Urinary Stones and Intervention Quality of Life (USIQoL): Development and Validation of a New Core Universal Patient-reported Outcome Measure for Urinary Calculi.

Outcomes health related quality of life (HRQoL) patient reported outcome measure (PROM) stones and intervention urinary calculi

Journal

European urology focus
ISSN: 2405-4569
Titre abrégé: Eur Urol Focus
Pays: Netherlands
ID NLM: 101665661

Informations de publication

Date de publication:
Jan 2022
Historique:
received: 20 09 2020
revised: 23 11 2020
accepted: 18 12 2020
pubmed: 12 1 2021
medline: 15 4 2022
entrez: 11 1 2021
Statut: ppublish

Résumé

Urolithiasis has a significant impact on patients' health-related quality of life (HRQoL). To develop a core patient-reported outcome measure (PROM) using modern psychometric methods to quantify the impact of urolithiasis and different treatments. Adult patients with urinary calculi, attending urology departments, covering all index categories and treatment spectrum, participated during different development phases. The pilot instrument was created from potential items (phases 1 and 2) within the conceptual framework. The instrument was pretested (phase 3) and then underwent psychometric evaluation in two parts (phases 4 and 5). The validity and reliability of the new PROM were assessed using Rasch measurement theory (RUMM 2030 statistical software) and traditional analyses. In total, 683 patients (median age 51 yr, range 18-92 yr) participated during different phases. The initial 60-item draft (five scales) was completed by 212 patients (phase 4). A revised 25-item draft was produced after removal of unstable items. In the second field test, the revised version was evaluated by 369 patients. This led to the final Urinary Stones and Intervention Quality of Life (USIQoL; 15 items) with summated logit scores. The PROM includes three scales: pain with physical health (six items), psychosocial health (seven items) and work performance (two items). Lower scores indicate better outcomes. Results demonstrate that USIQoL is reliable (r ≥ 0.8) and internally consistent (α ≥ 0.7), and has good construct validity (good hypothesised correlations, r > 0.3) and satisfactory sensitivity to change (p < 0.01). All scales demonstrated unidimensionality with good item fit and person separation indices. A limitation is that USIQoL was developed in the English language within the UK population. USIQoL is a short, unidimensional, valid, and reliable PROM for assessing the HRQoL impact of urinary calculi and treatments. It is expected to serve as a core PROM across the entire spectrum of urolithiasis. Kidney stones are a common condition for which various treatment options are available. The condition and treatments have a significant impact on a patient's quality of life. This can be measured objectively using a valid and reliable patient-reported outcome measure (PROM) developed using modern methods. We have developed a PROM that provides helpful and accurate measurement useful for all stakeholders.

Sections du résumé

BACKGROUND BACKGROUND
Urolithiasis has a significant impact on patients' health-related quality of life (HRQoL).
OBJECTIVE OBJECTIVE
To develop a core patient-reported outcome measure (PROM) using modern psychometric methods to quantify the impact of urolithiasis and different treatments.
DESIGN, SETTING, AND PARTICIPANTS METHODS
Adult patients with urinary calculi, attending urology departments, covering all index categories and treatment spectrum, participated during different development phases. The pilot instrument was created from potential items (phases 1 and 2) within the conceptual framework. The instrument was pretested (phase 3) and then underwent psychometric evaluation in two parts (phases 4 and 5).
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS METHODS
The validity and reliability of the new PROM were assessed using Rasch measurement theory (RUMM 2030 statistical software) and traditional analyses.
RESULTS AND LIMITATIONS CONCLUSIONS
In total, 683 patients (median age 51 yr, range 18-92 yr) participated during different phases. The initial 60-item draft (five scales) was completed by 212 patients (phase 4). A revised 25-item draft was produced after removal of unstable items. In the second field test, the revised version was evaluated by 369 patients. This led to the final Urinary Stones and Intervention Quality of Life (USIQoL; 15 items) with summated logit scores. The PROM includes three scales: pain with physical health (six items), psychosocial health (seven items) and work performance (two items). Lower scores indicate better outcomes. Results demonstrate that USIQoL is reliable (r ≥ 0.8) and internally consistent (α ≥ 0.7), and has good construct validity (good hypothesised correlations, r > 0.3) and satisfactory sensitivity to change (p < 0.01). All scales demonstrated unidimensionality with good item fit and person separation indices. A limitation is that USIQoL was developed in the English language within the UK population.
CONCLUSIONS CONCLUSIONS
USIQoL is a short, unidimensional, valid, and reliable PROM for assessing the HRQoL impact of urinary calculi and treatments. It is expected to serve as a core PROM across the entire spectrum of urolithiasis.
PATIENT SUMMARY RESULTS
Kidney stones are a common condition for which various treatment options are available. The condition and treatments have a significant impact on a patient's quality of life. This can be measured objectively using a valid and reliable patient-reported outcome measure (PROM) developed using modern methods. We have developed a PROM that provides helpful and accurate measurement useful for all stakeholders.

Identifiants

pubmed: 33423970
pii: S2405-4569(20)30313-8
doi: 10.1016/j.euf.2020.12.011
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

283-290

Informations de copyright

Copyright © 2020 European Association of Urology. All rights reserved.

Auteurs

Hrishikesh B Joshi (HB)

School of Medicine, Cardiff University, Cardiff, UK; Department of Urology, University Hospital of Wales, Heath Park, Cardiff, UK. Electronic address: hrishi.joshi@wales.nhs.uk.

Hans Johnson (H)

University of Bristol Medical School, Bristol, UK.

Amelia Pietropaolo (A)

University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Aditya Raja (A)

School of Medicine, Cardiff University, Cardiff, UK; Department of Urology, University Hospital of Wales, Heath Park, Cardiff, UK.

Adrian D Joyce (AD)

Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Bhaskar Somani (B)

University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Joe Philip (J)

University of Bristol Medical School, Bristol, UK.

Chandra Shekhar Biyani (CS)

Leeds Teaching Hospitals NHS Trust, Leeds, UK.

Tim Pickles (T)

School of Medicine, Cardiff University, Cardiff, UK.

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