Interpretability of the Quality Of Life in Hand Eczema Questionnaire (QOLHEQ)

ABSTRACT The Quality Of Life in Hand Eczema Questionnaire (QOLHEQ) is used to measure impairment of health-related quality of life (HRQoL) in hand eczema. Here, we prospectively studied the interpretability of international QOLHEQ scores at three time points: baseline, after 1-3 days (T1) and after 4-12 weeks (T2). Adult patients with hand eczema completed the QOLHEQ and anchor questions for overall assessment of HRQoL impairment. Interpretability of single scores was assessed at baseline by defining severity bands based on agreement with the anchor questions. Smallest detectable change (SDC) was calculated at T1. Minimally important change (MIC) of improvement was calculated at T2 using three methods: mean cut-off, receiver operating curve (ROC) and 95% limit. N=294 adult patients were included (N=160 males, mean age 44.9). The final proposed severity band of overall QOLHEQ single scores (κ-coefficient of agreement, 0.431) was: not at all, 0-10; slightly, 11-39; moderately, 40-61; strongly, 62-86; very strongly, ≥87. Separate overall severity bands were proposed for males and females, and the four subscales of the QOLHEQ. The SDC in N=166 unchanged patients was 18.6 points. The preferred MIC, obtained with the ROC method was 21.5 points. An overall QOLHEQ score of ≥ 22 is recommended as cut-off for a minimally important, real change.