Danish translation and linguistic validation of the BODY-Q Chest Module

Vanderbilt Mini-PROM-Breast for Breast Reconstruction: A Short-Form, Patient-Reported Outcomes Measure

BACKGROUND

Breast reconstruction procedures are among the most commonly performed plastic surgery operations. Although there are well-validated patient-reported outcomes measures (PROMs) for breast reconstruction, there are several patient-, provider-, and service-level barriers to their implementation in routine clinical settings. Therefore, we developed a short-form PROM to evaluate breast reconstruction outcomes.

METHODS

Using a mixed-methods approach, the Vanderbilt Mini-PROM-Breast (VMP-B) was constructed and validated to assess patient-reported outcomes from breast reconstruction. Classic test theory methods were used to evaluate acceptability, reliability, and validity. External validation was subsequently performed using the BREAST-Q as a reference standard.

RESULTS

The VMP-B is a 16-item instrument composed of three domains: quality of life, body image, and breast satisfaction. Psychometric properties including acceptability, reliability, and validity exceeded reference criteria. When tested with 104 patients, the authors found significant benefits of breast reconstruction on quality of life, body image, and breast satisfaction. These results were associated with sizeable effect sizes (g) (g = 0.421, g = 0.520, and g = 1.25) demonstrative of clinically meaningful results. When tested concurrently in 70 patients, the VMP-B and the BREAST-Q showed similar results, exhibiting excellent convergent validity.

CONCLUSIONS

The VMP-B is a validated short-form PROM that reliably assesses breast reconstruction outcomes. As a short form, the VMP-B decreases both patient and provider burden, which allows for routine, point-of-care collection of breast reconstruction outcomes.

Polish Translation and Linguistic Validation of the SCAR-Q

Introduction Patient-reported outcome measurements (PROMs) are gaining considerable popularity as tools to assess the effectiveness of the treatment in plastic surgery, being a complement to surgical outcomes. The SCAR-Q questionnaire has been recently developed for patients with surgical, traumatic, and burn scars. Aim The study aims to describe the process of translation and linguistic validation of the scar questionnaire (SCAR-Q) for use in Polish patients undergoing scar treatment. Material and methods An official Polish translation and language validation of the SCAR-Q were done in adherence to International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. The process consisted of four steps: two independent forward translations, a back translation, a review of the back translation, and cognitive participant interviews. Results The field-tested version of the SCAR-Q consisted of 29 items across three scales measuring appearance concerns, symptoms, and the psychosocial impact of the scar. The forward translation was done by two independent translators and revealed specific difficulties in translation to the Polish language (4/29 items). The back translation showed no significant differences compared to the original English version. Cognitive debriefing interviews involved nine Polish patients with postraumatic scars, burn scars, and scars after skin tumor resection. Participants have not reported any major difficulties in understanding the content of the questionnaire. Conclusions The ISPOR provides a straightforward and thorough guideline for the PROMs translation process. The new SCAR-Q is an accessible and efficient PROM that can be implemented in Polish patients to assess the effectiveness of scar treatment.

Validation of the French version of the ICHOM adult oral health standard set

INTRODUCTION

The ICHOM Adult Oral Health Standard Set (AOHSS) recently developed by the ICHOM Oral Adult Health Working Group is a standard set of outcomes designed for its collection in clinical practice in dental health. The outcome standard set is made up of clinical-reported outcome measures (CROMs) and patient-reported outcome measures (PROMs). The purpose of this study was to translate and cross-culturally adapt the PROM section of the Standard Set in French for France to enable comprehensive evaluation of the patients' oral health quality of life in a French population.

METHODS

The questionnaire was translated following the guidelines of the International Society for Pharmacoeconomics and Outcome Research (ISPOR). We included patients consulting in a dentistry clinic (n = 127) and seeking dental care. The PROM and CROM data were collected from all patients. Both reliability and the internal consistency were evaluated.

RESULTS

The ICHOM AOHSS was successfully translated into French. We sampled and surveyed 126 patients in a dentistry clinic in France using the French translation of the ICHOM AOHSS. Cronbach's α was calculated to measure the internal consistency. The resulting Cronbach's α was 0.8, indicating acceptable homogeneity.

CONCLUSIONS

The French version of the ICHOM AOHSS shows acceptable psychometric properties in terms of reliability and internal consistency. This translation is suitable for its implementation in a French-speaking patient population.

Danish translation and linguistic validation of new body-Q scales measuring expectations, eating behavior, distress, symptoms and work life

The aim of this study was to translate and achieve a linguistical and cultural adaption of the newly developed BODY-Q Obesity Module for use in Danish patients. The BODY-Q Eating Module consists of five new modules aiming to measure expectations of weight-loss, eating behavior, eating-related distress, eating-related symptoms and work life. Translation and linguistic validation were performed using a combination of the recommendations developed by the World Health Organization and the International Society for Pharmacoeconomics and Outcomes Research. The translation was performed in five steps consisting of a forward translation, backward translation, expert panel meeting, cognitive debriefing and final proofreading. Each step aimed for a conceptual and cultural equal translation that was easily understood by patients. The discrepancies encountered in the forward translation included the use of layperson versus medical terminology, different tense and sentence structure. The harmonized version was then backwards translated which led to no conceptual differences. The expert panel reviewed the instrument in full and found two items needing correction in the instrument. Cognitive debriefing did not lead to any revisions and the instrument was well received by the participant group. Proofreading of the instrument led to few corrections in grammar and punctuation but no conceptual corrections. The translation of the BODY-Q Eating Module led to a conceptual and cultural equal version of the instrument for use in Danish patients. The instrument can be used in clinical care and research to inform advancements in the field of bariatric and body contouring surgery.

