Validation of the Wisconsin upper respiratory symptom survey-24, Chinese version

Yuanyuan Wang; Zehui He; Simin Chen; Yuntao Liu; Fang Li; Bruce Barrett; Zhongde Zhang; Guobin Su; Cecilia Stålsby Lundborg

doi:10.1080/07853890.2022.2043559

Validation of the Wisconsin upper respiratory symptom survey-24, Chinese version

Ann Med. 2022 Dec;54(1):655-665. doi: 10.1080/07853890.2022.2043559.

Authors

Yuanyuan Wang^{1

2}, Zehui He³, Simin Chen^{2

4}, Yuntao Liu^{2

5}, Fang Li², Bruce Barrett⁶, Zhongde Zhang^{2

5}, Guobin Su^{1

7

8

9}, Cecilia Stålsby Lundborg¹

Affiliations

¹ Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
² Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China.
³ Department of Clinical Epidemiology, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China.
⁴ Intensive Care Unit, Traditional Chinese Medicine Hospital Dianjiang, Chongqing, PR China.
⁵ Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, PR China.
⁶ Department of Family Medicine and Community Health, University of Wisconsin, Madison, WI, USA.
⁷ Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China.
⁸ Department of Nephrology, National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Guangdong Provincial Clinical Research Center for Kidney Disease, Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
⁹ Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Abstract

Background: The Wisconsin upper respiratory symptom survey (WURSS) is a validated English questionnaire to evaluate the quality of life and severity of upper respiratory tract infections (URTIs). We aimed to develop a Mandarin Chinese version of WURSS-24 (WURSS-24-C) and evaluate its reliability, validity and minimal important difference (MID).

Methods: The WURSS-24-C was developed using the forward-backward translation procedure. People with URTIs' symptoms within 48 h of onset were recruited and asked to fill in the WURSS-24-C daily for up to 14 d. Exploratory and confirmatory factor analyses were used to suggest domains. The 8-Item Short Form Health Survey (SF-8) assessing general mental and physical health was used to assess validity. Reliability estimated by Cronbach's alpha and mean day-to-day change for those indicating minimal improvement as MID were evaluated.

Results: The WURSS-24-C was found to be acceptable, relevant, and easy to complete in cognitive debriefing interviews. A total number of 300 participants (age 28.4 ± 9.3, female 70%) were monitored for 2500 person-days. Four domains (activity and function, systemic symptoms, nasal symptoms and throat symptoms) of the WURSS-24-C were confirmed (comparative fit index [CFI] = 0.93). The reliability of this 4-domain-structure is good (Cronbach's alphas varied from 0.849 to 0.943). Convergent validity is moderate (Pearson correlation coefficients between daily WURSS-24-C and the SF-8 were -0.780 and -0.721, for the SF-8 physical and mental health, respectively). Estimates of MID for individual items varied from -0.41 to -1.14.

Conclusions: The WURSS-24-C is a reliable and valid questionnaire for assessing illness-specific quality-of-life health status in Chinese-speaking patients with URTIs.Key messagesThe Wisconsin upper respiratory symptom survey (WURSS) series are patient-oriented questionnaire instruments assessing the quality of life and severity of upper respiratory tract infections (URTIs).The WURSS-24 was translated into Mandarin Chinese using the forward-backward translation procedure, and evaluated its validity, reliability and minimal important difference (MID) in 300 Chinese participants with URTIs.The WURSS-24 Chinese version (WURSS-24-C) seems to be a reliable and valid questionnaire for assessing illness-specific quality-of-life health status in Chinese patients with URTIs.

Keywords: WURSS; common cold; psychometrics; quality of life; reliability; upper respiratory infection; validation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
China
Female
Humans
Quality of Life*
Reproducibility of Results
Severity of Illness Index
Surveys and Questionnaires
Wisconsin
Young Adult

Grants and funding

The study was funded by China National Science and Technology Major Project, NO:2017ZX10305501- 006; Guangdong Provincial Key Laboratory of T CM Research on Emergency, NO: 2017B030314176; Evidence-based Capacity Building Project of Traditional Chinese Medicine, NO: 2019XZZX-LG003; Collaborative innovation team project of Guangzhou University of Chinese Medicine, NO:2021XK06 and 2021XK49; and Guangzhou Municipal Science and Technology Bureau, NO: 201803010121. G.S. acknowledges support from National Nature Science Foundation of China, China, NO: 82004205; China Postdoctoral Science Foundation, China, NO: 2020M672741 and 2020T Q0137; the Karolinska Institutet research funds, Sweden, NO: 2020-01616; the Science and Technology Research Fund from Guangdong provincial hospital of Chinese medicine, China, No: YN2018QL08. The funding body was not involved in the design, conduct, data collection, analysis, interpretation and writing of this study.