CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2021; 25(01): e92-e97
DOI: 10.1055/s-0040-1701270
Original Research

Validity and Reliability of the Thai Version of the Thyroid-Related Patient-Reported Outcome—A Thyroid-specific Quality of Life Questionnaire

1   Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Supachat Chaiudomsom
1   Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Pattaramon Wijakkanalan
1   Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Torquil Watt
2   Department of Medical Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
› Author Affiliations


Introduction The Thyroid-Related Patient-Reported Outcome (ThyPRO) is a new thyroid-specific quality of life patient-reported outcome measure for benign thyroid disorders.

Objective The objective of this study was to investigate the face validity, internal consistency, and test-retest reliability of the Thai version of the ThyPRO (ThyPROth).

Methods The translation of the ThyPRO questionnaire was performed using double forward translation, reconciliation, single backward translation, and cognitive debriefing, followed by a panel review. Five thyroid patients evaluated the face validity. The internal consistency and test-retest reliability were evaluated in 30 patients with thyroid diseases.

Results The overall validity score was 3.75 (range 0–4). The Cronbach α coefficient ranged from 0.76 to 0.95, with a total coefficient of 0.97 (95% CI 0.962–0.959), indicating excellent internal consistency. The test-retest reliability coefficient ranged from 0.70 to 0.97. All values were 0.70 and above. The total reliability coefficient was 0.86 (95% CI 0.724–0.932), indicating excellent reliability.

Conclusion The ThyPROth was found to be valid and to exhibit good internal consistency and test-retest reliability. The questionnaire is ready for implementation in the assessment of health-related quality of life in Thai patients with benign thyroid diseases.

Supplementary Material

Publication History

Received: 13 August 2019

Accepted: 03 December 2019

Article published online:
27 April 2020

© 2020. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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  • References

