Quality of Life Research

, Volume 26, Issue 1, pp 213–220 | Cite as

Development of a French version of the Endometriosis Health Profile 5 (EHP-5): cross-cultural adaptation and psychometric evaluation

  • Arnaud Fauconnier
  • Cyrille Huchon
  • Laura Chaillou
  • Gabrielle Aubry
  • Frederique Renouvel
  • Pierre Panel
Brief Communication



The Endometriosis Health Profile 5 (EHP-5) is a short version of an endometriosis-specific quality of life questionnaire. The objective of the study was to assess the psychometric validity of its French version.


A total of 125 patients with histologically proven endometriosis who underwent surgery for painful symptoms and 80 asymptomatic controls completed the EHP-5. Principal components analysis was performed to determine the dimensions of the instrument. Internal consistency was assessed using Cronbach’s alpha. Construct validity was assessed by testing the relationship between the EHP-5 and the characteristics of endometriosis.


For each item of EHP-5, endometriosis patients scored significantly higher than control women (p > 0.0001). Eleven items of the EHP-5 were unidimensional with excellent internal consistency (Cronbach’s alpha = 0.92), and a summary aggregated index was then constructed. The EHP-5 index was sensitive to the presence of endometriosis, the type, location, severity of the disease, and pain or infertility as the main complaint with effect sizes ranging from 0.48 (95 % CI 0.11–0.85) for superficial endometriosis to 2.56 (95 % CI 2.18–2.93) for deeply infiltrating endometriosis.


The French version of EHP-5 is valid and can be used for reporting patient-orientated outcome in future studies of French-speaking patients with endometriosis.


Endometriosis Pelvic pain Quality of life questionnaire Psychometric validation 



This study was partly funded by the French public funding agency Délégation à la Recherche Clinique et à l’Innovation (DRCI), Versailles, France.

Conflict of interest

All Authors declare that they no conflict of interest.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The 11th ethics research committee of Ile-de-France considered that our study involved no intervention and was thus exempt from the French statute on biomedical research (modified version of Law 2004-806, dated August 9, 2004). We complied with all French statutes concerning patient data, confidentiality, and restrictions.


