Translation and psychometric properties of the King\u2019s Sarcoidosis Questionnaire (KSQ) in German language

Abstract

BackgroundKing’s Sarcoidosis Questionnaire (KSQ) is a novel, validated, health-related quality of life questionnaire on sarcoidosis with 5 scales and 29 items. For future multinational observational and interventional studies on sarcoidosis, a validated German version of the KSQ is needed. The objective of our study is to translate the original KSQ and develop a German version possessing good psychometric properties and with as few modifications as possible.MethodsWe translated the KSQ into German, tested it in structured interviews in sarcoidosis patients, and asked consecutive patients in an outpatient clinic to complete it. We relied on the KSQ’s original version to achieve its psychometric properties in the German version. Structural validity, internal consistency, construct validity, and fit to Rasch model were assessed. Our procedure’s logic meant that in the first step we optimized the item selection in the German version to maximize its psychometric quality. In step two, we assessed the unmodified version‘s properties in comparison to the modified version’s.ResultsOne hundred ninety-four patients with sarcoidosis were included and completed the questionnaires. Due to ambiguous factor loadings, four items of the scale “General Health Status” had to be eliminated. Another item was excluded to ensure the Rasch model fit. This modified, 24-item version of the KSQ shows acceptable Rasch model fit and good model fit in confirmatory factor analyses (TLI = 0.90, CFI = 0.91, RMSEA = 0.08). Cronbach’s Alpha ranges from 0.82 to 0.91. Several hypotheses concerning construct validity (e.g., correlations with SF-36) are confirmed or partly confirmed. The measurement properties of the original unmodified version are similar in their construct validity and internal consistency; however, we were unable to confirm structural validity and fit to the Rasch model in the original version.ConclusionsWe translated and validated the German KSQ and report good psychometric properties. The reduced 24-item version has the advantage that all scales are unidimensional and fulfil the requirements of the Rasch model, ensuring its benefits. The original 29-item version, on the other hand, allows us to compare German data to international data however, at the price, of less structural validity and the lack of fit to the Rasch model.Trial registrationThis study was registered in the German Clinical Trials Register (reference number DRKS00010072). Registered January 2016.