ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2021
A Rasch model analysis of two interpretations of 'not relevant' responses on the Dermatology Life Quality Index (DLQI).
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review of 207 Studies Describing Validation Aspects of the Dermatology Life Quality Index.Acta dermato-venereologica · 2024Pooled it
- Patient-Reported Outcome Measures for Health-Related Quality of Life in Patients With Psoriasis: A Systematic Review.JAMA dermatology · 2024Pooled it
- Comparing the measurement properties, informativity and responsiveness of the DLQI, DLQI-Relevant (DLQI-R), and Skindex-29 in patients with chronic skin disease: a prospective cohort study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Confirmation of unidimensionality of the Dermatology Life Quality Index (DLQI) using a multinational 3,408 patient dataset.Journal of patient-reported outcomes · 2026Article
- Psychosexual burden in adult genital psoriasis: outcome measurement, construct coverage, and clinical recognition gaps.Frontiers in psychiatry · 2026Review
- English version of the Computer Vision Symptom Scale (CVSS17): Translation and Rasch analysis-based cultural adaptation.PloS one · 2025Article
- Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L descriptive systems and utilities in atopic dermatitis.The European journal of health economics : HEPAC : health economics in prevention and care · 2023Article
- Evidence of the content validity, acceptability, and feasibility of a new Patient-Reported Impact of Dermatological Diseases measure.Frontiers in medicine · 2023Article
- Measurement properties of the ICECAP-A capability well-being instrument among dermatological patients.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Article
- Impact of Psoriasis on Quality of Life.Indian journal of dermatologyArticle
- General and Skin-Specific Health-Related Quality of Life in Patients With Atopic Dermatitis Before and During the COVID-19 Pandemic.Dermatitis : contact, atopic, occupational, drugArticle
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Authors and funding
12 authors.
Funding
Abstract
purposeEight of the ten items of the Dermatology Life Quality Index (DLQI) have a 'not relevant' response (NRR) option. There are two possible ways to interpret NRRs: they may be considered 'not at all' or missing responses. We aim to compare the measurement performance of the DLQI in psoriasis patients when NRRs are scored as '0' (hereafter zero-scoring) and 'missing' (hereafter missing-scoring) using Rasch model analysis.
methodsData of 425 patients with psoriasis from two earlier cross-sectional surveys were re-analysed. All patients completed the paper-based Hungarian version of the DLQI. A partial credit model was applied. The following model assumptions and measurement properties were tested: dimensionality, item fit, person reliability, order of response options and differential item functioning (DIF).
resultsPrincipal component analysis of the residuals of the Rasch model confirmed the unidimensional structure of the DLQI. Person separation reliability indices were similar with zero-scoring (0.910) and missing-scoring (0.914) NRRs. With zero-scoring, items 6 (sport), 7 (working/studying) and 9 (sexual difficulties) suffered from item misfit and item-level disordering. With missing-scoring, no misfit was observed and only item 7 was illogically ordered. Six and three items showed DIF for gender and age, respectively, that were reduced to four and three by missing-scoring.
conclusionsMissing-scoring NRRs resulted in an improved measurement performance of the scale. DLQI scores of patients with at least one vs. no NRRs cannot be directly compared. Our findings provide further empirical support to the DLQI-R scoring modification that treats NRRs as missing and replaces them with the average score of the relevant items.
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