Translation and validation of the Dutch VEINES-QOL/Sym in varicose vein patients

* Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands.
Phlebology (Impact Factor: 1.77). 04/2013; 29(4). DOI: 10.1177/0268355513476279
Source: PubMed


To translate from English to Dutch and evaluate the psychometric properties of the VEnous INsufficiency Epidemiological and Economic Studies (VEINES) questionnaire, divided in symptom (VEINES-Sym) and quality of life (VEINES-QOL) subscales.

Standard forward-backward translation method was used to translate the 26 items of the VEINES-QOL/Sym. Eligible patients had to complete a standardized questionnaire. Demographic, venous disease characteristics, clinical venous signs, CEAP (clinical, aetiological, anatomical and pathological elements) classification and ultrasound findings were also noted. If item's scores were in an extreme category in more than 70% of patients a floor or ceiling effect was present. Feasibility of the individual items was considered poor if 5% or more of the responses were missing. The validity was tested by comparing the VEINES-QOL/Sym scores to the Short Form 36 (SF-36) scores and across the different 'CEAP' categories. Confirmatory factor analysis was used to assess the underlying structure of the VEINES-QOL/Sym.

Sixty-six patients were included (response rate of 72%). None of the 26 items missed <10% of responses, but two showed ceiling effect. Both the VEINES-QOL and VEINES-Sym showed an excellent internal consistency (Cronbach's alpha of 0.88 and 0.81, respectively). The VEINES-QOL demonstrated a good construct validity for the physical component of the SF-36, but not for the mental component (rho = 0.62 and 0.22, respectively), as expected. The VEINES-Sym correlated poorly to both SF-36's components. According to the confirmatory principle axis factoring, only three out of 25 items did not load sufficiently on the factor.

The Dutch VEINES-QOL/Sym can be used for health-related quality of life research in varicose veins patients and the evaluation of therapies.

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    ABSTRACT: To prospectively evaluate the psychometric properties of the Venous Insufficiency Epidemiological and Economic Study (VEINES-QOL/Sym) questionnaire, an instrument to measure disease-specific quality of life and symptoms in elderly patients with deep vein thrombosis (DVT), and to validate a German version of the questionnaire. In a prospective multicenter cohort study of patients aged ≥65 years with acute venous thromboembolism, we used standard psychometric tests and criteria to evaluate the reliability, validity, and responsiveness of the VEINES-QOL/Sym in patients with acute symptomatic DVT. We also performed an exploratory factor analysis. Overall, 352 French- and German-speaking patients were enrolled (response rate of 87 %). Both language versions of the VEINES-QOL/Sym showed good acceptability (missing data, floor and ceiling effects), reliability (internal consistency, item-total and inter-item correlations), validity (convergent, discriminant, known-groups differences), and responsiveness to clinical change over time in elderly patients with DVT. The exploratory factor analysis of the VEINES-QOL/Sym suggested three underlying dimensions: limitations in daily activities, DVT-related symptoms, and psychological impact. The VEINES-QOL/Sym questionnaire is a practical, reliable, valid, and responsive instrument to measure quality of life and symptoms in elderly patients with DVT and can be used with confidence in prospective studies to measure outcomes in such patients.
    No preview · Article · May 2014 · Quality of Life Research
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    ABSTRACT: Acute thrombus removal therapies may reduce post-thrombotic syndrome in certain deep venous thrombosis patients. The LET classification is designed to identify patients at high risk for developing post-thrombotic syndrome in the acute phase using thrombus location and extent. This study evaluates the use of the LET classification to predict post-thrombotic syndrome in a cohort of patients after deep venous thrombosis. A cohort of 660 deep venous thrombosis patients was invited to participate and fill out a questionnaire with Quality of life questionnaires, basic information, a modified self-assessment version of the Villalta scale for post-thrombotic syndrome and potential confounders. Original data on thrombus extension was available, and the LET classes were determined. Obtained information was analysed using ANOVA and in a multiple logistic regression model to correct for confounders. All different LET classes were compared to post-thrombotic syndrome occurrence, post-thrombotic syndrome prediction and disease specific quality of life scores (VEINES-Sym/Qol). Three hundred and fifteen patients responded, and in 309 a post-thrombotic syndrome score was distilled. LET I,II,III (n = 63) had an odds ratio of 3.4(1.2-9.2) for predicting severe post-thrombotic syndrome, and LET II (n = 17) had an odds ratio of 5.1(1.3-20.8) compared to LET class I (n = 97). Both the VEINES-Sym and VEINES-Qol score were significantly lower for LET I,II,III compared to LET I, and LET II compared to LET I. The LET classification can be used to classify patients according to acute thrombus location and extent. Extensive and centrally located (LET I,II,III) deep venous thrombosis showed the highest probability in developing severe post-thrombotic syndrome and lower disease specific quality of life. © The Author(s) 2015 Reprints and permissions:
    No preview · Article · Mar 2015 · Phlebology
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    ABSTRACT: Objective We conducted a systematic review of the literature about quality-of-life (QOL) scales in chronic venous disorders (CVDs) comprising leg ulcers to identify the respective advantages and deficits of existing tools. Methods A research protocol was built following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the PICO (population, intervention, comparator, and outcome) criteria. The following databases were screened: MEDLINE, SCOPUS, EMBASE, CINHAL, and Cochrane. Psychometric and linguistic validation studies in English were included, as were clinical trials that have used QOL scales in CVDs. The data search was up to date as of October 31, 2013. Results Inclusion criteria were met in 103 of the 511 recorded references, in which 10 scales were identified: two for the full spectrum of CVDs, three for patients with CVDs without leg ulceration, four for leg ulcers, and one exclusively for patients with varicose veins. Among them, the ChronIc Venous Insufficiency Questionnaire (CIVIQ), Aberdeen Varicose Vein Questionnaire (AVVQ), and VEnous INsufficiency Epidemiological and Economic Study on Quality of Life (VEINES-QOL) scales were the most highly used according to the literature, and CIVIQ and VEINES-QOL were the most extensively validated scales and had the longest iterative validation process. A total of 31 psychometric and linguistic validations of the 10 QOL scales and 66 clinical trials that have used these scales were identified. The validation studies were based on acceptability, content validity, construct validity, reliability, and responsiveness. The clinical trials were composed of 25 randomized controlled trials and 41 observational studies. Only the randomized controlled trials are considered in the present article. Conclusions This systematic review confirmed that CVDs have an important effect on QOL. The majority of the studies addressed the application rather than the validation of the 10 identified scales. Two scales, CIVIQ and VEINES-QOL, emerged as being thoroughly validated instruments, although factorial stability was not demonstrated for the VEINES-QOL. Our findings confirm a paucity of validation studies.
    Full-text · Article · Apr 2015
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