Development of a Short Version of MSQOL-54 Using Factor Analysis and Item Response Theory
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BACKGROUND: The Multiple Sclerosis Quality of Life-54 (MSQOL-54, 52 items grouped in 12 subscales plus two single items) is the most used MS specific health related quality of life inventory. OBJECTIVE: To develop a shortened version of the MSQOL-54. METHODS: MSQOL-54 dimensionality and metric properties were investigated by confirmatory factor analysis (CFA) and Rasch modelling (Partial Credit Model, PCM) on MSQOL-54s completed by 473 MS patients. Their mean age was 41 years, 65% were women, and median Expanded Disability Status Scale (EDSS) score was 2.0 (range 0-9.5). Differential item functioning (DIF) was evaluated for gender, age and EDSS. Dimensionality of the resulting short version was assessed by exploratory factor analysis (EFA) and CFA. Cognitive debriefing of the short instrument (vs. the original) was then performed on 12 MS patients. RESULTS: CFA of MSQOL-54 subscales showed that the data fitted the overall model well. Two subscales (Role Limitations--Physical, Role Limitations--Emotional) did not fit the PCM, and were removed; two other subscales (Health Perceptions, Social Function) did not fit the model, but were retained as single items. Sexual Satisfaction (single-item subscale) was also removed. The resulting MSQOL-29 consisted of 25 items grouped in 7 subscales, plus 4 single items. PCM fit statistics were within the acceptability range for all MSQOL-29 items except one which had significant DIF by age. EFA and CFA indicated adequate fit to the original two-factor (Physical and Mental Health Composites) hypothesis. Cognitive debriefing confirmed that MSQOL-29 was acceptable and had lost no key items. CONCLUSIONS: The proposed MSQOL-29 is 50% shorter than MSQOL-54, yet preserves key quality of life dimensions. Prospective validation on a large, independent MS patient sample is ongoing.
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The study assessed coping, health-related quality of life, and general distress using validated instruments: the Coping Responses Inventory-Adult form, the Multiple Sclerosis Quality of Life-29, and the Depression Anxiety Stress Scale-21.
“Coping Responses Inventory-Adult Form (CRI-Adult [33]; Italian version [38]): measure made up of 48 items assessing approach (logical analysis, positive reappraisal, guidance/support seeking, and problem-solving) and avoidance coping (cognitive avoidance, resigned acceptance, alternative rewards, and emotional discharge).”
From Coping strategies and their impact on quality of life and physical disability of people with multiple sclerosis (2021) · cites this paper as [39]
The printed citing sentence describes the 48-item Coping Responses Inventory–Adult Form and its coping subscales. The Results sections of our copy concern the MSQOL-29; searches for the Coping Responses Inventory, its 48 items, and the Depression Anxiety Stress Scale found no passage addressing those instruments. The source therefore does not verify the description attached to the citation. (LLM, conf=0.76)
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Subjective assessment of quality of life in patients with multiple sclerosis
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- Authors
- Rosato, R., Testa, S., Bertolotto, A., Confalonieri, P., Patti, F., Lugaresi, A., Grasso, M. G., Toscano, A., Giordano, A., & Solari, A.
- Affiliations
- University of Turin (IT)
- Ospedale San Luigi Gonzaga (IT)
- Fondazione IRCCS Istituto Neurologico Carlo Besta (IT)
- Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco" (IT)
- University of Chieti-Pescara (IT)
- Fondazione Santa Lucia (IT)
- Corresponding author
- Solari, Alessandra
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-04-14
- Volume
- 11
- Issue
- 4
- Pages
- e0153466
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4831784
- OpenAlex
- W2336057040
- Cited by
- 46
- References
- 53
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 12 · 2020: 4 · 2019: 1 · 2018: 5 · 2017: 7
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Funders
- Fondazione Italiana Sclerosi Multipla (2013/R/20.)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Keywords
- MSQOL-54, multiple sclerosis, health-related quality of life, Rasch model, partial credit model, differential item functioning, cognitive debriefing, Expanded Disability Status Scale
- MeSH terms
- Adult, Aged, Cognition, Disability Evaluation, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Prospective Studies, Psychomotor Performance, Quality of Life
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