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J Endometr Pelvic Pain Disord. 2018 Jun;10(2):107-115. doi: 10.1177/2284026518780638. Epub 2018 Jun 19.

Lack of cross-cultural validity of the Endometriosis Health Profile-30.

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Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Research Centre for Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway.
Institute of Health and Society, University of Oslo, Oslo, Norway.
Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.
Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Department of Reproductive Medicine, Oslo University Hospital, Oslo, Norway.
Department of Gynecology, Oslo University Hospital, Oslo, Norway.



The Endometriosis Health Profile-30 is a disease-specific patient-reported outcome measure of health-related quality of life. Cross-cultural validation of the Endometriosis Health Profile-30 has been performed for several translated versions. The aim of this study was to evaluate the measurement properties of a Norwegian version Endometriosis Health Profile-30.


This study was designed as a cross-sectional anonymous postal questionnaire study. A total of 157 women with endometriosis were included during a period from 2012 to 2013. Women aged 18-45 years were recruited from the Norwegian Endometriosis Association. Principal components analysis with varimax rotation was used to assess construct validity. Short Form-36 was used to determine convergent validity. Cronbach's alpha was used to measure internal consistency. Intraclass correlation coefficients and paired t-tests were used to evaluate test-retest reliability. Floor and ceiling effects were estimated.


Factor analysis resulted in a three and five-factor model for the core and modular questionnaire, respectively. Factor analysis could not support construct validity of the scales self-image and treatment. The Norwegian version Endometriosis Health Profile-30 demonstrated acceptable internal consistency and test-retest reliability, except for the scale relationship with children. Floor effects were observed for the scales self-image (20.1%), work life (33.9%), relationship with children (34.2%), and medical profession (20.5%).


The construct self-image does not seem to be measured appropriately by the Norwegian version Endometriosis Health Profile-30, suggesting a lack of cross-cultural validity of the Endometriosis Health Profile-30. With multinational studies increasing, adequate translation, cross-cultural adaptation, and cross-cultural validation of instruments are essential to ensure equivalence in languages and cultures other than the original.


Endometriosis; Endometriosis Health Profile-30; health-related quality of life; reliability; validity

Conflict of interest statement

Declaration of conflicting interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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