The Myotonic Dystrophy Type-1 Health Index (MDHI Type-1) Italian Translation

The Myotonic Dystrophy Health Index (MDHI) Italian Version is a survey designed to efficiently measure the overall level of disease burden in a patient with myotonic dystrophy type-1 whose native language is Italian. This disease-specific patient-reported outcome measure is designed is designed to reliably and responsively measure therapeutic benefit in myotonic dystrophy clinical trials. It may also be used to measure overall patient health in a clinical setting. It covers the 17 areas of greatest importance to the adult myotonic dystrophy population.

The MDHI is a disease-specific, patient reported outcome measure for myotonic dystrophy type-1 (DM1).  Each question in the MDHI was selected based on its relevance to a large DM1 population, its ability to be consistently understood by patients, its reliability during test-retest evaluation, its content validity, its face validity, its construct validity, and its responsiveness in detecting therapeutic change.  FDA guidelines were implemented during instrument development in order to allow the MDHI to be utilized to support drug labeling claims. 

The instrument is capable of measuring the total health of a myotonic dystrophy patient as well as seventeen additional areas of relevant DM1 subhealth.  Subscales of the MDHI measure a patient’s perception of their health as it relates to: 1) Mobility; 2) Upper Extremity Function; 3) Ability to do Activities; 4) Fatigue; 5) Pain; 6) Gastrointestinal Issues; 7) Vision; 8) Communication; 9) Sleep; 10) Emotional Issues; 11) Cognitive Impairment; 12) Social Satisfaction; 13) Social Performance; 14) Myotonia; 15) Breathing; 16) Swallowing; and 17) Hearing.  Overall, the MDHI is optimally suited to detect small but clinically relevant changes in several key areas of myotonic dystrophy health over the course of a treatment trial.   

This Italian version of the MDHI is designed for use as a primary or secondary outcome measure during myotonic dystrophy clinical trials.  Alternatively, the MDHI may be used as a marker of disease severity for patients with myotonic dystrophy.

This MDHI is a validated instrument capable of measuring clinically meaningful changes in patient health during clinical trials.  As a disease-specific instrument, this outcome measure focuses on the symptoms that are most important to myotonic dystrophy patients while excluding questions that are less relevant.  The instrument was translated into Italian using standard techniques including forward and backward translations and was culturally validated using a population of Italian myotonic dystrophy type-1 patients. The content validity, face validity, construct validity, convergent validity, test retest reliability, and responsiveness of the questions in this instrument have been previously evaluated in preparation for this instrument’s use in drug labeling applications.

URV Reference Number: 6-2189A
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Cynthia Zhang
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University of Rochester
Chad Heatwole