Hyperhidrosis quality of life index (HidroQoL): further validation by applying classical test theory and item response theory using data from a phase III clinical trial

Arabic Translation, Cultural Adaptation, and Validation of the Hyperhidrosis Disease Severity Scale (Ar-HDSS)

Background: Hyperhidrosis (HH) is characterized by excessive sweating, which affects quality of life. The Hyperhidrosis Disease Severity Scale (HDSS) is a four-point scale used to evaluate HH severity by measuring how much excessive sweating disrupts daily activities. This study aimed to translate, validate, and adapt the HDSS tool into Arabic. Methods: A quantitative, analytical, cross-sectional study was carried out from May to June 2024 on patients clinically diagnosed with HH. The process of translating the HDSS into Arabic involved three independent forward translations, followed by a preliminary version created by a reviewer. Three additional independent translators conducted backward translations. All of the versions were then revised and merged to produce the final version. Reliability was evaluated through a test-retest reliability approach to ensure the reproducibility of the results. For validity, we used construct validity to compare the HDSS with the HidroQoL index. Results: A total of 167 patients were included, with a mean age of 29 ± 9.02 years, and over half of the patients were male (61%). The interrater agreement between the HDSS test and the retest results was substantial, with a kappa coefficient of 0.732. Significant positive correlations were observed between the HDSS score and daily life (r = 0.413, p < 0.001), the psychological domain (r = 0.374, p < 0.001), and HidroQOL (r = 0.425, p < 0.001). Conclusions: Our findings demonstrate that the Arabic HDSS has excellent psychometric properties, including construct validity and reproducibility. Proper use of the Arabic HDSS will allow the effective assessment of HH severity.

The Creation of the Arabic Version of the Hyperhidrosis Quality of Life Index (HidroQoL©) with Validation and Cross-Cultural Adaptation

Purpose

Hyperhidrosis (HH) is characterized by excessive sweating, which can significantly affect quality of life. The Hyperhidrosis Quality of Life Index (HidroQoL©) is the latest tool that has been developed and validated for assessing the quality of life of patients with HH. Because of the absence of an Arabic version of the HidroQoL©, this research aimed to create, validate, and adapt the HidroQoL© into Arabic.

Patients and Methods

A quantitative, analytical, cross-sectional study was conducted with HH patients followed up in dermatology or thoracic surgery clinics. We assessed the results reliability through internal consistency and reproducibility by assessing test‒retest reliability. For validity, we conducted an exploratory factor analysis with an interitem correlation matrix and a rotated component matrix.

Results

A total of 167 participants were enrolled in this study; 61.1% were males, and 92.8% were Saudi. All 18 items of the HidroQoL©, including the daily life activities domain, psychosocial life domain, and whole HidroQoL©, had Cronbach's alpha values above 0.7. The test-retest reliability assessment demonstrated strong reproducibility. The correlations between each item and the other 17 items of the scale were positive, ranging between 0.2 and 0.6, and the results of the components analysis suggested that the questionnaire has three domains. The correlation between the test-retest results of the HidroQoL© revealed a significant strong positive correlation (r=0.9, P˂0.001).

Conclusion

Our findings revealed excellent psychometric properties of the Arabic HidroQoL© in terms of structural and construct validity, internal consistency, and reproducibility. Proper utilization of the Arabic HidroQoL© adequately assesses the quality of life of those affected by HH.

Iontophoresis Improves the Impact on the Quality of Life of Children with Primary Hyperhidrosis-A Prospective Study and a Short Review

BACKGROUND

Primary hyperhidrosis (PH) is a somatic and idiopathic pediatric skin disease. The eccrine glands are tiny and very numerous, with approximately 3 million distributed throughout the skin. There is no commonly accepted amount of sweating to define hyperhidrosis, but people with this disease suffer real limitations integrating into society, which can be quantified through quality of life measurement scales. We want to draw attention to this disease and its impact on children's quality of life because it is significant and there are no studies conducted on groups consisting solely of children.

METHODS

There are various quality of life evaluation questionnaires for hyperhidrosis. We studied 103 children with hyperhidrosis by monitoring their sweat severity and its impact on quality of life, using the Hyperhidrosis Disease Severity Scale. We compared the scale results before and after 10 days of iontophoresis. This study includes only children under 18 years old, treated with iontophoresis.

RESULTS

The average age of the group is 11.84 ± 2.89 years. Treatment success is recorded in 68 (66.02%) children, but a change in the score is recorded in 74 (71.84%) children. The average HDSS score at T0 is 2.95 ± 0.70, compared to the HDSS score at T1 of 1.92 ± 0.86.

CONCLUSIONS

Hyperhidrosis has a negative impact on daily life, especially self-esteem, occupational productivity, emotional well-being, and interpersonal relationships. Iontophoresis is a safe and effective treatment method that reduces the severity of hyperhidrosis and increases the quality of life.

What do Hyperhidrosis Quality of Life Index (HidroQoL©) scores mean? Transferring science into practice by establishing a score banding system

BACKGROUND

The Hyperhidrosis Quality of Life Index (HidroQoL©) is a measure of quality of life (QoL) impacts in hyperhidrosis (HH).

OBJECTIVES

We aimed to establish score banding systems for the HidroQoL total score for specific contexts representing different severity/impact categories by using the Dermatology Life Quality Index (DLQI) and the Hyperhidrosis Disease Severity Scale (HDSS) as anchors, including data from 357 patients from a phase III clinical trial.

METHODS

We used the HDSS, the established DLQI score bands and two single items (items 5 and 7) of the DLQI as anchors for the creation of banding systems for the HidroQoL. These anchors were chosen via consensus among an expert group according to relevance to patient experience. Due to the distribution of the HDSS and the single DLQI item 7, receiver operating characteristic curves were computed in order to create an optimal cut-off value of the HidroQoL total score. For the DLQI banding system and the single DLQI item 5, we created a banding system for the HidroQoL based on the distribution of their different categories.

RESULTS

A score of 30 and greater is proposed as the cut-off value for sweating that 'always interferes in daily activities', based on the HDSS as anchor. In terms of overall skin QoL effects, score bands of 0-6, 7-18, 19-25, 26-32 and 33-36 represent 'no effect', 'small effect', 'moderate effect', 'very large effect' and 'extremely large effect' on the patient's life, respectively.

CONCLUSIONS

In this study, we propose different banding systems for four different contexts: skin-specific QoL (DLQI banding), HH severity (HDSS), working and studying (single DLQI item 7) and social and leisure activities (single DLQI item 5). These banding systems and cut-off values can be used in clinical research and practice to place the patients in different severity categories.