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El Khoury MAJ, Chartier-Kastler E, Parra J, Vaessen C, Roupret M, Seisen T, Lenfant L. Continent cutaneous diversion: Unveiling the interplay of neuro-urology and oncological challenges. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102665. [PMID: 38849033 DOI: 10.1016/j.fjurol.2024.102665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/09/2024]
Abstract
OBJECTIVES The objective of our study is to demonstrate the practical application of continent cutaneous urinary diversion (CCUD) in oncological patients, with a focus on various aspects of the procedure: surgical challenges, functional outcomes, and quality of life. MATERIALS AND METHODS We studied the perioperative and follow-up data of patients who underwent cystectomy for cancer associated with CCUD (Mitrofanoff, Monti or Casale). We retrospectively analyzed complications within 30days and beyond 30days post-surgery. We evaluated oncological outcomes. Patients' quality of life was assessed using the Bladder Cancer Index (BCI) questionnaire. Results are given on an intention-to-treat basis. RESULTS A total of 24 patients were included in the study (July 2001 and May 2022), with a median follow-up of 62.5months. We report three deaths due to neoplasic recurrence. Forty-six percent had an early postoperative complication, two of whom required revision surgery. Overall, the medium-term complication rate was 70% and the reoperation rate was 62%. There were 8 stomal cutaneous stenoses (33%) and 3 uretero-ileal stenoses (12.5%). Overall satisfaction was rated at 9.2/10 on average, and body image was unaltered or slightly altered in 62.5% of patients. Of the patients who responded to the BCI, 75% had complete continence. DISCUSSION The experience gained with continent stomas in neuro-urology has allowed, in carefully selected cases, to offer patients an alternative that can improve their quality of life in a context already burdened by the shadow of cancer. CCUD can be proposed as an alternative to Bricker diversion in cases of urethral invasion or a high risk of neobladder incontinence, in selected patients. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- Michael-Abdo-Jefferson El Khoury
- Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France; Université libre de Bruxelles, Faculté de Médecine, Bruxelles, Belgium.
| | - Emmanuel Chartier-Kastler
- Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France; Sorbonne Université, Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France
| | - Jérome Parra
- Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France
| | | | - Morgan Roupret
- Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France; Sorbonne Université, Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France
| | - Thomas Seisen
- Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France; Sorbonne Université, Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France
| | - Louis Lenfant
- Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France
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Pervaiz A, Ather MH, Bashir A, Aziz W. Urdu Translation and Linguistic Validation of the Bladder Cancer Index Questionnaire. Cureus 2022; 14:e27487. [PMID: 36060374 PMCID: PMC9423128 DOI: 10.7759/cureus.27487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 11/15/2022] Open
Abstract
Background This study aimed to translate the Bladder Cancer Index (BCI) questionnaire to Urdu and validate it to assess the quality of life of patients with bladder cancer. Material and methods After forward and backward translation of the BCI questionnaire into Urdu, content validity was calculated using the content validity index (CVI) based on input from five health experts regarding the clarity and relevance of the questionnaire. Construct validity was measured by comparing the inter-scale domains and subdomains of BCI and by comparing BCI with Short Form 36 (SF-36) using correlations. For assessment of reliability, Cronbach’s alpha was calculated to measure internal consistency and for test-retest reliability, the questionnaire was re-administered four weeks later and the correlation of responses at baseline and at a four-week time point was evaluated. Results The questionnaire has good content validity for clarity (0.91) and relevance (0.87). The construct validity of BCI was also adequately displayed by moderate to high correlation between different subdomains of BCI (Pearson’s r: urinary - 0.62, bowel - 0.78, sexual function - 0.43) and low to moderate correlation between responses of BCI compared with SF-36 (Pearson’s r mostly >0.45). Test-retest reliability was excellent (Pearson’s r 0.90-0.98), and there was good internal consistency (Cronbach’s alpha 0.79-0.92) in the different domains of the questionnaire. Conclusion The Urdu-translated BCI is a valid and reliable tool to measure the impact of bladder cancer on the quality of life of patients.
