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Published on: July 14, 2023
Validation of the Italian version of the hypoparathyroidism patient questionnaire-28 (HPQ-28): a multicenter study
Francesco Arcidiacono1, Gianluca Sesso2, Antonio Prinzi3,4
1Endocrinology Unit, Department of Clinical and Experimental Medicine, University of Catania, Garibaldi-Nesima Medical Center, Catania, Italy. francescoarcidiacono.fa@gmail.com.
Purpose:
Hypoparathyroidism (HypoPT) is a rare endocrine disorder frequently associated with impaired quality of life. Disease-specific patient-reported outcome measures may help to better characterize symptom burden in Hypoparathyroid patients. The Hypoparathyroidism Patient Questionnaire-28 (HPQ-28) was originally developed in German and subsequently validated French. The aim of this study was to validate the Italian version of the HPQ-28 in a multicenter cohort.
Methods:
In this cross-sectional study, adult participants were recruited from two tertiary referral centres in Italy. The study population were divided in three groups: patients with chronic postsurgical HypoPT (Group 1), patients with hypothyroidism without HypoPT (Group 2), and healthy controls (Group 3). Structural validity was assessed using confirmatory factor analysis with a weighted least squares mean- and varianceadjusted estimator. Internal consistency was evaluated using Cronbach's alpha and McDonald's omega coefficients. Test-retest reliability was assessed using intraclass correlation coefficients in a subgroup of patients. Construct validity was examined by comparing HPQ-28 scores across clinical groups.
Results:
A total of 163 participants were included (69 HypoPT patients, 60 hypothyroid patients, and 34 controls). Confirmatory factor analysis supported the original six-factor structure of the HPQ-28, with acceptable goodness-of-fit indices (CFI = 0.933, TLI = 0.924, RMSEA = 0.075, SRMR = 0.081). Internal consistency was satisfactory across domains, with Cronbach's alpha ranging from 0.70 to 0.89 and McDonald's omega from 0.75 to 0.93. Test-retest reliability demonstrated good temporal stability. Patients with HypoPT reported significantly higher symptom burden compared with both hypothyroid patients and healthy controls across several domains.
Conclusions:
The Italian version of the HPQ-28 demonstrates good psychometric properties and represents a reliable disease-specific instrument for assessing symptom burden in patients with hypoparathyroidism in both clinical practice and research settings.
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