Cross-Cultural Adaptation and Psychometric Validation of the Arabic Chronic Venous Insufficiency Quality-of-Life Questionnaire (CIVIQ-20) in Saudi Arabia

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Abstract
Background/Objectives: Chronic venous disease significantly impairs health-related quality of life (HRQoL). Although the Chronic Venous Insufficiency Questionnaire (CIVIQ-20) is widely used internationally, a validated Arabic version is lacking. The objectives of this study were to translate and culturally adapt the CIVIQ-20 into Arabic and to examine its reliability, construct, and discriminative validity in Arab patients with chronic venous disease. Methods: Following standardized guidelines, the CIVIQ-20 was translated and cross-culturally adapted. For psychometric evaluation, 139 participants with chronic venous disease were selected. They completed the Arabic version of Chronic Venous Insufficiency Questionnaire-20 (CIVIQ-20-Ar) and 36-Item Short Form Health Survey (SF-36). Psychometric evaluation included internal consistency (Cronbach’s alpha) and test–retest reliability using the two-way random intraclass correlation coefficient ICC (2,1). Minimal detectable change (MDC95) was assessed, along with both convergent validity (using the SF-36 as a comparator) and known-group validity (across CEAP severity stages), using seven predefined hypotheses. Results: The CIVIQ-20-Ar questionnaire had adequate internal consistency and very strong test–retest reliability. As hypothesized, the CIVIQ-20-Ar subscales and global index demonstrated a moderate-to-strong correlation with the SF-36 summary and domain scores (r = −0.42 to −0.79, p < 0.001), with the strongest correlation in the pain subscale (r = −0.79, p < 0.001). Known-group validity was established by significant score discrimination across advancing Clinical–Etiology–Anatomy–Pathophysiology (CEAP) severity stages (p < 0.01). Conclusions: The CIVIQ-20-Ar Questionnaire has adequate psychometric properties. Therefore, vascular surgeons, phlebologists, and rehabilitation specialists can use the CIVIQ-20-Ar in routine clinical practice and research to evaluate health-related quality of life in the Arabic-speaking population with chronic venous disease.
Funding Information
  • King Saud University (ORF-2026-1997)

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