Abstract
BACKGROUND AND AIM: Assessment of health-related quality-of-life (HRQOL) in patients with chronic liver disease (CLD) requires the use of validated instruments that are understood by patients in their native language. We previously translated the Chronic Liver Disease Questionnaire into the Singapore-Mandarin version (CLDQ-SG). This study aims to examine the internal consistency and validity of the CLDQ-SG in patients with CLD. METHODS: We conducted a cross-sectional study of adult patients with CLD seen in a tertiary center in Singapore who completed both the CLDQ-SG and Short Form Health Survey 36 version 2 (SF-36v2) questionnaires. Internal consistency of the CLDQ-SG was assessed using Cronbach's alpha coefficient. Convergent and divergent validity of the SF-36v2 was assessed using the Spearman correlation coefficient, while discriminant validity was assessed using the Jonckheere-Terpstra test for trend. Exploratory factor analysis was performed to evaluate the factor structure of the CLDQ-SG. RESULTS: We enrolled 242 subjects (68.2% males, median age 67 years). Predominant etiology of CLD was chronic hepatitis B. Severity of CLD was divided into noncirrhotic (67.3%), compensated cirrhosis (24.0%), and decompensated cirrhosis (8.7%). Item convergent and discriminant validity of the CLDQ-SG was excellent, with 100% scaling success in all six domains. All domains exhibited good internal consistency, with Cronbach's α > 0.70. We observed a consistent trend of a reduction in mean CLDQ-SG score in the three groups reflecting the discriminant validity of the CLDQ-SG to assess changes in HRQOL in different severities of CLD. Factor analysis of the CLDQ-SG demonstrated an independent factor assessing sleep. CONCLUSION: The Singapore-Mandarin version of CLDQ-SG is a valid and reliable instrument to measure HRQOL in patients with CLD.