Interpreting the Chinese version of quality of life questionnaire
for functional digestive disorders
Zheng-kun Hou,* Hong Mi,* Feng-bin Liu,* Zhuo-qun Chen,
and Xiao-lu Che
Department of *Gastroenterology, First Afﬁliation Hospital,
Preventive Medicine and Health Statistics, College of Basic Medical Sciences,
First School of
Clinic Medicine, Guangzhou University of Chinese Medicine, Guangzhou, and
Department of Gastroenterology, Jiangmen Wuyi Traditional Chinese
Medicine Hospital, Jiangmen, China
clinically meaningful change, functional
dyspepsia, interpretation, minimum clinically
Accepted for publication 11 October 2017.
Zheng-kun Hou and Feng-bin Liu, Department
of Gastroenterology, First Afﬁliation Hospital,
Guangzhou University of Chinese Medicine,
Guangzhou 510405, Guangdong, China.
Email: firstname.lastname@example.org; liufb163@163.
Declaration of conflict of interest: The authors
declare that they have no competing interests.
Author contribution: Z.-k. Hou, and Prof. F.-b.
Liu were co-guarantors of integrity of the entire
study and were responsible for the conception
and design of the study; acquisition, analysis,
and interpretation of data; and afforded funding
and administrative support for the study. Z.-k.
Hou, H. Mi, and Z.-q. Chen drafted the article;
Background and Aim: The Chinese version quality of life questionnaire for functional di-
gestive disorders (Chin-FDDQL) is a useful health assessment instrument for functional
dyspepsia. This study aims to identify its score interpretation for clinical practice.
Methods: Data of Chin-FDDQL from the functional dyspepsia patients (≥ 18 years) be-
tween November 2009 and April 2013 were enrolled in the 1st and 14th day. After baseline
and responsiveness analysis, the single score interpretation and percentile ranks were
established. The statistically reliable change was deﬁned with effect size, standardized re-
sponse mean, minimal detectable change, and others. Then the receiver operating charac-
teristic curve analysis for health improvement was performed to deﬁne the clinically
Results: Two hundred two functional dyspepsia patients, 150 healthy participants, and 25
missing data were enrolled for analysis. Compared with the intake patients, the discharged
and healthy persons have signiﬁcant better health status in all domains (P < 0.001, expect
discomfort in discharged people, P = 0.142), totally contrast to missing data. The reliability
for single total intake and discharge were both ± 1. Based on score distribution, the 25th,
50th, and 75th percentile ranks were 49, 58, and 66 for intake scores and 59, 65, and 72
for discharge scores, respectively. The minimal detectable change and Reliable Change In-
dex were 6 and 11 for total score. Receiver operating characteristic analyses supported that
total score changes 4 or more represented minimal clinically important improvement.
Conclusions: The score interpretation system of the Chin-FDDQL could assist clinician’s
decision making during the therapy practice.
X.-l. Chen, Y.-h.Wu, and X.-l Che were respon-
sible for the collection and assemblyof data. All
authors were involved in reviewing, discussion,
and ﬁnal approval of the version to be published.
Financial support: This work was supported by
the National Natural Science Foundation of
China (nos 81774450 and 81303148),
Functional dyspepsia (FD), affecting up to 29.2% of population
worldwide, is deﬁned as a condition in which dyspeptic symptoms
occur in the epigastric region in the absence of an organic dis-
At present, there are various scales to assess its symptoms
Of those, the quality of life questionnaire for func-
tional digestive disorders (FDDQL), which aims to measure the
pathology and symptoms of FD and irritable bowel syndrome with
8 domains and 43 items, has good scientiﬁc attributes.
now, it has been translated into many languages: English, French,
German, and others.
In the previous study, the research group
successfully translated it into mandarin language and found that
it had good reliability, validity, responsibility, item test function,
and differential item functioning characters.
In spite of well-established development of instruments, bias in
interpreting health-related quality of life scores may limit its use in
As a limitation, we did not explain the clinical
Pearl River S&T Nova Program of Guangzhou (no. 201710010077), and Medical Scientiﬁc Research
Foundation of Guangdong Province (A2017504).
Statement of previous publication: The abstract of this research was published in the Quality of
Life Research, 2015,24(Suppl 1):118, which was the Proceedings of 22th Annual Conference of
International Society for Quality of Life Research.
Journal of Gastroenterology and Hepatology 33 (2018) 869–877
© 2017 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
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