  • 1 Sriphrapradang C, Pavarangkoon S, Jongjaroenprasert W, Chailurkit LO, Ongphiphadhanakul B, Aekplakorn W. Reference ranges of serum TSH, FT4 and thyroid autoantibodies in the Thai population: the national health examination survey. Clin Endocrinol (Oxf) 2014; 80 (05) 751-756 DOI: 10.1111/cen.12371.
  • 2 Garmendia Madariaga A, Santos Palacios S, Guillén-Grima F, Galofré JC. The incidence and prevalence of thyroid dysfunction in Europe: a meta-analysis. J Clin Endocrinol Metab 2014; 99 (03) 923-931 DOI: 10.1210/jc.2013-2409.
  • 3 Hollowell JG, Staehling NW, Flanders WD. et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002; 87 (02) 489-499 DOI: 10.1210/jcem.87.2.8182.
  • 4 Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull 2011; 99: 39-51 DOI: 10.1093/bmb/ldr030.
  • 5 Parle JV, Franklyn JA, Cross KW, Jones SC, Sheppard MC. Prevalence and follow-up of abnormal thyrotrophin (TSH) concentrations in the elderly in the United Kingdom. Clin Endocrinol (Oxf) 1991; 34 (01) 77-83
  • 6 Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab 2008; 22 (06) 901-911
  • 7 Tangjaturonrasme N, Vatanasapt P, Bychkov A. Epidemiology of head and neck cancer in Thailand. Asia Pac J Clin Oncol 2018; 14 (01) 16-22 DOI: 10.1111/ajco.12757.
  • 8 Piromchai P, Wijakkanalan P, Teeramatwanich W, Kasemsiri P, Laohasiriwong S, Ratanaanekchai T. Postauricular-submental approach endoscopic thyroidectomy. Clin Otolaryngol 2018; 43 (02) 767-769 DOI: 10.1111/coa.12791.
  • 9 Piromchai P, Vatanasapt P, Reechaipichitkul W, Phuttharak W, Thanaviratananich S. Is the routine pressure dressing after thyroidectomy necessary? A prospective randomized controlled study. BMC Ear Nose Throat Disord 2008; 8: 1 DOI: 10.1186/1472-6815-8-1.
  • 10 Piromchai P. Early Outcomes of the Postauricular-Submental Approach Endoscopic Thyroidectomy. J Med Assoc Thai 2017; 100: 202
  • 11 Suttajit S, Pilakanta S. Prevalence of and predictors for depression in individuals with schizophrenia. Eur Neuropsychopharmacol 2016; 2: S497-S498
  • 12 Leurmarnkul W, Meetam P. Properties testing of the retranslated SF-36 (Thai version). Thaiphesatchasan 2005; 29: 69-90
  • 13 Vasupongaiya J, Lerkiatbundit S, Premprabha T. Testing of the Validity and Reliability of the Quality of Life-Thyroid Version (Thai). Thai J Pharm Pract 2013; 5: 43-62
  • 14 Watt T, Hegedüs L, Groenvold M. et al. Validity and reliability of the novel thyroid-specific quality of life questionnaire, ThyPRO. Eur J Endocrinol 2010; 162 (01) 161-167 DOI: 10.1530/EJE-09-0521.
  • 15 Watt T, Bjorner JB, Groenvold M. et al. Establishing construct validity for the thyroid-specific patient reported outcome measure (ThyPRO): an initial examination. Qual Life Res 2009; 18 (04) 483-496 DOI: 10.1007/s11136-009-9460-8.
  • 16 Wong CK, Lang BH, Lam CL. A systematic review of quality of thyroid-specific health-related quality-of-life instruments recommends ThyPRO for patients with benign thyroid diseases. J Clin Epidemiol 2016; 78: 63-72 DOI: 10.1016/j.jclinepi.2016.03.006.
  • 17 Albaum G. The Likert scale revisited. Market Res Soc J 1997; 39: 1-21
  • 18 Wild D, Eremenco S, Mear I. et al. Multinational trials-recommendations on the translations required, approaches to using the same language in different countries, and the approaches to support pooling the data: the ISPOR Patient-Reported Outcomes Translation and Linguistic Validation Good Research Practices Task Force report. Value Health 2009; 12 (04) 430-440
  • 19 Reeve BB, Wyrwich KW, Wu AW. et al. ISOQOL recommends minimum standards for patient-reported outcome measures used in patient-centered outcomes and comparative effectiveness research. Qual Life Res 2013; 22 (08) 1889-1905
  • 20 Yurdugül H. Minimum sample size for Cronbach's coefficient alpha: a Monte-Carlo study. Hacettepe Üniv Eğitim Fakültesi Dergisi 2008; 35: 1-9
  • 21 Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297-334
  • 22 Pearson K. VII. Note on regression and inheritance in the case of two parents. Proc R Soc Lond 1895; 58: 240-242
  • 23 Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res 2005; 19 (01) 231-240
  • 24 Loewenthal K, Lewis CA. An introduction to psychological tests and scales. Psychology press; 2018
  • 25 Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med 2016; 15 (02) 155-163 DOI: 10.1016/j.jcm.2016.02.012.
  • 26 Lehman A. JMP for basic univariate and multivariate statistics: a step-by-step guide. SAS Institute; 2005
  • 27 Mallery P, George D. SPSS for Windows step by step: a simple guide and reference. Allyn, Bacon; Boston: 2003
  • 28 Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 1994; 6: 284
  • 29 Thammawan S. A study of the differences of some grammatical structures of English and Thai that cause English speaking problems for Thai people. Language Institute, Thammasat University; 2008
  • 30 Zahan AE, Watt T, Pascanu I. et al. The romanian version of the thyroid-related patient-reported outcomes thypro and thypro-39. translation and assessment of reliability and cross-cultural validity. Acta Endocrinol (Bucur) 2018; 14 (02) 192-200
  • 31 Bukvić B, Živaljević V, Šipetić S, Diklić A, Taušanović K, Paunović I. Validation and cross-cultural adaptation of the questionnaire ThyPRO in thyroid patients in Serbia. Vojnosanit Pregl 2015; 72 (07) 583-588
  • 32 Bland JM, Altman DG. Cronbach's alpha. BMJ 1997; 314 (7080): 572 DOI: 10.1136/bmj.314.7080.572.
  • 33 DeVellis RF. Scale development: Theory and applications. Sage publications; 2016
  • 34 Tavakol M, Dennick R. Making sense of Cronbach's alpha. Int J Med Educ 2011; 2: 53-55 DOI: 10.5116/ijme.4dfb.8dfd.
  • 35 Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess 2003; 80 (01) 99-103 DOI: 10.1207/S15327752JPA8001_18.
  • 36 Bujang MA, Omar ED, Baharum NA. A Review on Sample Size Determination for Cronbach's Alpha Test: A Simple Guide for Researchers. Malays J Med Sci 2018; 25 (06) 85-99 DOI: 10.21315/mjms2018.25.6.9.