Development And Validation Of A Chinese Adult Polycystic Liver Disease Complaint-specific Assessment(CAPA)

Background and Aims The vast majority of patients with Polycystic liver disease(PLD)are asymptomatic,a minority of patients may lead to extensive hepatomegaly and invalidating complaints.Therapeutic decisions are besides the existence of hepatomegaly,also guided by the severity of complaints.We developed and validated a self-report instrument to capture the presence and severity of disease specific complaints for PLD,in order to provide quantitative data on the symptoms to the clinician.The website is built to facilitate patient follow-up investigation.Methods The study population consisted of 112 patients.Items for the Chinese adult PCLD-complaint-specific assessment(CAPA)were developed based on the chart review of symptomatic PLD patients and literature,and discussed during expertconsensus-meetings.The 112 patients were divided into 2 groups(group A and group B)randomly.Patients in Group A were asked to complete the POLCA Chinese edition and Patients in Group B was asked to complete the candidate items for CAPA.Factor analysis was conducted to identify subscales and remove suboptimal items.Reliability was assessed by Cronbach's alpha.Convergent,criterion validity and responsiveness were tested using prespecified hypotheses in 24 surgery patients during this study.Results The Factor analysis and reliability analysis was not satisfied with the POLCA Chinese edition,the Cronbach's ? in Presence of complaints group,Severity of perceived illness group and in all items was 0.472,0.680,0.728,respectively.Factor analysis on all items was performed to identify 7 subscales which was inconsistent with the literature data of POLCA.Factor analysis on Presence of complaints group can not be performed because of the KMO value < 0.5.After remove suboptimal items in CAPA candidate items,Cronbach's ? in Presence of complaints group,Severity of perceived illness group and in all items was 0.818,0.758,0.698,respectively.Factor analysis on all items was performed to identify 3 subscales(eigenvalue >1),the Cumulative Contribution of the first 3 unique factors was 68.64 %,the CAPA analysis results was consistent with the theoretical framework.Non-parametric testing by Spearman was performed to describe correlations between CAPA scores decline ratio and resection liver volume ratio in 24 surgery patients during this study,Correlation coefficient was 0.771(p<0.01)indicate good criterion validity.After developed CAPA we set up follow-up site http://iheal.cc,in order to collect more data to further improve the CAPA.Conclusion In contrast to POLCA,the CAPA shows good validity and responsiveness to measure complaint severity in PLD.