Standard error of measurement and smallest detectable change of the Sarcopenia Quality of Life (SarQoL) questionnaire: An analysis of subjects from 9 validation studies

Anton Geerinck, Vidmantas Alekna, Charlotte Beaudart, Ivan Bautmans, Cyrus Cooper, Fabiana De Souza Orlandi, Jerzy Konstantynowicz, Beatriz Montero-Errasquín, Eva Topinková, Maria Tsekoura, Jean-Yves Reginster, Olivier Bruyère, Anton Geerinck, Vidmantas Alekna, Charlotte Beaudart, Ivan Bautmans, Cyrus Cooper, Fabiana De Souza Orlandi, Jerzy Konstantynowicz, Beatriz Montero-Errasquín, Eva Topinková, Maria Tsekoura, Jean-Yves Reginster, Olivier Bruyère

Abstract

Objectives: The Sarcopenia Quality of Life (SarQoL) questionnaire, a sarcopenia-specific patient-reported outcome measure, evaluates quality of life with 55 items. It produces 7 domain scores and 1 overall quality of life score, all between 0 and 100 points. This study aims to contribute to the interpretation of the SarQoL scores by calculating the standard error of measurement (SEM) and smallest detectable change (SDC) in a sample of subjects from 9 studies.

Methods: Subjects from 9 studies (conducted in Belgium, Brazil, Czech Republic, England, Greece, Lithuania, Poland and Spain) were included. The SEM, a measure of the error in the scores that is not due to true changes, was calculated by dividing the standard deviation of the difference between test and retest scores (SDdiff) by √2. The SDC, defined as change beyond measurement error, was calculated by multiplying SDdiff by 1.96. Bland-Altman plots were assessed for the presence of systematic errors.

Results: A total of 278 sarcopenic subjects, aged 77.67 ± 7.64 years and 61.5% women, were included. The SEM for the overall SarQoL score ranged from 0.18 to 4.20 points for the individual studies, and was 2.65 points when all subjects were analyzed together. The SDC for the overall score ranged from 0.49 to 11.65 points for the individual studies, and was 7.35 points for all subjects. The Bland-Altman plots revealed no systematic errors in the questionnaire.

Conclusion: This study shows that, for individual subjects, a change in overall quality of life of at least 7.35 points (on a scale from 0 to 100) would have to be observed to confirm that a true change, beyond measurement error, has occurred. It also demonstrated that the SarQoL questionnaire is a precise instrument, with the observed scores within less than 3 points of the theoretical "true score".

Conflict of interest statement

AG is supported by a FRIA fellowship grant from the F.R.S.-FNRS (Belgian Fund for Scientific Research). CB, OB, J-YR, IB & CC are shareholders of SarQoL sprl. J-YR is the president of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), which has endorsed the SarQoL® questionnaire. CC reports personal fees from Alliance for Better Bone Health, Amgen, Eli Lilly, GSK, Medtronic, Merck, Novartis, Pfizer, Roche, Servier, Takeda and UCB. All other authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Bland Altman plot for the…
Fig 1. Bland Altman plot for the SarQoL overall score in the complete sample.

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