The Short Food Allergy Quality of Life Questionnaire (FAQLQ-12) for Adults

BACKGROUND

The Food Allergy Quality of Life Questionnaire (FAQLQ) is the most widely used measure to assess health-related quality of life in food allergy. However, its length can lead to a series of disadvantages, such as reduced or incomplete participation and boredom and disengagement, affecting data quality, reliability, and validity.

OBJECTIVE

We shortened the well-known FAQLQ for adults and propose the FAQLQ-12.

METHODS

We applied reference-standard statistical analyses, mixing classic test theory and item response theory to identify relevant items for the new short form and confirm its structure fit and reliability. More specifically, we employed discrimination, difficulty, and information levels (item response theory), confirmatory factor analysis, Pearson's correlations, and reliability analysis (McDonald ω and Cronbach α).

RESULTS

We chose items with the highest discrimination values to compose the shortened FAQLQ because they were among the ones with the best difficulty levels and the highest amount of individual information. We retained three items per factor because this number allowed for acceptable reliability levels, resulting in 12 items. The FAQLQ-12 presented a better model fit compared with the complete version. The correlation patterns and reliability levels were similar for both the 29 and 12 versions.

CONCLUSIONS

Although the full version of the FAQLQ remains a reference standard to assess food allergy quality of life, the FAQLQ-12 is introduced as a powerful and beneficial alternative. It can help participants, researchers, and clinicians in specific settings, such as dealing with time and budget limitations, and provides high-quality and reliable responses.

Improvements in Quality of Life in Children Following Epicutaneous Immunotherapy (EPIT) for Peanut Allergy in the PEPITES and PEOPLE Studies

BACKGROUND

Food allergy quality of life (FAQL) is impaired in children with peanut allergy. Food Allergy Quality of Life Questionnaires (FAQLQs) provide disease-specific insight into the burden of peanut allergy and potential FAQL changes after peanut immunotherapy.

OBJECTIVE

To examine FAQL changes in children after treatment with epicutaneous immunotherapy for peanut allergy (250 μg, daily epicutaneous peanut protein; DBV712 250 μg).

METHODS

FAQL was prospectively measured using the FAQLQ parent proxy form (Food Allergy Quality of Life Questionnaire-Parent Proxy Form [FAQLQ-PF], for children aged ≤12 years) and child form (Food Allergy Quality of Life Questionnaire-Child Form [FAQLQ-CF], child rated if aged ≥8 years) during the 12-month double-blind, randomized, controlled Peanut EPIT Efficacy and Safety Study (PEPITES) trial and the initial 12 months of the open-label PEPITES Open Label Extension Study (PEOPLE) follow-up study. Data were analyzed for between-group differences after treatment unblinding.

RESULTS

FAQLQs from placebo participants (FAQLQ-PF: 96; FAQLQ-CF: 47) and treatment group participants (FAQLQ-PF: 209; FAQLQ-CF: 105) were analyzed. Twenty-four-month global FAQL scores (FAQLQ-PF/FAQLQ-CF) were significantly improved in the treatment group versus the placebo group (least squares mean, 0.34, P = .008, and 0.46, P = .023, respectively). At 24 months, there was significant FAQLQ-PF score improvement in participants initially randomized to treatment who met the efficacy primary end point (n = 74; least squares mean, 0.55; P < .001) and in participants with any eliciting dose increase (n = 127; least squares mean, 0.66; P < .001). FAQLQ-PF improvements were observed in social dietary limitations (P = .002), food-related anxiety (P = .029), and emotional impact (P = .048) domains. FAQLQ-CF improvements were observed in risk of accidental exposure (P = .002) and allergen avoidance (P = .04) domains. Nearly all outcomes met a nontreatment context minimal clinically important difference previously cited for FAQLQ.

CONCLUSIONS

Epicutaneous immunotherapy treatment was observed to be associated with significant global and domain-specific FAQL improvement (FAQLQ-PF/FAQLQ-CF), largely driven by increases in eliciting dose, in children with peanut allergy.