Adapting the Asthma Life Impact Scale (ALIS) for use in Southern European (Italian) and Eastern European (Russian) cultures

Abstract

Background:

The Asthma Life Impact Scale (ALIS) is a disease-specific measure used to assess the quality-of-life of people with asthma. It was developed in the UK and US and has proven to be acceptable to patients, to have good psychometric properties, and to be unidimensional.

Objective:

This paper reports on the adaptation and validation of the ALIS for use in representative Southern European (Italian) and Eastern European (Russian) languages.

Methods:

The ALIS was translated for both cultures using the dual-panel process. The newly translated versions were then tested with asthma patients to ensure face and content validity. Psychometric properties of the new language versions were assessed via a test–re-test postal survey conducted in both countries.

Limitations:

It is possible that some cultural or language differences still exist between the different language versions. Further research should be undertaken to determine responsiveness. Further studies designed to determine the clinical validity of the Italian ALIS would be valuable.

Results:

Linguistic nuances were easily resolved during the translation process for both language adaptations. Cognitive debriefing interviews (Russia n = 9, male = 11.1%, age mean (SD) = 55.4 (13.2); Italy n = 15, male = 66.7%, age mean (SD) = 63.5 (11.2)) indicated that the ALIS was easy to read and acceptable to patients. Psychometric testing was conducted on the data (Russia n = 61, age mean (SD) = 40.7 (15.4); Italy n = 71, male = 42.6%, age mean (SD) = 49.5 (14.1)). The results showed that the new versions of the ALIS were consistent (Russian and Italian Cronbach’s alpha = 0.92) and reproducible (Russian test–re-test = 0.86; Italian test–re-test = 0.94). The Italian adaptation showed the expected correlations with the NHP and the Russian adaptation showed strong correlations with the CASIS and CAFS and weak-to-moderate correlations with %FEV1 and %PEF. In both adaptations the ALIS was able to distinguish between participants based on self-reported general health, self-reported severity, and whether or not they were hospitalized in the previous week.

Keywords::

• Adaptation
• ALIS
• Asthma
• Patient-reported outcomes
• Quality-of-life

Transparency

Declaration of funding

This study was funded by Novartis AG. The article was prepared without restrictions from the sponsors. All authors meet criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE) and all authors contributed to the development of the manuscript.

Declaration of financial relationships

JT, SPM, and SRC were all employees of Galen Research Ltd. at the time that the manuscript was prepared. MT was an employee of the University of Tartu and NCO was an employee of the University of Verona when the manuscript was prepared.

Acknowledgments

The authors would like to acknowledge the help of the Italian and Russian patients who participated in the study. They would also like to thank Alastair Glendenning for his advice and encouragement during the study.