Construct Validity and Responsiveness of the Abdominal Surgery Impact Scale in the Context of Recovery After Colorectal Surgery.


Journal

Diseases of the colon and rectum
ISSN: 1530-0358
Titre abrégé: Dis Colon Rectum
Pays: United States
ID NLM: 0372764

Informations de publication

Date de publication:
03 2019
Historique:
pubmed: 30 11 2018
medline: 3 5 2019
entrez: 30 11 2018
Statut: ppublish

Résumé

The Abdominal Surgery Impact Scale is a patient-reported outcome measure that evaluates quality of life after abdominal surgery. Evidence supporting its measurement properties is limited. This study aimed to contribute evidence for the construct validity and responsiveness of the Abdominal Surgery Impact Scale as a measure of recovery after colorectal surgery in the context of an enhanced recovery pathway. This is an observational validation study designed according to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. This study was conducted at a university-affiliated tertiary hospital. Included were 100 consecutive patients undergoing colorectal surgery (mean age, 65; 57% male). There were no interventions. Construct validity was assessed at 2 days and 2 and 4 weeks after surgery by testing the hypotheses that Abdominal Surgery Impact Scale scores were higher 1) in patients without vs with postoperative complications, 2) with higher preoperative physical status vs lower, 3) without vs with postoperative stoma, 4) in men vs women, 5) with shorter time to readiness for discharge (≤4 days) vs longer, and 6) with shorter length of stay (≤4 days) vs longer. To test responsiveness, we hypothesized that scores would be higher 1) preoperatively vs 2 days postoperatively, 2) at 2 weeks vs 2 days postoperatively, and 3) at 4 weeks vs 2 weeks postoperatively. The data supported 3 of the 6 hypotheses (hypotheses 1, 5, and 6) tested for construct validity at all time points. Two of the 3 hypotheses tested for responsiveness (hypotheses 1 and 2) were supported. This study was limited by the risk of selection bias due to the use of secondary data from a randomized controlled trial. The Abdominal Surgery Impact Scale was responsive to the expected trajectory of recovery up to 2 weeks after surgery, but did not discriminate between all groups expected to have different recovery trajectories. There remains a need for the development of recovery-specific, patient-reported outcome measures with adequate measurement properties. See Video Abstract at http://links.lww.com/DCR/A814.

Sections du résumé

BACKGROUND
The Abdominal Surgery Impact Scale is a patient-reported outcome measure that evaluates quality of life after abdominal surgery. Evidence supporting its measurement properties is limited.
OBJECTIVE
This study aimed to contribute evidence for the construct validity and responsiveness of the Abdominal Surgery Impact Scale as a measure of recovery after colorectal surgery in the context of an enhanced recovery pathway.
DESIGN
This is an observational validation study designed according to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist.
SETTING
This study was conducted at a university-affiliated tertiary hospital.
PATIENTS
Included were 100 consecutive patients undergoing colorectal surgery (mean age, 65; 57% male).
INTERVENTION
There were no interventions.
MAIN OUTCOME MEASURES
Construct validity was assessed at 2 days and 2 and 4 weeks after surgery by testing the hypotheses that Abdominal Surgery Impact Scale scores were higher 1) in patients without vs with postoperative complications, 2) with higher preoperative physical status vs lower, 3) without vs with postoperative stoma, 4) in men vs women, 5) with shorter time to readiness for discharge (≤4 days) vs longer, and 6) with shorter length of stay (≤4 days) vs longer. To test responsiveness, we hypothesized that scores would be higher 1) preoperatively vs 2 days postoperatively, 2) at 2 weeks vs 2 days postoperatively, and 3) at 4 weeks vs 2 weeks postoperatively.
RESULTS
The data supported 3 of the 6 hypotheses (hypotheses 1, 5, and 6) tested for construct validity at all time points. Two of the 3 hypotheses tested for responsiveness (hypotheses 1 and 2) were supported.
LIMITATIONS
This study was limited by the risk of selection bias due to the use of secondary data from a randomized controlled trial.
CONCLUSIONS
The Abdominal Surgery Impact Scale was responsive to the expected trajectory of recovery up to 2 weeks after surgery, but did not discriminate between all groups expected to have different recovery trajectories. There remains a need for the development of recovery-specific, patient-reported outcome measures with adequate measurement properties. See Video Abstract at http://links.lww.com/DCR/A814.

Identifiants

pubmed: 30489323
doi: 10.1097/DCR.0000000000001288
doi:

Types de publication

Journal Article Randomized Controlled Trial Video-Audio Media

Langues

eng

Sous-ensembles de citation

IM

Pagination

309-317

Auteurs

Saba Balvardi (S)

Department of Surgery, McGill University, Montreal, Quebec, Canada.
Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada.

Nicolò Pecorelli (N)

Department of Surgery, McGill University, Montreal, Quebec, Canada.
Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada.

Tanya Castelino (T)

Department of Surgery, McGill University, Montreal, Quebec, Canada.
Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada.

Petru Niculiseanu (P)

Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada.

A Sender Liberman (AS)

Department of Surgery, McGill University, Montreal, Quebec, Canada.

Patrick Charlebois (P)

Department of Surgery, McGill University, Montreal, Quebec, Canada.

Barry Stein (B)

Department of Surgery, McGill University, Montreal, Quebec, Canada.

Franco Carli (F)

Department of Anesthesia, McGill University, Montreal, Quebec, Canada.

Nancy E Mayo (NE)

Division of Clinical Epidemiology.

Liane S Feldman (LS)

Department of Surgery, McGill University, Montreal, Quebec, Canada.
Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada.

Julio F Fiore (JF)

Department of Surgery, McGill University, Montreal, Quebec, Canada.
Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, Quebec, Canada.

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