  1. 1.
    Jones, G., Jenkinson, C., & Kennedy, S. (2004). The impact of endometriosis upon quality of life: A qualitative analysis. Journal of Psychosomatic Obstetrics and Gynaecology, 25(2), 123–133.CrossRefPubMedGoogle Scholar
  2. 2.
    Simoens, S., Dunselman, G., Dirksen, C., Hummelshoj, L., Bokor, A., Brandes, I., et al. (2012). The burden of endometriosis: Costs and quality of life of women with endometriosis and treated in referral centres. Human Reproduction, 27(5), 1292–1299.CrossRefPubMedGoogle Scholar
  3. 3.
    Jones, G., Kennedy, S., Barnard, A., Wong, J., & Jenkinson, C. (2001). Development of an endometriosis quality-of-life instrument: The Endometriosis Health Profile-30. Obstetrics and Gynecology, 98(2), 258–264.PubMedGoogle Scholar
  4. 4.
    Jones, G., Jenkinson, C., & Kennedy, S. (2004). Development of the short form Endometriosis Health Profile Questionnaire: The EHP-5. Quality of Life Research, 13(3), 695–704.CrossRefPubMedGoogle Scholar
  5. 5.
    Renouvel, F., Fauconnier, A., Pilkington, H., & Panel, P. (2009). Linguistic adaptation of the Endometriosis Health Profile 5: EHP 5. Journal de Gynécologie Obstétrique et Biologie de la Reproductio (Paris), 38(5), 404–410.CrossRefGoogle Scholar
  6. 6.
    Guillemin, F., Bombardier, C., & Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 46(12), 1417–1432.CrossRefPubMedGoogle Scholar
  7. 7.
    The American Society for Reproductive Medicine. (1996). Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertility and Sterility, 67(5), 817–821.CrossRefGoogle Scholar
  8. 8.
    Chapron, C., Fauconnier, A., Vieira, M., Barakat, H., Dousset, B., Pansini, V., et al. (2003). Anatomical distribution of deeply infiltrating endometriosis: Surgical implications and proposition for a classification. Human Reproduction, 18(1), 157–161.CrossRefPubMedGoogle Scholar
  9. 9.
    Rouquette, A., & Falissard, B. (2011). Sample size requirements for the internal validation of psychiatric scales. International Journal of Methods in Psychiatric Research, 20(4), 235–249.CrossRefPubMedGoogle Scholar
  10. 10.
    Feldt, L. S. (1965). The approximate sampling distribution of Kuder–Richardson reliability coefficient twenty. Psychometrika, 30(3), 357–370.CrossRefPubMedGoogle Scholar
  11. 11.
    Cattell, R. B. (1966). The scree test for the number of factors. Multivariate Behavioral Research, 1, 245–276.CrossRefPubMedGoogle Scholar
  12. 12.
    Cronbach, L. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16, 297–334.CrossRefGoogle Scholar
  13. 13.
    Chapron, C., Fauconnier, A., Dubuisson, J. B., Barakat, H., Vieira, M., & Breart, G. (2003). Deep infiltrating endometriosis: Relation between severity of dysmenorrhoea and extent of disease. Human Reproduction, 18(4), 760–766.CrossRefPubMedGoogle Scholar
  14. 14.
    Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Mahwah, NJ: Lawrence Earlbaum Associates.Google Scholar
  15. 15.
    Rosnow, R. L., & Rosenthal, R. (1996). Computing contrasts, effect sizes, and counternulls on other people’s published data: General procedures for research consumers. Psychological Methods, 1, 331–340.CrossRefGoogle Scholar
  16. 16.
    Mokkink, L. B., Terwee, C. B., Stratford, P. W., Alonso, J., Patrick, D. L., Riphagen, I., et al. (2009). Evaluation of the methodological quality of systematic reviews of health status measurement instruments. Quality of Life Research, 18(3), 313–333.CrossRefPubMedGoogle Scholar
  17. 17.
    Terwee, C. B., Bot, S. D., de Boer, M. R., van der Windt, D. A., Knol, D. L., Dekker, J., et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60(1), 34–42.CrossRefPubMedGoogle Scholar
  18. 18.
    Guyatt, G. H., Feeny, D. H., & Patrick, D. L. (1993). Measuring health-related quality of life. Annals of Internal Medicine, 118(8), 622–629.CrossRefPubMedGoogle Scholar
  19. 19.
    Jia, S. Z., Leng, J. H., Shi, J. H., Sun, P. R., & Lang, J. H. (2012). Health-related quality of life in women with endometriosis: A systematic review. Journal of Ovarian Research, 5(1), 29.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Fauconnier, A., Dubuisson, J. B., Foulot, H., Deyrolles, C., Sarrot, F., Laveyssiere, M. N., et al. (2006). Mobile uterine retroversion is associated with dyspareunia and dysmenorrhea in an unselected population of women. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 127(2), 252–256.CrossRefPubMedGoogle Scholar
  21. 21.
    Pezzone, M. A., Liang, R., & Fraser, M. O. (2005). A model of neural cross-talk and irritation in the pelvis: Implications for the overlap of chronic pelvic pain disorders. Gastroenterology, 128(7), 1953–1964.CrossRefPubMedGoogle Scholar
  22. 22.
    Jones, G. L., Kennedy, S. H., & Jenkinson, C. (2002). Health-related quality of life measurement in women with common benign gynecologic conditions: A systematic review. American Journal of Obstetrics and Gynecology, 187(2), 501–511.CrossRefPubMedGoogle Scholar
  23. 23.
    Jones, G., Jenkinson, C., & Kennedy, S. (2004). Evaluating the responsiveness of the Endometriosis Health Profile questionnaire: The EHP-30. Quality of Life Research, 13(3), 705–713.CrossRefPubMedGoogle Scholar
  24. 24.
    Jones, G., Jenkinson, C., Taylor, N., Mills, A., & Kennedy, S. (2006). Measuring quality of life in women with endometriosis: Tests of data quality, score reliability, response rate and scaling assumptions of the Endometriosis Health Profile questionnaire. Human Reproduction, 21(10), 2686–2693.CrossRefPubMedGoogle Scholar
  25. 25.
    Jia, S. Z., Leng, J. H., Sun, P. R., & Lang, J. H. (2013). Translation and psychometric evaluation of the simplified Chinese-version Endometriosis Health Profile-30. Human Reproduction, 28(3), 691–697.CrossRefPubMedGoogle Scholar
  26. 26.
    van de Burgt, T. J., Hendriks, J. C., & Kluivers, K. B. (2011). Quality of life in endometriosis: Evaluation of the Dutch-version Endometriosis Health Profile-30 (EHP-30). Fertility and Sterility, 95(5), 1863–1865.CrossRefPubMedGoogle Scholar
  27. 27.
    Goshtasebi, A., Nematollahzadeh, M., Hariri, F. Z., & Montazeri, A. (2011). The short form Endometriosis Health Profile (EHP-5): Translation and validation study of the Iranian version. Journal of Ovarian Research, 4, 11.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Selcuk, S., Sahin, S., Demirci, O., Aksoy, B., Eroglu, M., Ay, P., & Cam, C. (2015). Translation and validation of the Endometriosis Health Profile (EHP-5) in patients with laparoscopically diagnosed endometriosis. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 185, 41–44.CrossRefPubMedGoogle Scholar
  29. 29.
    Minas, V., & Dada, T. (2014). Laparoscopic treatment of endometriosis and effects on quality of life: A retrospective study using the short form EHP-5 endometriosis specific questionnaire. Journal of Obstetrics and Gynaecology, 34(4), 336–340.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Arnaud Fauconnier
    • 1
    • 2
  • Cyrille Huchon
    • 1
    • 2
  • Laura Chaillou
    • 1
  • Gabrielle Aubry
    • 2
  • Frederique Renouvel
    • 3
  • Pierre Panel
    • 3
  1. 1.Department of Gynecology and ObstetricsCentre Hospitalier Intercommunal de Poissy – Saint-GermainPoissyFrance
  2. 2.Research Unit EA7285, Risk and Safety in Clinical Medicine for Women and Perinatal HealthVersailles St-Quentin UniversityMontigny-le-BretonneuxFrance
  3. 3.Department of Gynecology and ObstetricsCentre Hospitalier André MignotVersaillesFrance

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