title: Quality of life in a german graves orbitopathy population.
abstract: OBJECTIVE
  To evaluate the validity and responsiveness of a German-language version of the disease-specific Graves orbitopathy quality-of-life questionnaire (GO-QOL).
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  At a multidisciplinary university orbital center, 310 consecutive unselected Graves orbitopathy outpatients answered the GO-QOL before undergoing complete ophthalmic and endocrine assessment. The main outcome measures were the GO-QOL and its 2 subscales, Visual Functioning and Appearance.
  
  
  RESULTS
  The QOL scores for the subscales Visual Functioning and Appearance were (mean ± SE) 72.5 ± 1.4 and 71.3 ± 1.5, respectively. Visual Functioning and Appearance were higher in mild (82.2 ± 2.2 and 86.0 ± 17.6) than in moderate to severe (66.6 ± 1.8, p < .001, 95% CI 15.6-2.9 and 65.5 ± 25.5, P < .001, 95% CI 15.1-26.0) and in sight-threatening Graves orbitopathy (41.9 ± 9.9, P < .001, 95% CI 25.4-55.3 and 58.5 ± 9.0, P < .001, 95% CI 15.0-39.4). Visual Functioning and Appearance were also lower in active (63.3 ± 2.2 and 64.5 ± 2.2) than in inactive stages (77.0 ± 1.9; P < .001, 95% CI 7.9-19.3 and 78.3 ± 1.8, P < .001, 95% CI 8.2-19.2). Visual Functioning was 81.6 ± 1.8 in patients without and 62.4 ± 2.0 in patients with diplopia (P < .001, 95% CI 13.8-24.6). Appearance was lower in those receiving psychotherapy (64.7 ± 3.2) than in those without psychotherapy (74.6 ± 1.6, P = .005, 95% CI 3.0-16.7). Significant ceiling effects (≥15% at the highest value of the subscale) were observed for Appearance in 59 patients (19%) and for Visual Functioning in 85 patients (27%).
  
  
  CONCLUSIONS
  The German-language version of the GO-QOL shows evidence of validity in Graves orbitopathy and it usefully complements ophthalmic assessment in these patients.
authors.affiliation: Department of Ophthalmology, University Medical Center, Mainz, Germany.
authors.forename: Katharina A
authors.initials: KA
authors.lastname: Ponto
authors.affiliation: Department of Medical Statistics, University Medical Center, Mainz, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hommel
authors.affiliation: Department of Ophthalmology, University Medical Center, Mainz, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Pitz
authors.affiliation: Department of Ophthalmology, University Medical Center, Mainz, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Elflein
authors.affiliation: Department of Ophthalmology, University Medical Center, Mainz, Germany.
authors.forename: Norbert
authors.initials: N
authors.lastname: Pfeiffer
authors.affiliation: Department of Medicine I, University Medical Center, Mainz, Germany. Electronic address: kahaly@ukmainz.de.
authors.forename: George J
authors.initials: GJ
authors.lastname: Kahaly
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D049970:Graves Ophthalmopathy / Q000523:psychology*; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D055815:Young Adult