Psychometric testing of the ICECAP-A in patients with coeliac disease: a comparative analysis with EQ-5D-5L

Health Qual Life Outcomes. 2025 Oct 31;23(1):112. doi: 10.1186/s12955-025-02443-2.

Abstract

Objectives: This study aimed to assess the psychometric properties of the ICEpop CAPability measure for Adults (ICECAP-A) in patients with coeliac disease (CD) and compare its performance with EQ-5D-5L.

Methods: An online cross-sectional survey was conducted among 312 adult patients with CD in Hungary, who completed both the ICECAP-A and EQ-5D-5L. Psychometric properties assessed included distributional characteristics, convergent validity with the Gastrointestinal Symptom Rating Scale (GSRS), Satisfaction with Life Scale (SWLS), and known-group validity.

Results: Mean age was 35.8 years (range: 18-80), and 70.2% were female. On the ICECAP-A, 51% (attachment) to 81% (stability) of patients reported limitations, while on the EQ-5D-5L, 2% (self-care) to 41% (pain/discomfort) reported problems. Ceiling effect was not observed for the ICECAP-A (6.7%), but reached 38.8% for EQ-5D-5L. The mean index value was 0.85 for the ICECAP-A and 0.92 for the EQ-5D-5L. ICECAP-A correlated strongly with SWLS (r=0.698), moderately with EQ-5D-5L (r=0.551) and weakly with GSRS (r=-0.284). Both the ICECAP-A and EQ-5D-5L were able to differentiate between known groups based on general health status and relevant clinical variables (e.g. symptoms, comorbidities, duration on gluten-free diet and adherence to it); however, the EQ-5D-5L typically showed somewhat larger effect sizes.

Conclusion: This study is the first to validate ICECAP-A in patients with CD, demonstrating good psychometric performance, including strong convergent and known-group validity. Its ability to capture broader aspects of well-being supports its use as a valuable tool in outcome assessments for this patient population.

Keywords: Coeliac disease; EQ-5D-5L; Health-related quality of life; ICECAP; Well-being.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Celiac Disease* / psychology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hungary
  • Male
  • Middle Aged
  • Psychometrics*
  • Quality of Life* / psychology
  • Reproducibility of Results
  • Surveys and Questionnaires / standards
  • Young Adult