Validation of the German version of the Chronic Liver Disease Questionnaire

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Abstract
The Chronic Liver Disease Questionnaire is an instrument for the assessment of health-related quality of life in patients with chronic liver diseases. So far it has not been validated for German speaking countries. Two hundred and three consecutive patients with chronic liver diseases (age, 52.7 +/- 13.9 years; 47% female; 45% no cirrhosis, 21% Child's class A, 15% Child's class B and 17% Child's class C cirrhosis; 52% with chronic viral hepatitis, 32% with alcoholic and 16% with other liver diseases) of a liver centre completed the German version of the Chronic Liver Disease Questionnaire (CLDQ-D), the Short Form Health Survey SF-36, the Hospital Anxiety and Depression Scale (HADS) and the Giessener Symptom List GBB-24. Fifty stable patients filled in the CLDQ-D a second time within 3 - 8 days. With 97.7% completed items the acceptance by the patients was high. The internal consistency (Cronbach alpha) for the subscales ranged from 0.69 to 0.95, the test-retest reliability ranged from 0.79 to 0.88. The correlation coefficients with similar subscales of the instruments used for validation ranged between 0.5 and 0.9 (convergent validity). Patients with liver cirrhosis Child-Pugh stage C scored significantly lower in the subscales 'Abdominal Symptoms', 'Activity' and 'Worry', indicating a reduced health-related quality of life than in patients without cirrhosis (P < 0.05) (discriminant validity). The CLDQ-D is well accepted by patients with chronic liver diseases and has good reliability and satisfactory discriminant validity.