. 2024 Jan 10;24(1):71.

doi: 10.1186/s12879-023-08958-7.

Episodic disability questionnaire (EDQ) measurement properties among adults living with HIV in Canada, Ireland, United Kingdom, and United States

Kelly K O'Brien^{1

2

3}, Kristine M Erlandson⁴, Darren A Brown⁵, Soo Chan Carusone^{6

7}, Jaime H Vera⁸, Colm Bergin^{9

10}, Lisa Avery¹¹, Ahmed M Bayoumi^{12

13

14

15}, Steven E Hanna¹⁶, Richard Harding¹⁷, Patricia Solomon¹⁸, Natalie St Clair-Sullivan⁸, Noreen O'Shea⁹, Carolann Murray⁷, Marta Boffito⁵, George Da Silva¹⁹, Brittany Torres¹⁹, Kiera McDuff¹⁹, Aileen M Davis^{19

12

20}

Affiliations

¹ Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada. kelly.obrien@utoronto.ca.
² Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. kelly.obrien@utoronto.ca.
³ Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON, Canada. kelly.obrien@utoronto.ca.
⁴ University of Colorado Denver-Anschutz Medical Campus, Aurora, CO, USA.
⁵ Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
⁶ McMaster Collaborative for Health and Aging, McMaster University, Hamilton, ON, Canada.
⁷ Casey House, Toronto, ON, Canada.
⁸ Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
⁹ GUIDE Clinic, St. James's Hospital, Hospital, Dublin, Ireland.
¹⁰ School of Medicine, Trinity College Dublin, Dublin, Ireland.
¹¹ Biostatistics Department, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
¹² Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
¹³ MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
¹⁴ Department of Medicine, University of Toronto, Toronto, ON, Canada.
¹⁵ Division of General Internal Medicine, St. Michael's Hospital, Toronto, ON, Canada.
¹⁶ Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
¹⁷ Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK.
¹⁸ School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
¹⁹ Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.
²⁰ Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON, Canada.

PMID: 38200425
PMCID: PMC10782617
DOI: 10.1186/s12879-023-08958-7

Episodic disability questionnaire (EDQ) measurement properties among adults living with HIV in Canada, Ireland, United Kingdom, and United States

Kelly K O'Brien et al. BMC Infect Dis. 2024.

. 2024 Jan 10;24(1):71.

doi: 10.1186/s12879-023-08958-7.

Authors

Affiliations

¹ Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada. kelly.obrien@utoronto.ca.
² Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. kelly.obrien@utoronto.ca.
³ Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON, Canada. kelly.obrien@utoronto.ca.
⁴ University of Colorado Denver-Anschutz Medical Campus, Aurora, CO, USA.
⁵ Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
⁶ McMaster Collaborative for Health and Aging, McMaster University, Hamilton, ON, Canada.
⁷ Casey House, Toronto, ON, Canada.
⁸ Department of Global Health and Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, UK.
⁹ GUIDE Clinic, St. James's Hospital, Hospital, Dublin, Ireland.
¹⁰ School of Medicine, Trinity College Dublin, Dublin, Ireland.
¹¹ Biostatistics Department, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
¹² Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
¹³ MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
¹⁴ Department of Medicine, University of Toronto, Toronto, ON, Canada.
¹⁵ Division of General Internal Medicine, St. Michael's Hospital, Toronto, ON, Canada.
¹⁶ Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
¹⁷ Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK.
¹⁸ School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
¹⁹ Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, 160-500 University Avenue, Toronto, ON, M5G 1V7, Canada.
²⁰ Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON, Canada.

PMID: 38200425
PMCID: PMC10782617
DOI: 10.1186/s12879-023-08958-7

Abstract

Background: The Episodic Disability Questionnaire (EDQ) is a generic 35-item patient-reported outcome measure of presence, severity and episodic nature of disability. We assessed the measurement properties of the Episodic Disability Questionnaire (EDQ) with adults living with HIV.