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Pattou M, Baboudjian M, Pinar U, Parra J, Rouprêt M, Karsenty G, Phe V. Continent cutaneous urinary diversion with an ileal pouch with the Mitrofanoff principle versus a Miami pouch in patients undergoing cystectomy for bladder cancer: results of a comparative study. World J Urol 2022; 40:1159-1165. [DOI: 10.1007/s00345-022-03954-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/30/2022] [Indexed: 11/29/2022] Open
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Osawa T, Wei JT, Abe T, Honda M, Rew KT, Dunn R, Yamada S, Furumido J, Kikuchi H, Matsumoto R, Sato Y, Harabayashi T, Takada N, Minami K, Morita K, Kashiwagi A, Fukuhara S, Murai S, Ito YM, Ogasawara K, Shinohara N. Comparison of Health-Related Quality of Life Between Japanese and American Patients with Bladder Cancer as Measured by a Newly Developed Japanese Version of the Bladder Cancer Index. Bladder Cancer 2021; 7:61-69. [PMID: 38993225 PMCID: PMC11181757 DOI: 10.3233/blc-200359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/11/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this study is to characterize health related quality of life (HRQOL) in Japanese patients after bladder cancer surgery and to perform cross-cultural comparison between Japanese and American patients. METHODS Firstly, we cross-sectionally assessed HRQOL of 371 patients in Japan using the Bladder Cancer Index (BCI-Japanese). HRQOL of the four groups of patients (native bladder without intravesical therapy, native bladder with intravesicaltherapy, cystectomy with ileal conduit, and cystectomy with neobladder) were assessed. Secondly, we compared the Japanese with the American cohort (n = 315) from the original BCI paper. After adjusting for age and gender, the differences in each BCI subdomain score was analyzed. RESULTS Among Japanese patients, the urinary domain function score was significantly lower among the cystectomy with neobladder group, compared to the cystectomy with ileal conduit group (p < 0. 01). Despite this, the urinary bother was comparable between the two groups. Although there were apparent differences between Japanese and American patients, there were few differences in Urinary and Bowel HRQOL. In three of the four treatment groups (other than native bladder with intravesical therapy), Japanese patients were more likely than Americans to report poor sexual function (p < 0.05). However, Japanese patients were less likely than Americans to be bothered by their lower sexual function, regardless of treatment (p < 0.05). CONCLUSIONS HRQOL outcomes following treatment of bladder cancer in Japan are comparable to those in the USA, except for sexual functioning and sexual bother. The BCI can be used for cross-cultural assessments of HRQOL in bladder cancer patients.
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Affiliation(s)
- Takahiro Osawa
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - John T. Wei
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Takashige Abe
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Michitaka Honda
- Department of Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Karl T. Rew
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Rod Dunn
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Shuhei Yamada
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Jun Furumido
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroshi Kikuchi
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ryuji Matsumoto
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yasuyuki Sato
- Department of Urology, Keiyukai Hospital, Sapporo, Japan
| | | | - Norikata Takada
- Department of Urology, Hokkaido Cancer Center, Sapporo, Japan
| | - Keita Minami
- Department of Urology, Sapporo City General Hospital, Sapporo, Japan
| | - Ken Morita
- Department of Urology, Kushiro City General Hospital, Kushiro, Japan
| | - Akira Kashiwagi
- Department of Urology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Shunichi Fukuhara
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University, Kyoto, Japan
- Department of General Medicine, Shirakawa STAR, Fukushima Medical University, Fukushima, Japan
| | - Sachiyo Murai
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yoichi M. Ito
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | | | - Nobuo Shinohara
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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[Single, immediate postoperative intra-vesical instillation (SI) compared to a single preoperative intra-vesical instillation of mitomycin C in non-muscle invasive bladder cancer (NMIBC). Phase II randomized trial]. Prog Urol 2020; 31:63-70. [PMID: 32891506 DOI: 10.1016/j.purol.2020.07.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/24/2020] [Accepted: 07/08/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE A single immediate instillation of mitomycin C is recommended after a complete transurethral resection of the bladder (TURB) in low- and intermediate-risk patients with NMIBC. Actually, post-TURB instillation is seldom used due to logistical difficulties and surgical contraindications. Our aim was to compare patients with single pre-TURB intra-vesical instillation and patients with a single, immediate post-TURB intra-vesical instillation of mitomycin C. METHODS We performed a multicenter randomized trial between February 17, 2014 and November 24, 2016 (registration number 2012-004341-32). Sixty patients with two or less, primary or recurrent papillary bladder tumors and a negative urinary cytology were planned. Cystoscopy was performed at 3, 6 and 12 months after TURB. Our primary endpoint was disease-free interval. Secondary endpoints were recurrence rate at 3 and 12 months, rate of patients in whom instillation could not be performed and tolerance 1 month after TURB using BCI-Fr score. RESULTS Among 35 eligible participants, 20 were randomly assigned in the pre-TURB instillation group and 15 in the post-TURB instillation group. Follow-up was comparable: 12,3±1,6 months in the SI group and 10,2±4,5 months in the pre-TURB instillation group. In the post-TURB instillation group, 2 patients didn't have any instillation. We did not identify significant differences in disease-free interval. Tolerance at 1 month after TURB was similar in both groups. CONCLUSION Tolerance and efficacy were not significantly different. As expected, logisitics were easier for the health providers in the pre-TURB group where all patients had their instillation conversely to the post-TURB group. These results suggest that the advantages of a single immediate pre-TURB instillation warrant further evaluation of this strategy in a phase III randomized trial.
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Osawa T, Wei JT, Abe T, Honda M, Yamada S, Furumido J, Kikuchi H, Matsumoto R, Hirakawa K, Sato Y, Sasaki Y, Harabayashi T, Takada N, Minami K, Tanaka H, Morita K, Kashiwagi A, Miyajima N, Akino T, Murai S, Ito YM, Fukuhara S, Ogasawara K, Shinohara N. Health-related quality of life in Japanese patients with bladder cancer measured by a newly developed Japanese version of the Bladder Cancer Index. Int J Clin Oncol 2020; 25:2090-2098. [PMID: 32833102 PMCID: PMC7677272 DOI: 10.1007/s10147-020-01770-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/11/2020] [Indexed: 11/12/2022]
Abstract
Introduction We validated a Japanese version of the Bladder Cancer Index (BCI) as a tool for measuring health-related quality of life (HRQOL) in bladder cancer patients treated with various surgical procedures. Methods The reliability and validity of the Japanese BCI were examined in 397 Japanese patients with bladder cancer via cross-sectional analysis. The patients simultaneously completed the Short Form (SF)-12, EQ-5D, and the Functional Assessment of Cancer Therapy-General and Bladder (FACT-G and FACT-BL). The differences in BCI subscales among various treatment groups were analyzed. Results This study involved 397 patients (301 males and 96 females), with a mean age of 70 years and a median disease duration of 29 months (IQR: 12–66 months). Of these patients, 221 underwent transurethral resection of a bladder tumor, and 176 patients underwent radical cystectomy (ileal conduit: 101 patients, ileal neobladder: 49, and ureterostomy: 26). Cronbach’s alpha coefficient was ≥ 0.78 for all subscales, except the bowel bother subscale. Despite moderate correlations being detected between the function and bother score in urinary and bowel domains, the sexual function score was inversely correlated with the sexual bother score (r = − 0.19). A missing value percentage of > 15% was associated with old age (p < 0.05). The mean domain scores differed significantly among distinct clinically relevant treatment groups. Conclusions Although revisions are needed to make it easier for elderly patients to comprehend, we confirmed the reliability and validity of the Japanese BCI. The Japanese BCI could be used for cross-cultural assessments of HRQOL in bladder cancer patients. Electronic supplementary material The online version of this article (10.1007/s10147-020-01770-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Takahiro Osawa
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
| | - John T Wei
- Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Takashige Abe
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Michitaka Honda
- Department Minimally Invasive Surgical and Medical Oncology, Fukushima Medical University, Fukushima, Japan
| | - Shuhei Yamada
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Jun Furumido
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hiroshi Kikuchi
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Ryuji Matsumoto
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Yasuyuki Sato
- Department of Urology, Keiyukai Hospital, Sapporo, Japan
| | | | | | - Norikata Takada
- Department of Urology, Hokkaido Cancer Center, Sapporo, Japan
| | - Keita Minami
- Department of Urology, Sapporo City General Hospital, Sapporo, Japan
| | - Hiroshi Tanaka
- Department of Urology, Sapporo City General Hospital, Sapporo, Japan
| | - Ken Morita
- Department of Urology, Kushiro City General Hospital, Kushiro, Japan
| | - Akira Kashiwagi
- Department of Urology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Naoto Miyajima
- Department of Urology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Tomoshige Akino
- Department of Urology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Sachiyo Murai
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Yoichi M Ito
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Shunichi Fukuhara
- Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University, Kyoto, Japan.,Department of General Medicine, Shirakawa STAR, Fukushima Medical University, Fukushima, Japan
| | | | - Nobuo Shinohara
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Michels CTJ, Wijburg CJ, Abma IL, Witjes JA, Grutters JPC, Rovers MM. Translation and validation of two disease-specific patient-reported outcome measures (Bladder Cancer Index and FACT-Bl-Cys) in Dutch bladder cancer patients. J Patient Rep Outcomes 2019; 3:62. [PMID: 31522328 PMCID: PMC6745039 DOI: 10.1186/s41687-019-0149-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Bladder Cancer Index (BCI) and Functional Assessment of Cancer Therapy-Bladder-Cystectomy (FACT-Bl-Cys) were developed to measure disease-specific health-related quality of life (HRQOL) in bladder cancer patients and patients treated with radical cystectomy, respectively. Both patient-reported outcome measures (PROMs) are frequently used in clinical practice, but are not yet validated according to the COSMIN criteria and not yet available in Dutch. Therefore, the aim of this study was to translate the BCI and FACT-Bl-Cys into Dutch and to evaluate their measurement properties according to the COSMIN criteria. METHODS The BCI and FACT-Bl-Cys were translated into Dutch using a forward-backward method, and subsequently administered at baseline (pre-operatively) and 3 months post-operatively in bladder cancer patients who received a radical cystectomy. Validity (content and construct), reliability (internal consistency, test-retest reliability, and measurement error), floor and ceiling effects, and responsiveness were assessed according to the COSMIN criteria. RESULTS Forward-backward translation encountered no particular linguistic problems. In total 260 patients completed the baseline measurement, while 182 patients completed the three-month measurement. Only a ceiling effect was identified for the BCI. Hypotheses testing for construct validity was satisfying, as 67% and 92% of the hypothesized correlations were confirmed. Structural validity was moderate for both measures, as confirmatory factor analyses showed limited fit. Reliability of both PROMs was good. The intraclass correlation coefficient (ICC) of the BCI domains ranged from 0.47 to 0.93, minimal value of Cronbach's α was 0.70, smallest detectable change on group level (SDC group) ranged from 1.9 to 8.6. The ICC of the FACT-Bl-Cys domains ranged from 0.43 to 0.83, minimal value of Cronbach's α was 0.77, SDC group was around 1. Only the FACT-Bl-Cys total score was found to be responsive to changes in generic quality of life. CONCLUSIONS The Dutch versions of the BCI and FACT-Bl-Cys were shown to be reliable and have good content validity. Structural validity was limited for both measures. Only the FACT-Bl-Cys total score was responsive to changes in generic HRQOL. Despite some limitations, both PROMs seem suitable for use in clinical practice and research.
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Affiliation(s)
- Charlotte T. J. Michels
- Department of Urology, Rijnstate Hospital, Arnhem, Netherlands
- Department of Operating Rooms, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Carl J. Wijburg
- Department of Urology, Rijnstate Hospital, Arnhem, Netherlands
| | - Inger L. Abma
- IQ healthcare, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - J. Alfred Witjes
- Department of Urology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Janneke P. C. Grutters
- Department of Operating Rooms, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
- Department for Health Evidence, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Maroeska M. Rovers
- Department of Operating Rooms, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
- Department for Health Evidence, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
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Ileal conduit vs orthotopic neobladder: Which one offers the best health-related quality of life in patients undergoing radical cystectomy? A systematic review of literature and meta-analysis. Prog Urol 2018; 28:241-250. [DOI: 10.1016/j.purol.2018.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/12/2017] [Accepted: 02/10/2018] [Indexed: 12/29/2022]
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Vuichoud C, Perrouin-Verbe MA, Phe V, Bitker MO, Parra J, Chartier-Kastler E. La dérivation cutanée continente après cystectomie pour cancer, une alternative fiable ? Étude rétrospective monocentrique. Prog Urol 2016; 26:642-650. [DOI: 10.1016/j.purol.2016.09.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/29/2016] [Accepted: 09/15/2016] [Indexed: 11/29/2022]
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Hevér NV, Péntek M, Balló A, Gulácsi L, Baji P, Brodszky V, Damásdi M, Bognár Z, Tóth G, Buzogány I, Szántó Á. Health related quality of life in patients with bladder cancer: a cross-sectional survey and validation study of the Hungarian version of the Bladder Cancer Index. Pathol Oncol Res 2014; 21:619-27. [PMID: 25434791 DOI: 10.1007/s12253-014-9866-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 11/04/2014] [Indexed: 12/11/2022]
