔR 2 > 0.02). Scale level was estimated by the sum score, after purification.

Results

For twelve of the 84 tested items, DIF was identified in more than one language. Eight of these were small, but four were indicative of possible low translatability. Twenty-one instances of DIF in single languages were identified, indicating potential problems with the particular translation. However, only seven were of a magnitude which could affect scale scores, most of which could be explained by sample differences not controlled for.

Conclusion

The ThyPRO has good cross-cultural validity with only minor cross-cultural invariance and is recommended for use in international multicenter studies.

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Acknowledgments

This study has been supported by grants from the Danish Agency for Science, Technology and Innovation: Council for Strategic Research and Council for Independent Research and by Genzyme Corporation by an unrestricted research grant. Special thanks to Sabrina Sereni, Supriya Mathur, Kajsa Bergman, Gitte Karina Geil, Kim Æbelø, Selma Flora Watt and Laura Siim Magnussen for assistance with data entry and logistics.

Conflict of interest

None of the authors have any financial conflict of interest to declare. The ThyPRO was developed by TW, UFR, ÅKR, JBB, MG, SB and LH.

Author information

Authors and Affiliations

  1. Department of Endocrinology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark

    Torquil Watt, Åse Krogh Rasmussen & Ulla Feldt-Rasmussen

  2. Massachusetts General Hospital, Boston, MA, USA

    Giuseppe Barbesino

  3. QualityMetric, Lincoln, RI, USA

    Jakob Bue Bjorner

  4. Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

    Steen Joop Bonnema & Laszlo Hegedüs

  5. Clinical Centre of Serbia, Belgrade, Serbia

    Branka Bukvic, Ivan Paunovic & Vladan Zivaljevic

  6. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK

    Russell Drummond & Terence J. Quinn

  7. Research Unit, Department of Palliative Medicine, Bispebjerg Hospital and Department of Health Service Research, University of Copenhagen, Copenhagen, Denmark

    Mogens Groenvold

  8. Health Research Associates Inc., Mountlake Terrace, WA, USA

    Valeska Kantzer

  9. Pharmerit International, Bethesda, MD, USA

    Kathryn E. Lasch

  10. University Department of Clinical and Experimental Medicine, University of Pisa, and Endocrine Unit 2, University Hospital of Pisa, Pisa, Italy

    Claudio Marcocci

  11. Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

    Anjali Mishra

  12. Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands

    Romana Netea-Maier, Merel Ekker & Johannes Smit

  13. University College Cork, Cork, Ireland

    Audrey Russell

  14. Christian Medical College, Vellore, India

    Mayilvaganan Sabaretnam

  15. Institution for Clinical Science and Education, Karolinska Institutet Södersjukhuset, Stockholm, Sweden

    Ove Törring

Authors
  1. Torquil Watt
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  2. Giuseppe Barbesino
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  3. Jakob Bue Bjorner
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  4. Steen Joop Bonnema
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  5. Branka Bukvic
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  6. Russell Drummond
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  7. Mogens Groenvold
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  8. Laszlo Hegedüs
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  9. Valeska Kantzer
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  15. Ivan Paunovic
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  16. Terence J. Quinn
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  17. Åse Krogh Rasmussen
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  18. Audrey Russell
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  20. Johannes Smit
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  21. Ove Törring
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  22. Vladan Zivaljevic
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  23. Ulla Feldt-Rasmussen
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Corresponding author

Correspondence to Torquil Watt.

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Watt, T., Barbesino, G., Bjorner, J.B. et al. Cross-cultural validity of the thyroid-specific quality-of-life patient-reported outcome measure, ThyPRO. Qual Life Res 24, 769–780 (2015). https://doi.org/10.1007/s11136-014-0798-1

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