Psychometric properties of Endometriosis Health survey-Swedish version

The Swedish version of the "Endometriosis Health Survey" is an acceptable and useful tool

Key Points

Highlights: 

• The Swedish version of Endometriosis Health Profile-30 can be used reliably both for the clinical daily routine and also for research purposes for endometriosis patients.

 Importance:

• Women with endometriosis can be assessed psychometrically using the Swedish version of Endometriosis Health Profile-30.

What’s done here?

• The  “Swedish version of Endometriosis Health Profile-30 (EHP-30)” was sent through e-mail to be completed by the participants who have laparoscopically diagnosed endometriosis.
• The EHP-30 includes 30 items with 5 subcategories including pain, control and powerlessness, emotional wellbeing, social support, and self-image.
• The psychometric part of EHP-30 evaluates data completeness, descriptive statistics including score distributions, internal consistency, factor analysis, and test-retest reliability. 
• The demographic and clinical characteristics (age, marital status, parity, highest completed education, language, occupation, year at symptom onset, year of endometriosis diagnosis, and symptoms) were also recorded.
• Additionally, one more questionnaire was sent to the first 150 women to assess test-retest reliability.

Key results:

• A total of 369 women with laparoscopically confirmed endometriosis were selected randomly and the Swedish version of EHP-30 was e-mailed.
• 211 women completed the questionnaire with a total primary response rate of 57%.
• From the psychometric aspect, data completeness was 99.5% while the highest median score was found in the control and powerlessness subscale, and lowest in pain.
• Score distributions towards disease were low regarding the pain subscale whereas no noteworthy floor or ceiling effects were described.
• Internal consistency and test-retest analysis had good reliability. 

Strengths and Limitations

• Being the first study assessing the psychometric properties of the Swedish version of EHP-30 is the major strength of the study.
• Limitations of this study are the selection of the patients from an endometriosis care center, resulting in an over-representation of women with severe symptoms, and not sufficient explanation of criterion validity.

Lay Summary

Endometriosis is a chronic estrogen-dependent disease resulting in a broad spectrum of symptoms and signs including dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. Additionally, gastrointestinal and urinary systems may be affected by this disease. All of these clinical findings impair health-related quality of life which is difficult to define.

Several generic surveys have been used to understand the physical, mental, social, and psychosexual well-being of these patients. However, none could measure the degree of the quality of life accurately due to its multi-dimensional characteristics.

The Endometriosis Health Profile (EHP-30) with 30 items was developed in the early 2000s and is an endometriosis-specific tool. Because it is the most reliable and acceptable validated questionnaire for endometriosis, its use has been recommended by several societies including the American Society for Reproductive Medicine, the European Society for Human Reproduction and Embryology, and the National Board of Health and Welfare in Sweden.

Grundström et al., from Sweden, published a study entitled “Psychometric evaluation of the Swedish version of the 30-item endometriosis health profile (EHP-30)” in the journal named "BMC Women’s Health". The authors aimed to investigate the clinical usefulness of the Swedish version of the EHP-30 from the psychometric aspect in Swedish patients with endometriosis. EHP-30 was sent through e-mail to 369 randomly selected patients with laparoscopically confirmed endometriosis patients. The total primary response rate of 57%. Data completeness, score distributions, floor and ceiling effects, internal consistency, factor analysis, and test-retest reliability were assessed in psychometric evaluation.

Considering all parameters, it was confirmed that EHP-30 can be used reliably in patients with endometriosis to determine the health-related quality of life. Consequently, the clinical management of these patients may be planned more properly in all aspects. “The Swedish version of EHP-30 is a valid, reliable, understandable, acceptable, and usable instrument that can be used to measure health-related quality of life in daily clinical practice and in research.” the authors added.

Research Source: https://pubmed.ncbi.nlm.nih.gov/32928218/