Psychometric Performance of the Adult Sickle Cell Quality-of-Life Measurement Information System (ASCQ-Me) in...

The Adult Sickle Cell Quality-of-Life Measurement Information System (ASCQ-Me), developed in the USA, assesses disease-specific health-related quality of life in adults with sickle cell disease (SCD). This study aims to evaluate the psychometric properties of ASCQ-Me for use among adults with SCD in Jamaica. Cronbach's α assessed the internal consistency reliability of each ASCQ-Me impact domain. Convergent validity was evaluated using Pearson's correlations between ASCQ-Me impact scores and the previously validated 36-item short-form health survey (SF-36 version 2) scale and component summary scores. Known-groups validity was examined using t-tests comparing ASCQ-Me impact scores between study-designated more-severe and less-severe disease groups. Confirmatory factor analysis (CFA) using structural equation modeling was conducted to investigate the construct validity of the ASCQ-Me. The study enrolled 366 adult participants (60.1% females; mean age 34.5 ± 12.2 years; 74.6% SS). Cronbach's α (range: 0.80-0.94) indicated excellent consistency across all ASCQ-Me impact domains. Pearson's correlations tested were all statistically significant (p-value < 0.01), except for the ASCQ-Me sleep impact with the SF-36 physical component summary. Persons with 'less severe disease' scored higher on ASCQ-Me impact in all five domains than those with 'more severe disease.' On CFA, the standardized coefficients for all items ranged from 0.61 to 0.95, with p-values < 0.001. All model fit indices showed moderate fit (Comparative Fit Index: 0.915; Tucker-Lewis Index: 0.904; Root Mean Squared Error of Approximation: 0.076; and Standardized Root Mean Square Residual: 0.047). The study confirms the ASCQ-Me is a reliable and valid tool for use in Jamaica.