Adaptation and cross-cultural validation of the Spanish version of the Thyroid-Related Quality-of-Life Patient-Reported Outcome questionnaire / Adaptación y validación transcultural de la versión española del cuestionario Thyroid-Related Quality-of-Life Patient-Reported Outcome

Introduction: The ThyPRO questionnaire is the most widely used tool for measuring quality of life in patients with benign thyroid diseases. The purpose of this study was to adapt and validate a Spanish translation of the ThyPRO and its abbreviated version (ThyPRO-39). Material and methods: Adaptation to the Spanish language was performed using the forward-backward translation method, followed by a pretesting study on five representative patients. The final questionnaire (ThyPROes) was administered to 155 patients with thyroid disorders recruited in a tertiary Spanish hospital. Psychometric properties were evaluated by multitrait scaling and estimation of internal consistency reliability (Cronbach's alpha coefficient). Data from a previous sample of 902 Danish patients were used to analyze differential item functioning (DIF) between the Spanish and the original Danish versions of the questionnaire using ordinal logistic regression. Results: Three of 85 items in ThyPROes and four of the 39 items in ThyPRO-39es lacked convergent validity, while lack of discriminant validity was found for in nine and 14 items of each version respectively. Cronbach's alpha was >0.7 for 12 of 13 scales in the ThyPRO and 10 of 12 scales in the ThyPRO-39es. Eight items in the ThyPROes were flagged with DIF (one with non-uniform DIF), as were two items in the ThyPRO-39es. DIF magnitude was small (explained variance in the item score <3%) in most cases, with a minor impact on scale scores. Conclusions: The Spanish versions of the ThyPRO and ThyPRO-39 show acceptable psychometric properties and good cross-lingual validity, and are suitable for use in clinical studies

Introducción: El cuestionario Thyroid-Related Quality-of-Life Patient-Reported Outcome (ThyPRO) es el instrumento más utilizado para medir la calidad de vida en pacientes con enfermedades tiroideas benignas. Este estudio tiene como objetivo adaptar y validar una traducción al español del ThyPRO y su versión abreviada (ThyPRO-39). Material y métodos: La adaptación al español se realizó utilizando el método de traducción-retrotraducción, seguido de una prueba preliminar en 5 pacientes representativos. El cuestionario definitivo ThyPROes se administró a 155 pacientes con trastornos tiroideos en un hospital terciario en España. Las propiedades psicométricas se evaluaron mediante la matriz multirrasgo-multimétodo y la estimación de la fiabilidad de la consistencia interna (alfa de Cronbach). Se utilizaron datos previos de 902 pacientes daneses para analizar el funcionamiento diferencial de los ítems (FDI) entre la versión original danesa del cuestionario y la española, mediante regresión logística ordinal. Resultados: Tres de 85 ítems del ThyPROes y 4 de 39 del ThyPRO-39es carecían de validez convergente, mientras que 9 y 14, respectivamente, carecían de validez discriminante. El alfa de Cronbach fue >0,7 para 12 de 13 escalas del ThyPROes y 10 de 12 del ThyPRO-39es. Ocho ítems del ThyPROes mostraron FDI (uno con FDI no uniforme) y 2 lo hicieron en el ThyPro-39es. La magnitud del FDI fue pequeña (varianza explicada en la puntuación del ítem <3%) en la mayoría de casos, con un impacto menor en las puntuaciones de las escalas. Conclusiones: Las versiones españolas del ThyPRO y ThyPRO-39 muestran aceptables propiedades psicométricas y buena validez interlingüística, y son adecuadas para su uso en estudios clínicos

Adaptation and cross-cultural validation of the Spanish version of the Thyroid-Related Quality-of-Life Patient-Reported Outcome questionnaire.

INTRODUCTION: The ThyPRO questionnaire is the most widely used tool for measuring quality of life in patients with benign thyroid diseases. The purpose of this study was to adapt and validate a Spanish translation of the ThyPRO and its abbreviated version (ThyPRO-39). MATERIAL AND METHODS: Adaptation to the Spanish language was performed using the forward-backward translation method, followed by a pretesting study on five representative patients. The final questionnaire (ThyPROes) was administered to 155 patients with thyroid disorders recruited in a tertiary Spanish hospital. Psychometric properties were evaluated by multitrait scaling and estimation of internal consistency reliability (Cronbach's alpha coefficient). Data from a previous sample of 902 Danish patients were used to analyze differential item functioning (DIF) between the Spanish and the original Danish versions of the questionnaire using ordinal logistic regression. RESULTS: Three of 85 items in ThyPROes and four of the 39 items in ThyPRO-39es lacked convergent validity, while lack of discriminant validity was found for in nine and 14 items of each version respectively. Cronbach's alpha was >0.7 for 12 of 13 scales in the ThyPRO and 10 of 12 scales in the ThyPRO-39es. Eight items in the ThyPROes were flagged with DIF (one with non-uniform DIF), as were two items in the ThyPRO-39es. DIF magnitude was small (explained variance in the item score <3%) in most cases, with a minor impact on scale scores. CONCLUSIONS: The Spanish versions of the ThyPRO and ThyPRO-39 show acceptable psychometric properties and good cross-lingual validity, and are suitable for use in clinical studies.

Tetralogy of fallot associated with invasive adrenocortical tumor in an adult woman.

Migration of cardiac neural crest cells into the pharyngeal arches and the pharyngeal and splanchnic mesoderm contributes to the development of the cardiac outflow tract. The adrenal cortex is derived from the splanchnic mesoderm. Neuroblastoma is more prevalent in patients with congenital heart disease than in the general population, because both originate from embryonal neural crest-derived cells. Similarly, and in light of recent embryological findings, abnormal development or migration of splanchnic mesoderm, possibly due to an underlying genetic defect, could contribute to the association of adrenocortical carcinoma and tetralogy of Fallot. We present the case of a cardiologically asymptomatic 49-year-old woman with total correction of tetralogy of Fallot in the first year of life.