Methods: We conducted a measurement study with adults living with HIV in eight clinical settings in Canada, Ireland, United Kingdom, and United States. We electronically administered the EDQ followed by three reference measures (World Health Organization Disability Assessment Schedule; Patient Health Questionnaire; Social Support Scale) and a demographic questionnaire. We administered the EDQ only 1 week later. We assessed the internal consistency reliability (Cronbach's alpha; > 0.7 acceptable), and test-retest reliability (Intra Class Correlation Coefficient; > 0.7 acceptable). We estimated required change in EDQ domain scores to be 95% certain that a change was not due to measurement error (Minimum Detectable Change (MDC95%)). We evaluated construct validity by assessing 36 primary hypotheses of relationships between EDQ scores and scores on the reference measures (> 75% hypotheses confirmed indicated validity).

Results: Three hundred fifty nine participants completed the questionnaires at time point 1, of which 321 (89%) completed the EDQ approximately 1 week later. Cronbach's alpha for internal consistency ranged from 0.84 (social domain) to 0.91 (day domain) for the EDQ severity scale, and 0.72 (uncertainty domain) to 0.88 (day domain) for the EDQ presence scale, and 0.87 (physical, cognitive, mental-emotional domains) to 0.89 (uncertainty domain) for the EDQ episodic scale. ICCs for test-retest reliability ranged from 0.79 (physical domain) to 0.88 (day domain) for the EDQ severity scale and from 0.71 (uncertainty domain) to 0.85 (day domain) for the EDQ presence scale. Highest precision was demonstrated in the severity scale for each domain (MDC95% range: 19-25 out of 100), followed by the presence (MDC95% range: 37-54) and episodic scales (MDC95% range:44-76). Twenty-nine of 36 (81%) construct validity hypotheses were confirmed.

Conclusions: The EDQ possesses internal consistency reliability, construct validity, and test-retest reliability, with limited precision when administered electronically with adults living with HIV across in clinical settings in four countries. Given the measurement properties, the EDQ can be used for group level comparisons for research and program evaluation in adults living with HIV.

Keywords: Disability evaluation; HIV; Measurement; Questionnaires; Reliability; Validity.

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Conflict of interest statement

The authors declare no competing interests.

Update of

Episodic Disability Questionnaire (EDQ) measurement properties among adults living with HIV in Canada, Ireland, United Kingdom, and United States.
O'Brien KK, Erlandson KM, Brown DA, Carusone SC, Vera JH, Bergin C, Avery L, Bayoumi AM, Hanna SE, Harding R, Solomon P, St Clair-Sullivan N, O'Shea N, Murray C, Boffito M, Da Silva G, Torres B, McDuff K, Davis AM. O'Brien KK, et al. Res Sq [Preprint]. 2023 Apr 5:rs.3.rs-2758163. doi: 10.21203/rs.3.rs-2758163/v1. Res Sq. 2023. Update in: BMC Infect Dis. 2024 Jan 10;24(1):71. doi: 10.1186/s12879-023-08958-7. PMID: 37066168 Free PMC article. Updated. Preprint.

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O'Hara ME, McDuff K, Wei H, McCorkell L, Thomson C, Kelly M, Goulding S, O'Donovan I, O'Connell S, Stokes R, Malli N, St Clair-Sullivan N, Chan Carusone S, Cheung AM, Erlandson KM, Bannan C, Townsend L, Bergin C, Vera JH, Harding R, Avery L, Brown DA, O'Brien KK. O'Hara ME, et al. Health Expect. 2025 Aug;28(4):e70365. doi: 10.1111/hex.70365. Health Expect. 2025. PMID: 40783949 Free PMC article.
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Episodic disability questionnaire (EDQ) measurement properties among adults living with HIV in Canada, Ireland, United Kingdom, and United States

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Episodic disability questionnaire (EDQ) measurement properties among adults living with HIV in Canada, Ireland, United Kingdom, and United States

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