title: Development of a disease-specific quality of life questionnaire in Addison's disease.
abstract: BACKGROUND
  Patients with Addison's disease reproducibly self-report impairment in specific dimensions of general well-being questionnaires, suggesting particular deficiencies in health-related quality-of-life (HRQoL).
  
  
  OBJECTIVE
  We sought to develop an Addison's disease-specific questionnaire (AddiQoL) that could better quantify altered well-being and treatment effects. Design, Setting, Patients, Intervention, and Outcomes: We reviewed the literature to identify HRQoL issues in Addison's disease and interviewed patients and their partners in-depth to explore various symptom domains. A list of items was generated, and nine expert clinicians and five expert patients assessed the list for impact and clarity. A preliminary questionnaire was presented to 100 Addison's outpatients; the number of items was reduced after analysis of the distribution of the responses. The final questionnaire responses were assessed by Cronbach's alpha and Rasch analysis.
  
  
  CONCLUSIONS
  Published studies of HRQoL in Addison's disease indicated reduced vitality and general health perception and limitations in physical and emotional functioning. In-depth interviews of 14 patients and seven partners emphasized the impact of the disease on the emotional domain. Seventy HRQoL items were generated; after the expert consultation process and pretesting in 100 patients, the number of items was reduced to 36. Eighty-six patients completed the final questionnaire; the responses showed high internal consistency with Cronbach's alpha 0.95 and Person Separation Index 0.94 (Rasch analysis).
  
  
  CONCLUSIONS
  We envisage AddiQoL having utility in trials of hormone replacement and management of patients with Addison's disease, analogous to similar questionnaires in GH deficiency (AGHDA) and acromegaly (AcroQoL).
authors.affiliation: Institute of Medicine, Haukeland University Hospital, 5021 Bergen, Norway. Kristian.lovas@helse-bergen.no
authors.forename: Kristian
authors.initials: K
authors.lastname: Løvås
authors.forename: Suzanne
authors.initials: S
authors.lastname: Curran
authors.forename: Marianne
authors.initials: M
authors.lastname: Oksnes
authors.forename: Eystein S
authors.initials: ES
authors.lastname: Husebye
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Huppert
authors.forename: V Krishna K
authors.initials: VK
authors.lastname: Chatterjee
mesh_terms: D000224:Addison Disease / Q000523:psychology*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires