Quality of life in patients with kidney stones: translation and validation of the Spanish Wisconsin Stone Quality of Life Questionnaire

Translation and validation of the Italian version of the Wisconsin Stone Quality of Life Questionnaire (I-WISQOL) for assessing quality of life in patients with urolithiasis

BACKGROUND

Urolithiasis is a chronic condition, and it has been associated with a significant negative impact on patients' health-related quality of life (HRQOL). Several tools to assess patients' HRQOL have been validated in Italian, however disease-specific HRQOL instruments are still lacking. We aimed to develop and validate the Italian version of the WISQOL (I-WISQOL) in patients with urolithiasis.

METHODS

The Italian version of the WISQOL was developed in a multistep process involving primary translation, back-translation, and pilot testing among a group of patients (N.=10). Patients presenting with urolithiasis were prospectively recruited from the outpatient stone clinics and completed both questionnaire WISQOL and SF-36. Demographic information, as well as medical and surgical data, were obtained through an interview. Internal consistency of the I-WISQOL was obtained with Cronbach's α. Correlation of total scores of the I-WISQOL and SF36 was assessed to determine convergent validity using Spearman Rho. Correlations between clinical variables and results from the I-WISQOL were analyzed to descriptively assess the association of interest.

RESULTS

A total of 93 participants were evaluated and completed the Italian version of the I-WISQOL. The I-WISQOL demonstrated excellent internal consistency (Cronbach's α 0.95) and good convergent validity with the validated SF-36 (Spearman Rho r=0.70, P<0.001). Using ANOVA analysis, a significant decline in WISQOL Score was noted with the increasing number of renal colics (P=0.0543), ER visits (P=0.037), number of inpatient hospitalization (P=0.025). At multivariate analysis, worse WISQOL total score was predicted by a greater number of renal colic events (ß=-4.92 [-8.81-1.04], P=0.014) and by a greater number inpatient hospitalization (ß=-7.31 [-14.35 -0.26], P=0.042).

CONCLUSIONS

The I-WISQOL is an internally consistent and valid instrument to assess HRQOL in Italian-speaking patients with kidney stones. Its use in clinical practice should be implemented in order to tailor the management of each patient.

Translation and validation of the Chinese version of Wisconsin Stone Quality of Life questionnaire in patients with kidney stones

BACKGROUND

Wisconsin Stone Quality of Life (WISQOL) has been designed specifically for patients with kidney stones. The present study aimed to develop the Chinese version of WISQOL and reach its validation.

METHODS

The WISQOL was translated into Chinese following a standard procedure. Kidney stone patients admitted for surgical treatment were enrolled and fulfilled both WISQOL and SF-36 on the admission day and at one month postoperatively. The internal consistency, inter-domain correlation and convergent validity were analyzed.

RESULTS

One hundred twenty-four 124 males and 76 females were enrolled. The total WISQOL Score and SF-36 had significant correlation both preoperatively (r=0.772, P<0.01) and postoperatively (r=0.639, P<0.01). The internal consistency of the Chinese version WISQOL's different domains ranged from 0.766 to 0.959. The value of Spearman rank correlation to assess the convergent validity of different domains ranged from 0.444 to 0.687. The postoperative WISQOL raised about 20% showing a better quality of life.

CONCLUSIONS

The Chinese version of WISQOL questionnaire was a reliable tool to evaluate the health quality of life in Chinese-speaker patients with kidney stones. To evaluate its test-retest reliability, reliability and validity in a longer term, further studies are required.

Validation of the Italian version of wisconsin stone quality of life (WISQOL): a prospective Italian multicenter study

Urolithiasis is a worldwide spread condition that affects patients' Health-Related Quality of Life (HRQOL), which measurement is an important tool for routine clinical and research practice. Disease-specific HRQOL measures demonstrated to perform better in assessing the effects of specific conditions. A disease-specific questionnaire for kidney stones, the WISQOL, has been validated in different languages, but an Italian version is still missing. Our aim is to produce and validate the Italian version of WISQOL (IT-WISQOL). Patients undergoing any elective treatment for upper urinary tract stones were enrolled. A multi-step process with forward- and back-translation was used to translate WISQOL into Italian. Patients were evaluated within 15 days pre-operatively and then at 30-, 90 days post-operatively and administered both IT-WISQOL and SF-36v2. Post-operative data such as 30 days postoperative complications, late stone-related events, successful status, and stone complexity were collected. Cronbach's α was used to evaluate the internal consistency of IT-WISQOL, while Spearman's rho was used for item and inter-domain correlations and IT-WISQOL with SF-36v2 correlation. We found excellent internal consistency across all domains (α ≥ 0.88), particularly when the total score is considered (α = 0.960). Test-retest reliability showed excellent results for the total questionnaire (Pearson correlation value: 0.85). The Inter-domain association ranged from 0.497 to 0.786. Convergent validity was confirmed by a good correlation with subdomains of the SF-36v2 measures. IT-WISQOL is a reliable tool to measure HRQOL in stone patients. It shows analog characteristics if compared to English WISQOL.

High prevalence of hypocitraturia in stone formers from the Maya region of Yucatan, Mexico

BACKGROUND

Urinary Stone Disease (USD) arises from an interaction of genetic and environmental factors. Urinary metabolic abnormalities are well described as risk factors. In Mexico, the Maya region holds the highest prevalence of USD. Treatment of these abnormalities lowers the risk of recurrences.

AIM

Assess the underlying metabolic abnormalities of patients with USD to provide a rationale to lead further prevention strategies.

METHODS

Clinical and demographical data from patients coming to the Stone Clinic were prospectively collected along with a 24 h urinary panel to identify metabolic abnormalities. All participants signed consent and the study was approved by the hospital's institutional review board.

RESULTS

A total of 126 patients were included, with a mean age of 47.2 ± 13 years, 75.4% were female. A positive family history of stones was observed in 40 and 87.3% were overweight/obese. The frequency of hypocitraturia, hypercalciuria, hypomagnesuria, hyperoxaluria, and hyperuricosuria was 91.3, 68.5, 42.1, 36.5, and 26.6%, respectively. Median urinary citrate was 79.5 (37.5-160) mg/24 h and was inversely correlated to glycemia. Urine Calcium/Creatinine index was correlated with Hounsfield units (HU) (p = 0.01). Oxalate was correlated with HU and stone burden. Interestingly, dietary distribution of macro- and micronutrients were similar between groups. Patients with a single kidney had lower citrate and higher urinary calcium.

CONCLUSIONS

Interestingly, a shortage of inhibitors such as citrate and magnesium are highly prevalent in patients with USD from the Maya region and seems to be influenced by other metabolic conditions as malnutrition next to the genetic component.

Validation of The Japanese Version of The Wisconsin Stone Quality of Life Questionnaire (WISQOL): Results from SMART Study Group

BACKGROUND

The Wisconsin Stone Quality of Life questionnaire (WISQOL) is a health-related quality of life measure designed for patients with urinary stones. It has been translated and used in several languages. This study aimed to validate the Japanese version of the WISQOL (J-WISQOL).

MATERIALS AND METHODS

The J-WISQOL was translated and validated using a multistep process proposed by the World Health Organization that involved forward translation, back-translation, and pilot testing with a group of patients. This study enrolled 150 patients with urinary stones who visited three academic hospitals for stone treatment. We assessed convergent validity of correlation patterns and internal consistency of the J-WISQOL and Short-Form 36-item survey version 2 (SF-36v2).

RESULTS

Overall, 150 patients were enrolled. The mean total score of the J-WISQOL was 108.18 ± 20.26 (raw score min-max, 28-140), suggesting that the onset and symptoms of urinary stones reduced the health-related quality of life in the patients. The J-WISQOL showed good internal consistency (Cronbach's α = 0.96) and inter-domain associations (Spearman's correlation coefficient r = 0.67-0.94). The J-WISQOL was correlated with the SF-36v2 in all domains: social, emotional, health, and vitality impact (r = 0.47-0.66).

CONCLUSION

The J-WISQOL is a reliable instrument for evaluating health-related quality of life measures in patients with urinary stones. It could be a useful quality of life questionnaire for urinary stones in Japan.

Is health-related quality of life of patients after single-use flexible ureteroscopy superior to extracorporeal shock wave lithotripsy? A randomised prospective study

The aims of the study were to compare the change in the Wisconsin Stone Quality of Life (WISQOL) score in patients who underwent retrograde intrarenal surgery (RIRS) single-use ureteroscope or extracorporeal shock wave lithotripsy (ESWL) with a calculation of quality-adjusted life-years (QALYs). 158 patients treated with urinary stone disease were randomly divided into 80 patients in the validation and 78 patients in the intervention arm. Patients in the intervention arm were randomly divided into the RIRS or the ESWL group. Linguistic validation of the WISQOL into the Slovak language was performed using a standardised multistep process. Discriminant validity was assessed by comparing stone-forming patients to an additional 34 healthy individuals. Patients were asked to fill in the WISQOL before and in the 24th week after the intervention. The QALYs were calculated by the formula QALY = weight factor (WF) x time period after intervention. The Cronbach's α of the WISQOL was 0.94, the Pearson's coefficient for test-retest reliability was 0.91, and the discriminant validity confirmed a higher score for healthy individuals (p < 0.001). The median WISQOL score changed from 45.5 to 95.5 vs. 33.9 to 87.1 in the RIRS and ESWL groups, respectively (p < 0.001). Patients from the RIRS group had a good possibility of reaching 19.727 QALYs gained during life expectancy compared to 15.780 for the ESWL group (p < 0.001). RIRS single-use ureteroscope is significantly superior to ESWL in reaching more QALYs gained during life expectancy. The WISQOL Slovak version is valid, reliable and strictly specific for stone-forming patients.

Validation of the French version of the Wisconsin Quality of Life (WISQOL) questionnaire for patients with nephrolithiasis

INTRODUCTION

The Wisconsin Stone Quality of Life (WISQOL) questionnaire has been recently developed to objectively assess quality of life (QOL) in patients with nephrolithiasis. However, a French version of the questionnaire was lacking. Therefore, the aim of the present study was to develop and validate the French version of this tool.

METHODS

The French version of the WISQOL (F-WISQOL) was developed in a multistep process involving primary translation, back-translation, and pilot testing among a group of patients (n=12). Nephrolithiasis patients from two tertiary care institutions were recruited into this study and completed the following questionnaires: the medical history form and either the WISQOL or F-WISQOL. Internal consistency was assessed using Cronbach's α, and inter-domain associations were evaluated using Spearman's rank correlation (r). One-way ANOVA was used to compare scores from the two groups (WISQOL and F-WISQOL).

RESULTS

A total of 210 patients were enrolled in this study: 68 in the WISQOL group and 148 in the F-WISQOL group. Internal consistency was high for all domains in both groups (F-WISQOL: 0.924-0.970; WISQOL: 0.888-0.965). No statistically significant difference was found between the two groups' scores. Inter-domain association, measured by Spearman correlation, was moderate to very strong between all the domains in the F-WISQOL. Values ranged from r=0.676-0.915, with acceptable correlation between D1, D2, and D3, but weaker correlation between D4 (vitality) and the three other domains (r=0.676-0.729).

CONCLUSIONS

In the present study, the French version of the WISQOL questionnaire was validated at two academic institutions.