title: A reduced factor structure for the PROQOL-HIV questionnaire provided reliable indicators of health-related quality of life.
abstract: OBJECTIVE
  To identify a simplified factor structure for the PROQOL-human immunodeficiency virus (HIV) questionnaire to improve the measurement of the health-related quality of life (HRQL) of HIV-positive patients in clinical care and research settings.
  
  
  METHODS
  HRQL data were collected using the eight-dimension PROQOL-HIV questionnaire from 2,537 patients (VESPA2 study). Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) validated a simpler four-factor structure and assessed measurement invariance (MI). Multigroup analysis assessed the effect of sex, age, and antiretroviral therapy (ART) on the resulting factor scores. Correlations with symptom and Short Form (SF)-12 self-reports assessed convergent validity.
  
  
  RESULTS
  Item analysis, EFA, and CFAs confirmed the validity [comparative fit index (CFI), 0.948; root mean square error of approximation, 0.064] and reliability (α's ≥ 0.8) of four dimensions: physical health and symptoms, health concerns and mental distress, social and intimate relationships, and treatment-related impact. Strong MI was demonstrated across sex and age (decrease in CFI <0.01). A multiple-cause multiple-indicator model indicated that HRQL correlated as expected with sex, age, and the ART status. Correlations of HRQL, symptom reports, and SF-12 scores evidenced convergent validity criterion.
  
  
  CONCLUSIONS
  The simplified factor structure and scoring scheme for PROQOL-HIV will allow clinicians to monitor with greater reliability the HRQL of patients in clinical care and research settings.
authors.affiliation: University Paris Diderot, Paris Sorbonne Cité, EA 7334 (REMES), Patient-Centered Outcomes Research, Paris, France; AP-HP, Hôtel-Dieu Hospital, URC ECO, 1 Place du Parvis Notre-Dame, 75004, Paris, France. Electronic address: ch.lalanne@gmail.com.
authors.forename: Christophe
authors.initials: C
authors.lastname: Lalanne
authors.affiliation: University Paris Diderot, Paris Sorbonne Cité, EA 7334 (REMES), Patient-Centered Outcomes Research, Paris, France; AP-HP, Hôtel-Dieu Hospital, URC ECO, 1 Place du Parvis Notre-Dame, 75004, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Chassany
authors.affiliation: Inserm UMR 912 (SESSTIM), 23, rue Stanislas Torrents, 13006, Marseille, France; University Aix Marseille, IRD, UMR 912, 58 bd Charles Livon, 13284, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 23, rue Stanislas Torrents, 13006, Marseille, France.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Carrieri
authors.affiliation: Inserm UMR 912 (SESSTIM), 23, rue Stanislas Torrents, 13006, Marseille, France; University Aix Marseille, IRD, UMR 912, 58 bd Charles Livon, 13284, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 23, rue Stanislas Torrents, 13006, Marseille, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Marcellin
authors.affiliation: University Paris Diderot, Paris Sorbonne Cité, EA 7334 (REMES), Patient-Centered Outcomes Research, Paris, France; Australian Institute of Family Studies, 485 La Trobe St, Melbourne, VIC 3000, Australia.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Armstrong
authors.affiliation: Inserm UMR 1018, Centre de recherche en épidémiologie et santé des populations, Hôpital Paul Brousse, 16 avenue Paul Vaillant Couturier 94807 Villejuif, France; University Versailles Saint-Quentin-en-Yvelines, UMR 1018, 16 avenue Paul Vaillant Couturier 94807 Villejuif, France.
authors.forename: France
authors.initials: F
authors.lastname: Lert
authors.affiliation: Inserm UMR 912 (SESSTIM), 23, rue Stanislas Torrents, 13006, Marseille, France; University Aix Marseille, IRD, UMR 912, 58 bd Charles Livon, 13284, Marseille, France; ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, 23, rue Stanislas Torrents, 13006, Marseille, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.affiliation: Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Inserm UMR 1136, 27 rue Chaligny 75012 Paris, France; Department of Social Epidemiology, Pierre Louis Institute of Epidemiology and Public Health, Inserm UMR 1136, Sorbonne University, UPMC University Paris 06, 27 rue Chaligny 75012 Paris, France.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Dray-Spira
authors.affiliation: University Paris Diderot, Paris Sorbonne Cité, EA 7334 (REMES), Patient-Centered Outcomes Research, Paris, France; AP-HP, Hôtel-Dieu Hospital, URC ECO, 1 Place du Parvis Notre-Dame, 75004, Paris, France; Internal Medicine and Clinical Immunology, Bicêtre Hospital, AP-HP, 78, avenue du Général Leclerc 94270 Le Kremlin-Bicêtre, France.
authors.forename: Martin
authors.initials: M
authors.lastname: Duracinsky
mesh_terms: D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: Factor analysis; HIV; Health-related quality of life; Measurement invariance; Psychometrics; Structural equation modelling