title: Development and evaluation of the Liver Disease Quality of Life instrument in persons with advanced, chronic liver disease--the LDQOL 1.0.
abstract: OBJECTIVE
  Assessment of health-related quality of life (HRQOL) outcomes in studies of liver disease and liver transplantation is necessary. Reliable and valid disease-targeted HRQOL measures are thus needed. The objective of this study was to develop a reliable and valid self-report HRQOL instrument for ambulatory adults with chronic liver disease.
  
  
  METHODS
  The Liver Disease Quality of Life instrument, LDQOL 1.0 (an HRQOL measure that uses the SF-36 as a generic core and 12 disease-targeted multi-item scales) was administered in a multicenter, cross-sectional field test to 221 ambulatory adults with advanced, chronic liver disease referred for primary liver transplantation evaluation. Disease-targeted scales included liver disease-related symptoms, liver disease-related effects on activities of daily living, concentration, memory, sexual functioning, sexual problems, sleep, loneliness, hopelessness, quality of social interaction, health distress, and self-perceived stigma of liver disease. We estimated the internal consistency reliability (Cronbach's alpha) for multi-item scales and construct validity.
  
  
  RESULTS
  Interial consistency reliability coefficients were excellent, ranging from 0.62 to 0.95, with 19 of 20 scales >0.70. Multitrait scaling analysis provided strong support for item discrimination across scales, and exploratory factor analysis demonstrated distinguishable physical, mental, and social health dimensions. Significant associations were found between worse HRQOL and worse Child-Pugh class, worse self-rated liver disease severity, and increased number of disability days.
  
  
  CONCLUSIONS
  The results of this multicenter field test provide support for the reliability and validity of the LDQOL 1.0 as an HRQOL outcome measure for individuals with chronic liver disease.
authors.affiliation: Veterans Affairs Greater Los Angeles Health Care System, Division of Gastroenterology, California 90073, USA.
authors.forename: I M
authors.initials: IM
authors.lastname: Gralnek
authors.forename: R D
authors.initials: RD
authors.lastname: Hays
authors.forename: A
authors.initials: A
authors.lastname: Kilbourne
authors.forename: H R
authors.initials: HR
authors.lastname: Rosen
authors.forename: E B
authors.initials: EB
authors.lastname: Keeffe
authors.forename: L
authors.initials: L
authors.lastname: Artinian
authors.forename: S
authors.initials: S
authors.lastname: Kim
authors.forename: D
authors.initials: D
authors.lastname: Lazarovici
authors.forename: D M
authors.initials: DM
authors.lastname: Jensen
authors.forename: R W
authors.initials: RW
authors.lastname: Busuttil
authors.forename: P
authors.initials: P
authors.lastname: Martin
mesh_terms: D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008107:Liver Diseases / Q000453:epidemiology / Q000523:psychology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires