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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2010

Open Access 01-12-2010 | Research

Responsiveness of the Eating Disorders Quality of Life Scale (EDQLS) in a longitudinal multi-site sample

Authors: Carol E Adair, Gisele C Marcoux, Theanna F Bischoff, Brian S Cram, Carol J Ewashen, Jorge Pinzon, Joanne L Gusella, Josie Geller, Yvette Scattolon, Patricia Fergusson, Lisa Styles, Krista E Brown

Published in: Health and Quality of Life Outcomes | Issue 1/2010

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Abstract

Background

In eating disorders (EDs), treatment outcome measurement has traditionally focused on symptom reduction rather than functioning or quality of life (QoL). The Eating Disorders Quality of Life Scale (EDQLS) was recently developed to allow for measurement of broader outcomes. We examined responsiveness of the EDQLS in a longitudinal multi-site study.

Methods

The EDQLS and comparator generic QoL scales were collected in person at baseline, and 3 and 6 months from 130 participants (mean age 25.6 years; range 14-60) in 12 treatment programs in four Canadian provinces. Total score differences across the time points and responsiveness were examined using both anchor- and distribution-based methods.

Results

98 (75%) and 85 (65%) responses were received at 3 and 6 months respectively. No statistically significant differences were found between the baseline sample and those lost to follow-up on any measured characteristic. Mean EDQLS total scores increased from 110 (SD = 24) to 124.5 (SD = 29) at 3 months and 129 (SD = 28) at 6 months, and the difference by time was tested using a general linear model (GLM) to account for repeated measurement (p < .001). Responsiveness was good overall (Cohen's d = .61 and .80), and confirmed using anchor methods across 5 levels of self-reported improvement in health status (p < .001). Effect sizes across time were moderate or large for for all age groups. Internal consistency (Chronbach's alpha=.96) held across measurement points and patterns of responsiveness held across subscales. EDQLS responsiveness exceeded that of the Quality of Life Inventory, the Short Form-12 (mental and physical subscales) and was similar to the 16-dimension quality of life scale.

Conclusions

The EDQLS is responsive to change in geographically diverse and clinically heterogeneous programs over a relatively short time period in adolescents and adults. It shows promise as an outcome measure for both research and clinical practice.
Appendix
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Literature
1.
Engel S, Adair CE, Las Hayas C, Abraham S: Health-related quality of life and eating disorders: a review and update. Int J Eat Disord 2009, 42: 179–187. 10.1002/eat.20602PubMedCrossRef
2.
Hay P, Mond J: How to 'count the cost' and measure burden? A review of health-related quality of life in people with eating disorders. JMH 2005, 14: 539–552.
3.
Hudson J, Hiripi E, Pope H, Kessler R: The prevalence and correlates of eating disorders in the National Comorbidity Survey replication. Biol Psychiatr 2007, 61: 348–358. 10.1016/j.biopsych.2006.03.040CrossRef
4.
Field A, Camargo C, Barr-Taylor C, Berkley C, Roberts S, Colditz G: Peer, parent, and media influences on the development of weight concerns and frequent dieting among preadolescent and adolescent girls and boys. Pediatrics 2001, 107: 54–60. 10.1542/peds.107.1.54PubMedCrossRef
5.
Jones J, Bennett S, Olmsted M, Lawson M, Rodin G: Disordered eating attitudes and behaviours in teenaged girls: a school based study. CMAJ 2001, 165: 547–552.PubMedCentralPubMed
6.
7.
de la Rie S, van Furth E, de Koning A, Noordenbos G, Donker M: The quality of life of family caregivers of eating disorder patients. Eating Disorders 2005, 13: 345–351. 10.1080/10640260591005236PubMedCrossRef
8.
Berkman N, Bulik C, Brownley K, Lohr K, Sedway J, Rooks A, et al.: Management of eating disorders: Evidence Report/Technology Assessment. Rockville, MD: AHRQ; 2006.
9.
Wilson G, Shafran R: Eating disorders guidelines from NICE. Lancet 2005, 365: 79–81. 10.1016/S0140-6736(04)17669-1PubMedCrossRef
10.
de la Rie S, Noordenbos G, Donker M, van Furth E: The patient's view on quality of life and eating disorders. Int J Eat Disord 2006, 39: 1–8. 10.1002/eat.20317CrossRef
11.
Miller P: Redefining success in eating disorders. Addict Behav 1996, 21: 745–754. 10.1016/0306-4603(96)00033-0PubMedCrossRef
12.
Noordenbos G, Seubring A: Criteria for recovery from eating disorders according to patients and therapists. Eating Disorders 2006, 14: 41–54. 10.1080/10640260500296756PubMedCrossRef
13.
Treasure J: Getting beneath the phenotype of anorexia nervosa: The search for viable endophenotypes and genotypes. Can J Psychiat 2007, 52: 212–219.
14.
Doll H, Peterson S, Stewart-Brown S: Eating disorders and emotional and physical well-being: associations between student self-reports of eating disorders and quality of life as measured by the SF-36. Qual Life Res 2005, 14: 705–717. 10.1007/s11136-004-0792-0PubMedCrossRef
15.
Wiebe S, Guyatt G, Weaver B, Matijevic S, Sidwell C: Comparative responsiveness of generic and specific quality-of-life instruments. J Clin Epidemiol 2003, 56: 52–60. 10.1016/S0895-4356(02)00537-1PubMedCrossRef
16.
Guyatt G: Commentary on Jack Dowie, "Decision validity should determine whether a generic or condition-specific HRQOL measure is used in health care decisions". Health Econ 2002, 11: 9–12. 10.1002/hec.666PubMedCrossRef
17.
Guyatt G, Walter S, Norman G: Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis 1987, 40: 171–178. 10.1016/0021-9681(87)90069-5PubMedCrossRef
18.
Mallinson S: Listening to respondents: A qualitative assessment of the Short-Form 36 Health Status Questionnaire. Soc Sci Med 2002, 54: 11–21. 10.1016/S0277-9536(01)00003-XPubMedCrossRef
19.
Padierna A, Quintana J, Arostegui I, Gonzalez N, Horcajo M: Changes in health related quality of life among patients treated for eating disorders. Qual Life Res 2002, 11: 545. 10.1023/A:1016324527729PubMedCrossRef
20.
Abraham S, Brown T, Boyd C, Luscombe G, Russell J: Quality of life: eating disorders. Aust N Z J Psychiatry 2006, 40: 150–155.PubMedCrossRef
21.
Engel S, Wittrock D, Crosby R, Wonderlich S, Mitchell J, Kolotkin R: Development and psychometric validation of an eating disorder-specific health-related quality of life instrument. Int J Eat Disord 2006, 39: 62–71. 10.1002/eat.20200PubMedCrossRef
22.
Mond J, Hay P, Rogers B, Owen C, Beumont P: Assessing quality of life in eating disorder patients. Qual Life Res 2005, 14: 171–178. 10.1007/s11136-004-2657-yPubMedCrossRef
23.
Las Hayas C, Quintana J, Padierna A, Bilbao A, Munoz P, Madrazo A, et al.: The new questionnaire Health-Related Quality of Life for Eating Disorders showed good validity and reliability. J Clin Epidemiol 2006, 59: 192–200. 10.1016/j.jclinepi.2005.06.005PubMedCrossRef
24.
Adair CE, Marcoux GC, Cram BS, Ewashen CJ, Chafe J, Cassin SE, et al.: Development and multi-site validation of a new condition-specific quality of life measure for eating disorders. Health Qual Life Outcomes 2007, 5: 23–36. 10.1186/1477-7525-5-23PubMedCentralPubMedCrossRef
25.
Bohn K, Doll HA, Cooper Z, O'Connor M, Palmer RL, Fairburn CG: The measurement of impairment due to eating disorder psychopathology. Behav Res Ther 2008, 46: 1105–1110. 10.1016/j.brat.2008.06.012PubMedCentralPubMedCrossRef
26.
Revicki DA, Osoba D, Fairclough D, Barofsky I, Berzon R, Leidy NK, et al.: Recommendations on health-related quality of life research to support labelling and promotional claims in the United States. Qual Life Res 2000, 9: 887–900. 10.1023/A:1008996223999PubMedCrossRef
27.
Las Hayas C, Quintana JM, Padierna JA, Bilbao A, Munoz P, Cook FE: Health-related quality of life for eating disorders questionnaire version-2 was responsive 1-year after initial assessment. J Clin Epidemiol 2007, 60: 825–833. 10.1016/j.jclinepi.2006.10.004PubMedCrossRef
28.
WHOQOL Group: The World Health Organization Quality of Life Assessment (WHOQOL) position paper from the World Health Organization. Soc Sci Med 1995, 41: 1403–1409. 10.1016/0277-9536(95)00112-KCrossRef
29.
Burke L, Stifano T, Dawisha S: Guidance for industry: patient-reported outcome measures: use in medical product development to support labelling claims: draft guidance. Health Qual Life Outcomes 2006, 4: 79. 10.1186/1477-7525-4-79CrossRef
30.
Kessler RC, Mroczek DK: Some methodological issues in the development of quality of life measures for the evaluation of medical interventions. J Eval Clin Pract 1996, 2: 181–191. 10.1111/j.1365-2753.1996.tb00042.xPubMedCrossRef
31.
Fayers P, Fayers D: Quality of life assessment, analysis and interpretation. West Sussex: John Wiley & Sons Ltd; 2000.
32.
Juniper E, Guyatt G, Jaeschke R: How to develop and validate and new health-related quality of life instrument. In Quality of Life and Pharmacoeconomics in Clinical Trials. 2nd edition. Edited by: Spilker B. Philadelphia: Lippincott-Raven; 1996:49–55.
33.
McDowell I, Jenkinson C: Development standards for health measures. J Health Serv Res Policy 1996, 1: 238–246.PubMed
34.
Willis G: Cognitive interviewing: A tool for improving questionnaire design. Thousand Oaks, CA: Sage Publications; 2004.
35.
Collins D: Pretesting survey instruments: an overview of cognitive methods. Qual Life Res 2003, 12: 229–238. 10.1023/A:1023254226592PubMedCrossRef
36.
McColl E, Meadows K, Barofsky I: Cognitive aspects of survey methodology and quality of life assessment. Qual Life Res 2003, 12: 217–218. 10.1023/A:1023233432721PubMedCrossRef
37.
Trauer T, MacKinnon A: Why are we weighting? The role of importance ratings in quality of life measurement. Qual Life Res 2001, 10: 579–585. 10.1023/A:1013159414364PubMedCrossRef
38.
Frisch M, Clark M, Rouse S, Rudd M, Paweleck J, Greenstone A, et al.: Predictive and treatment validity of life satisfaction and the Quality of Life Inventory. Assessment 2005, 12: 66–78. 10.1177/1073191104268006PubMedCrossRef
39.
Ware J, Kosinski M, Keller S: A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996, 34: 220–233. 10.1097/00005650-199603000-00003PubMedCrossRef
40.
Apajasalo M, Sintonen H, Holmberg C, Sinkkonen J, Aalberg V, Pihko H, et al.: Quality of life in early adolescence: a sixteen-dimensional health-related measure (16D). Qual Life Res 1996, 5: 205–211. 10.1007/BF00434742PubMedCrossRef
41.
Derogatis L: Brief Symptom Inventory (BSI) Administration, scoring, and procedures manual. Minneapolis: NCS Pearson Inc; 1993.
42.
Garner DM: Eating Disorder Inventory-2 (EDI-2) Professional manual. Odessa: Psychological Assessment Resources Inc; 1993.
43.
Dillman DA: Mail and Internet Surveys: the Tailored Design Method. NY: Wiley; 1999.
44.
Guyatt GH, Osoba D, Wu A, Wyrwich KW: Norman GR & the Clinical Significance Consensus Meeting Group: Methods to explain the clinical significance of health status measures. Mayo Clin Proc 2002, 77: 371–383. 10.4065/77.4.371PubMedCrossRef
45.
Crosby RD, Kolotkin RL, Williams GR: Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol 2003, 56: 395–407. 10.1016/S0895-4356(03)00044-1PubMedCrossRef
46.
Norman GR, Sloan JA, Wyrwich KW: Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003, 41: 582–592. 10.1097/00005650-200305000-00004PubMed
47.
Norman GR, Wyrwich KW, Patrick DL: The mathematical relationship among different forms of responsiveness coefficients. Qual Life Res 2007, 16: 815–822. 10.1007/s11136-007-9180-xPubMedCrossRef
48.
Zou GY: Quantifying responsiveness of quality of life measures without an external criterion. Qual Life Res 2005, 14: 1545–1552. 10.1007/s11136-004-0027-4PubMedCrossRef
49.
Revicki DA, Cella D, Hays RD, Sloan JA, Lenderking WR, Aaronson NK: Responsiveness and minimal important differences for patient reported outcomes. Health Qual Life Outcomes 2006, 4: 70. 10.1186/1477-7525-4-70PubMedCentralPubMedCrossRef
50.
Fayers P, Hays R: Assessing quality of life in clinical trials: Analysis and Interpretation. 2nd edition. USA: Oxford University Press; 2005.
51.
Fowler FJ: Survey research methods. 4th edition. Thousand Oaks: Sage Publications; 2009.
Metadata
Title
Responsiveness of the Eating Disorders Quality of Life Scale (EDQLS) in a longitudinal multi-site sample
Authors
Carol E Adair
Gisele C Marcoux
Theanna F Bischoff
Brian S Cram
Carol J Ewashen
Jorge Pinzon
Joanne L Gusella
Josie Geller
Yvette Scattolon
Patricia Fergusson
Lisa Styles
Krista E Brown
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2010
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-8-83

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