Evaluation of health-related quality of life in patients with Cushing's syndrome with a new questionnaire

Chronic exposure to hypercortisolism has significant impact on patient’s health and health-related quality of life (HRQoL), as demonstrated with generic questionnaires. We have developed a diseasegenerated questionnaire to evaluate HRQoL in patients with Cushing’s syndrome (CS; CushingQoL). Objective: Validate the CushingQoL questionnaire in patients with CS in clinical practice conditions. Design: Observational, international, cross-sectional study. Methods: A total of 125 patients were recruited by 14 investigators from Spain, France, Germany, The Netherlands, and Italy over a 2-month period. Clinical and hormonal data were collected and correlated with results of the generic short form 36 (SF-36) questionnaire, a question on self-perceived general health status and the CushingQoL score. Results: A total of 107 patients were pituitary-dependent and 18 adrenal-dependent CS; 104 (83%) were females,meanage45years(range20‐73years);39(31%)werecurrentlyhypercortisolemic;and47(38%) adrenalinsufficient.Inclinicalpractice,CushingQoLwasfeasible(117;94%ofpatientsfullyrespondedtothe questionnaire in a mean time of 4 min), reliable (Crohnbach’s aZ0.87), and valid (factorial analysis demonstrated unidimensionality and Rasch analysis lead to a final version with 12 items). A significant (P!0.001) correlation was observed between CushingQoL score and patients self-perceived general health status and dimensions of SF-36 (Pearson’s correlation coefficient R0.597). Patients with current hypercortisolism scored worse (lower) than those without (44G22 vs 56G21, PZ0.004). Linear regression analysis identified female gender and hypercortisolism as significant predictors for worse QoL. Conclusion: CushingQoL is useful to evaluate HRQoL in patients with CS and correlates with clinical parameters.