Structural validation and dyadic child-parent measurement invariance of the celiac disease quality of life questionnaire

Sonya Meyer, Maor Shani

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Objective The celiac disease quality of life questionnaire (CDDUX) is used widely in numerous languages worldwide. However, it's structural and construct validity and child-parent invariance had not been thoroughly examined. The objective of this study was to examine the psychometric properties of the 12-item CDDUX and the extent to which it meets the acceptable requirements of reliability and structural and convergent validity, as well as its child-parent invariance. Methods In this cross-sectional study, 126 dyads of children aged 8-18 years and their parents completed the Hebrew version self-report and parent-proxy report CDDUX. Recently developed methods to examine psychometric properties and to measure invariance of dyadic samples were used while properly accounting for nonindependence in measurement patterns. Results A three-factor structure, each with sufficient internal consistency, is confirmed for both children and parents. Removing a single indicator of the diet subscale resulted in full configural (χ2(181) = 202.277, P > 0.05, RMSEA = 0.026) and metric (χ2(189) = 209.543, P > 0.05, RMSEA = 0.043) invariance of the measure between children and parents. However, this occurred only in partial-scalar (χ2(198) = 229.813, P > 0.05, RMSEA = 0.031) and uniqueness invariance, which is nevertheless sufficient for meaningful comparison between the groups. Conclusion Overall, with minor modifications, the Hebrew version of the CDDUX was found to be a valid measure of children's celiac-related quality of life when measured across children's self-reports and parent-proxy reports. The CDDUX provides meaningful measurement and allows child-parent comparison.

Original languageEnglish
Pages (from-to)39-47
Number of pages9
JournalEuropean Journal of Gastroenterology and Hepatology
Issue number1
StatePublished - 1 Jan 2022


  • celiac disease
  • measurement invariance
  • parent-report
  • quality of life
  • questionnaire
  • self-report


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