Abstract
Health-related quality of life (HRQoL) is an important outcome in oncology care although an underexplored area in bladder cancer (BC). Our aims were to assess HRQoL of patients with BC, analyse relationships between diverse HRQoL measures and validate the Hungarian version of the Bladder Cancer Index (BCI) questionnaire. A cross-sectional survey was performed among patients with BC (N = 151). Validated Hungarian versions of the FACT-Bl, SF-36 and EQ-5D were applied and SF-6D was derived. Psychometric analysis of the Hungarian BCI was performed. Pearson correlations between the five measures were analysed. Deterioration in SF-36 Physical Functioning was detected among patients aged 45-64 years. The EQ-5D score did not differ significantly from the age-matched population norm. Correlations between the FACT-Bl, EQ-5D and SF-6D utility measures were strong (r > 0.6). Cronbach alpha coefficients of the Hungarian BCI ranged from 0.75 to 0.97 and factor analysis confirmed that data fit to the six predefined subdomains. Test-retest correlations (reliability, N = 50) ranged from 0.67 to 0.87 and interscale correlations between urinary, bowel and sexual BCI domains were weak or moderate (r = 0.29 to 0.49). Convergent validity revealed a stronger correlation with FACT-Bl (r = 0.126 to 0.719) than with generic health state scores (r = 0.096 to 0.584). Results of divergent validity of the Hungarian BCI by treatment groups by Kruskal Wallis test were promising although limited by low sample sizes in cystectomy subgroups. Generic health state measures have limited capacity to capture HRQoL impact of BC. Validity tests yielded favourable results for the Hungarian BCI. Mapping studies to estimate utility scores from FACT-Bl are encouraged but less recommendable with the BCI.
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Affiliation(s)
- Noémi V Hevér
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary
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Schmidt S, Riel R, Frances A, Lorente Garin JA, Bonfill X, Martinez-Zapata MJ, Morales Suarez-Varela M, dela Cruz J, Emparanza JI, Sánchez MJ, Zamora J, Goñi JMR, Alonso J, Ferrer M. Bladder cancer index: cross-cultural adaptation into Spanish and psychometric evaluation. Health Qual Life Outcomes 2014; 12:20. [PMID: 24528506 PMCID: PMC3928086 DOI: 10.1186/1477-7525-12-20] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Bladder Cancer Index (BCI) is so far the only instrument applicable across all bladder cancer patients, independent of tumor infiltration or treatment applied. We developed a Spanish version of the BCI, and assessed its acceptability and metric properties. METHODS For the adaptation into Spanish we used the forward and back-translation method, expert panels, and cognitive debriefing patient interviews. For the assessment of metric properties we used data from 197 bladder cancer patients from a multi-center prospective study. The Spanish BCI and the SF-36 Health Survey were self-administered before and 12 months after treatment. Reliability was estimated by Cronbach's alpha. Construct validity was assessed through the multi-trait multi-method matrix. The magnitude of change was quantified by effect sizes to assess responsiveness. RESULTS Reliability coefficients ranged 0.75-0.97. The validity analysis confirmed moderate associations between the BCI function and bother subscales for urinary (r = 0.61) and bowel (r = 0.53) domains; conceptual independence among all BCI domains (r ≤ 0.3); and low correlation coefficients with the SF-36 scores, ranging 0.14-0.48. Among patients reporting global improvement at follow-up, pre-post treatment changes were statistically significant for the urinary domain and urinary bother subscale, with effect sizes of 0.38 and 0.53. CONCLUSIONS The Spanish BCI is well accepted, reliable, valid, responsive, and similar in performance compared to the original instrument. These findings support its use, both in Spanish and international studies, as a valuable and comprehensive tool for assessing quality of life across a wide range of bladder cancer patients.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Montse Ferrer
- Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader 88, 08003 Barcelona, Spain.
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