The development and validation of a disease-specific quality of life measure in hyperhidrosis : the Hyperhidrosis Quality of Life Index (HidroQOL©)

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original authors and the source are credited.PURPOSE: To develop and validate a new disease-specific quality of life measure in hyperhidrosis for use in both routine clinical practice and clinical research. METHODS: Interviews and focus group discussions with hyperhidrosis patients, reported elsewhere, provided the content for the measure validated in this study (n = 71). A panel of dermatologists (n = 5) and patients (n = 7) carried out content validation. Further, item reduction and the initial construct validation were carried out in a cross-sectional study (n = 595), using the unidimensional Rasch analysis and exploratory factor analysis. Subsequently, the construct validity, reliability and responsiveness of the revised measure were assessed in a longitudinal study (n = 260). Data collection for the item reduction and the final validation phases was entirely carried out online. RESULTS: The expert panels judged the HidroQoL as content valid. Rasch analysis supported the revision of response options from five to three. Following removal of misfitting items, a set of 15 items showed optimal fit to the model (chi-squared statistic = 159.64, p = 0.07). Three additional items were retained on consideration of their importance to patients, resulting in an 18-item instrument. The items were grouped into two subscales, daily life activities and psychosocial life domains, based on results of the factor analysis. In subsequent construct validation, the HidroQoL correlated with the DLQI (r s = 0.6, p < 0.01). Reliability was high (internal consistency, Cronbach's alpha: overall scale = 0.9; test-retest reliability, Intra-class correlation = 0.9). The HidroQoL scores were sensitive to change in patients' disease severity (score change from baseline to follow-up after 15-35 days, Cohen's ES = 0.47). CONCLUSION: This study has provided the initial evidence supporting measurement properties and the use of the HidroQoL instrument in both routine clinical practice and in research, for assessing quality of life impacts in hyperhidrosis.Peer reviewedFinal Published versio

BARiatric Basic Questionnairy for Traditional Chinese Medicine. Interest in complementary medicine in 789 obese patients from Austria, Switzerland and Germany

Aims: Obesity is the major multifactorial metabolic burden of the 21st century. Complementary and Alternative Medicine (CAM) including Traditional Chinese Medicine (TCM) add to the multidisciplinary treatment options. Aim of the study was to investigate the interest in TCM among bariatric patients. Methods: From April 2017, 789 patients from Germany (D: 265), Austria (A: 126) and Switzerland (CH: 398) answered the anonymous BARBQTCM questionnaires in the outpatient wards of the obesity centres. Age (median 46y), sex (female: 67.8%), Body Mass Index (BMI: median 37kg/m2; IQR: 30-44) and prior experience with CAM (414: 52.5%) were assessed. Results: 672 respondents (85.2%) had professional nutritional counselling, 602 underwent diverse dietary programs (76.3%). Nearly half of the Swiss tried out weight loss drugs (D-A-CH: 22.3% vs. 25.4% vs. 48.0%; p<0.05). 522 patients (66.2%) underwent bariatric surgery: gastric banding (61/522: 11.7%), sleeve gastrectomy (187/522: 35.8%), Y-Roux (227/522: 43.5%) and Omega-Loop (47/522: 9.0%) gastric bypass. 166 respondents (31.8%) reported weight regain (>10 kilograms) after bariatric surgery. 659 respondents (83.5%) were interested in TCM. Top-3 indications for TCM therapy included weight problems (505/659: 76.6%) followed by chronic fatigue (439/659: 66.6%) and joint complaints (399/659: 60.5%). Austrians were least interested in eastern therapies: TCM nutritional advices (D-A-CH: 53.4% vs. 41.3% vs. 53.0%; p<0.05), acupuncture (D-A-CH: 43.8% vs. 30.2% vs. 48.5%; p<0.05) and herbal therapy (D-A-CH: 31.3% vs. 30.2% vs. 35.7%; n.s.). Conclusions: TCM has developed as important option in the interest of obese people. Standardized programs have to be offered to face the therapeutic challenge, especially in Austria