Journal Article

Evaluation of the Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire in diarrheal-predominant irritable bowel syndrome patients

Covington, Paul S, Patrick, Donald L, Drossman, Douglas A, Andrae, David A

2013

Overview

Background Diarrhea-predominant irritable bowel syndrome (IBS-d) significantly diminishes the health-related quality of life (HRQOL) of patients. Psychological and social impacts are common with many IBS-d patients reporting comorbid depression, anxiety, decreased intimacy, and lost working days. The Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire is a 34-item instrument developed and validated for measurement of HRQOL in non-subtyped IBS patients. The current paper assesses this previously-validated instrument employing data collected from 754 patients who participated in a randomized clinical trial of a novel treatment, eluxadoline, for IBS-d. Methods Psychometric methods common to HRQOL research were employed to evaluate the IBS-QOL. Many of the historical analyses of the IBS-QOL validations were used. Other techniques that extended the original methods were applied where more appropriate for the current dataset. In IBS-d patients, we analyzed the items and substructure of the IBS-QOL via item reduction, factor structure, internal consistency, reproducibility, construct validity, and ability to detect change. Results This study supports the IBS-QOL as a psychometrically valid measure. Factor analyses suggested that IBS-specific QOL as measured by the IBS-QOL is a unidimensional construct. Construct validity was further buttressed by significant correlations between IBS-QOL total scores and related measures of IBS-d severity including the historically-relevant Irritable Bowel Syndrome Adequate Relief (IBS-AR) item and the FDA’s Clinical Responder definition. The IBS-QOL also showed a significant ability to detect change as evidenced by analysis of treatment effects. A minority of the items, unrelated to the IBS-d, performed less well by the standards set by the original authors. Conclusions We established that the IBS-QOL total score is a psychometrically valid measure of HRQOL in IBS-d patients enrolled in this study. Our analyses suggest that the IBS-QOL items demonstrate very good construct validity and ability to detect changes due to treatment effects. Furthermore, our analyses suggest that the IBS-QOL items measure a univariate construct and we believe further modeling of the IBS-QOL from an item response theory (IRT) approach under both non-treatment and treatment conditions would greatly further our understanding as item-based methods could be used to develop a short form.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V
• Subject: Abdomen / Adolescent / Adult / Aged / Bowel disease / Care and treatment / Clinical trials / Comorbidity / Constipation / Diaries / Diarrhea / Diarrhea - psychology / Dose-Response Relationship, Drug / Factor Analysis, Statistical / Female / Humans / Irritable bowel syndrome / Irritable Bowel Syndrome - drug therapy / Irritable Bowel Syndrome - physiopathology / Irritable Bowel Syndrome - psychology / Male / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Middle Aged / Pain / Patient Satisfaction / Principal components analysis / Psychometrics / Quality of life / Quality of Life - psychology / Quality of Life Research / Questionnaires / Randomized Controlled Trials as Topic / Studies / Surveys / Surveys and Questionnaires - standards / United States / Young Adult