Spanish translation and cultural adaptation of the 5-D itch scale in burn patients

The objective of this study was to make an equivalent and culturally adapted translation of an already existing scale for itching, the 5-D itch scale (5-D IS), developed as a short questionnaire and designed to measure pruritus, in order to be applied in a Spanish-speaking population. The 5-D IS consists of five sections that evaluate duration, degree, direction, disability and distribution of itching. The adequate translation process was performed according to the guidelines from the World Health Organization (WHO) and the International Society of Pharmacoeconomics and Outcomes Research (ISPOR). Two forward translations, one backwards translation, harmonization by an expert panel, and cognitive interviews with patients were included. The result was a culturally adapted Spanish version of the 5-D IS which was then field-tested in a burn population with an internal reliability of 0,83, considered good. As pruritus and pain are bothersome symptoms present in more that 90% of burned patients during the rehabilitation phase, this culturally adapted scale allows Spanish speakers clinicians to easily objectivize the severity of pruritus and measure the impact of any intervention or treatment.

Arabic Translation and Linguistic Validation of the SCAR-Q Scale Module

Scars are a fairly common complaint in the clinical setting; they can arise from trauma, burns, or after surgical procedures. They can have a detrimental impact on the quality of life of patients. A well-established method of quantifying such an impact is through patient-reported outcome measures (PROM). SCAR-Q is a relatively new and robust questionnaire that was developed and validated by McMaster University. Our study aims to translate SCAR-Q to Arabic. SCAR-Q has a holistic approach to scars and does not target scars of a specific etiology. It has three main components: scar appearance, psychological impact, and symptoms associated with the scar. This translation will enable data collection, analysis, and interpretation from a previously untouched demographic. This article explains the steps taken to develop an accurate and validated Arabic SCAR-Q questionnaire based on World Health Organization (WHO) and The Professional Society for Health Economics and Outcomes Research (ISPOR) guidelines. We were able to methodically produce a validated translation of the SCAR-Q into Arabic that should potentially allow data collection and feedback from a very large segment of the world population regarding the impact of scars on their quality of life.

Patients Decision-Making Characteristics Affects Gynecomastia Treatment Satisfaction: A Multicenter Study Using the BODY-Q Chest Module

BACKGROUND

Patient satisfaction is the most critical outcome in gynecomastia treatment. However, patient satisfaction may be affected by the patient's decision-making trait, such as exhaustively searching for the best outcome or being content with an outcome that satisfies a preconceived requirement.

OBJECTIVE

To assess whether patient's decision-making characteristic affect their satisfaction with gynecomastia treatment.

METHODS

This was a cross-sectional study including patients treated for gynecomastia between January 2009 and December 2019 at two tertiary hospitals in Denmark. Alive patients were sent the BODY-Q: Chest module, the SF-36 questionnaire, and the Maximizer/Satisficer decision-making survey. Patients were classified as Maximizers if they scored more than 40 points on the Maximizer/Satisficer survey. Percentage score differences (PDs) in quality of life scales were calculated between Maximizers and Satisficers.

RESULTS

In total, 192 gynecomastia patients were included in this study and classified as Maximizers (n = 152) or Satisficers (n = 40). Maximizers were younger and more had gynecomastia following abuse of anabolic steroids than Satisficers (p < 0.05). With respect to bodily satisfaction, Maximizers showed significantly worse satisfaction with nipples (PDs: - 12.98%), psychological function (PDs: - 13.68%) and social function (PDs: - 8.77%, p < 0.05). In addition, Maximizers had significantly worse emotional role functioning (- 11.03%), vitality (PDs: - 11.72%) and mental health (PDs: - 10.00%, p < 0.05).

CONCLUSION

Patients exhibiting maximizing-type decision-making characteristics have worse satisfaction with gynecomastia treatment and poorer psychosocial health. This information may facilitate patient counseling and alignment of treatment expectations.

LEVEL OF EVIDENCE IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Translation, Cross-Cultural Adaptation and Linguistic Validation of the FACE-Q Questionnaire for Brazilian Portuguese

BACKGROUND

Patient-reported outcomes measurement instruments (PRO) are a good way to measure results after aesthetic procedures. FACE-Q is a systematized and standardized PRO tool and was not available in Portuguese.

METHODS

This cross-sectional study included four stages: translation of FACE-Q, backtranslation, testing in patients who underwent facial aesthetic procedures and review of the questionnaires between September and December, 2018. Guidelines merging WHO and ISPOR's rules were followed.

RESULTS

Translation was conducted by two translators, resulting in two versions, translation A and translation B, which were reconciled to generate the first Portuguese version. Reconciliation showed inconsistencies between TA and TB in 63% (n = 222) of the 353 questions, which were solved by maintaining TA in 25% of cases (n = 87), TB in 27% and a new version in 11% (n = 40) of the questions. Backtranslation showed written differences with the original FACE-Q in 64 (22.7%) of the 353 question, but only one case of semantic difference, which was corrected resulting in production of the second Portuguese version. Seven patients with a mean age of 35.8 years were interviewed to assess the difficulty in understanding the questionnaires. Four patients had no or minor difficulties understanding the questionnaire, and the other three had difficulties and suggested changes that led to a third Portuguese version. The third version was reviewed for grammar and spelling resulting in the final Portuguese version.

CONCLUSION

A Brazilian Portuguese version of the FACE-Q questionnaire was obtained maintaining equivalency with the source instrument. This will allow cross-cultural research and comparison of results between different studies.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .