Abstract
BackgroundThe Disease Burden Morbidity Assessment (DBMA) is a self-report questionnaire used to estimate the disease burden experienced by patients. The aim of this study was to test and to measure the properties of the French translation of the DBMA (DBMA-Fv).MethodsThe original version of the DBMA was translated into French (Canadian) and first assessed during cognitive interviews. In the validation study, patients recruited during consecutive consultation periods completed the DBMA-Fv questionnaire while they were in the waiting room of a primary care setting (T1). Participants completed the same questionnaire mailed to their home two weeks later (T2). Concomitant validity of the DBMA-Fv was assessed using the Cumulative Illness Rating Scale (CIRS). Patient medical records were reviewed to verify chronic diseases and past medical history.ResultsNinety-seven patients were recruited and 85 (88%) returned the mailed questionnaires; 5 (5.9%) were incomplete. DBMA-Fv scores of the 80 participants with a complete questionnaire at T2 ranged from 0 to 30 (median 5.5, mean 7.7, SD = 7.0). Test-retest reliability of the DBMA-Fv was high (ICC: 0.86, 95% CI: 0.79-0.92). The DBMA-Fv and the CIRS correlated moderately at T1 (r = 0.46, 95% CI: 0.26 - 0.62, p < 0.01) and T2 (r = 0.56, 95% CI: 0.38 - 0.70, p < 0.01). The mean (SD) sensitivity of patient reports of a condition in relation to chart review at T2 was 73.9 (8.4) (range 62.5% to 90%). The overall mean (SD) specificity was 92.2 (6.7) (range 77.6% to 98.6%).ConclusionsThe DBMA-Fv's properties are similar to its English counterpart as to its median sensitivity and specificity compared to chart reviews. It correlated moderately with an established index of multimorbidity. A high percentage of patients were able to complete the test correctly as a mail questionnaire and it showed high test-retest reliability.
Highlights
The Disease Burden Morbidity Assessment (DBMA) is a self-report questionnaire used to estimate the disease burden experienced by patients
Significant differences between patients who completed the questionnaire correctly and those who did not were observed at T1 for age, Cumulative Illness Rating Scale (CIRS) score, education and marital status (Table 1)
In a multivariate logistic regression model, age (p < 0.05) was the most important factor associated with an incomplete questionnaire; sex (p = 0.37), education (p = 0.1), and CIRS score (p = 0.78) were not important
Summary
The Disease Burden Morbidity Assessment (DBMA) is a self-report questionnaire used to estimate the disease burden experienced by patients. Studies on multimorbidity should rely on valid and robust measurement to assess the disease burden experienced by patients with chronic diseases. Impact on daily living seems to be best evaluated by the patient because completed by older people and original validity assessment revealed good sensitivity and specificity using the chronic disease list in the medical chart as a gold standard [3,8]. Test-retest reliability and concomitant validity of the instrument have not been reported yet. We were interested in test-retest reliability, concomitant validity with another measure of multimorbidity and to explore the criterion diagnostic validity (sensitivity/specificity) with a gold standard
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