Health-Related Quality of Life in Jack Jumper Ant Venom Allergy: Validation of the Venom-Allergy Quality of Life Questionnaire.

Abstract

We assessed health-related quality of life (HRQoL) in patients with allergy to the venom of the jack jumper ant (JJA), Myrmecia pilosula, a Hymenoptera order species native and endemic to the Southeastern quarter of Australia. To our knowledge, this has not previously been studied despite an estimated population prevalence of generalized allergic symptoms as high as 3% in some areas. To validate the Venom Quality of Life Questionnaire (VQLQ) HRQoL instrument, which was previously validated in patients with wasp and bee venom allergy, for use in this specific ant venom-allergic population. The 14-item VQLQ survey instrument was administered to patients with clinical allergy to JJA venom presenting at the state treatment center for venom immunotherapy. Surveys were performed at different time points of the progression through visits for venom immunotherapy treatment. We performed cross-sectional and longitudinal validation against the Expectation of Outcome (EO) questionnaire by determining correlations and agreement. A total of 271 individuals contributed survey data, median age 52 years (range, 3-85 years; bimodal distribution with 25% aged <18 years). Internal consistency was excellent (Cronbach α = 0.95). Cross-sectional validity was demonstrated with a positive correlation of VQLQ to EO of 0.44 (P < .001). Performance was nearly identical when stratified into adults and children (aged <18 years). Longitudinal validity was suggested as both VQLQ and EO improved over time in both adults and children, but this had paired correlation at only two time points in adults. Bland-Altman analysis demonstrated acceptable agreement between VQLQ and EO and no evidence of systematic bias. The VQLQ appears to offer performance of HRQoL measurement in patients with JJA venom allergy, similar to that previously demonstrated in other Hymenoptera species. In addition, this study demonstrates cross-sectional validity specifically in a pediatric population aged 3 to 18 years.