Development and validation of an audit instrument: the Prostate Outcomes Questionnaire

Development and validation of a quality-of-life scale for Chinese patients with benign prostatic hyperplasia

OBJECTIVE

To develop and validate a quality of life (QoL) scale for Chinese patients with benign prostatic hyperplasia (BPH).

PATIENTS AND METHODS

According to the QoL definition of the World Health Organisation, we adhered to the rigorous guidelines of instrument development to form a pool of items, selected items and validated the scale, using data from 256 patients with BPH.

RESULTS

A 74-item QoL scale for BPH (prior test version; BPH-QLS), including five domains (disease, physical, social, psychological, satisfaction) was developed and had good reliability and validity. The test-retest correlation coefficient and Cronbach's alpha coefficient of the BPH-QLS were 0.892 and 0.966. Thirteen common factors were extracted according to the conceptual model. The correlations of the BPH-QLS with the Short Form-36, the International Prostate Symptom Score (IPSS), and IPSS QoL score, and a published BPH-specific QoL scale were 0.784, 0.493, 0.462 and 0.762, respectively. The BPH-QLS could be used to discriminate among patients with a different QoL.

CONCLUSION

The new scale is reliable, valid and sensitive, and we recommend using the BPH-QLS in Chinese and Chinese-born patients worldwide to assist in clinical practice.

The community-acquired pneumonia symptom questionnaire: a new, patient-based outcome measure to evaluate symptoms in patients with community-acquired pneumonia

STUDY OBJECTIVE

s: To develop and validate a patient-based outcome measure to evaluate symptoms in patients with community-acquired pneumonia (CAP).

DESIGN

A psychometric study within an international, prospective, randomized, double-blind study. The CAP-symptom questionnaire (CAP-Sym) is a new, 18-item, patient-reported outcome measure that evaluates the bothersomeness of CAP-related symptoms during the past 24 h using a 6-point Likert scale. We used "gold standard" psychometric methods to comprehensively evaluate the acceptability, reliability, validity, and responsiveness of the CAP-Sym.

SETTING

Sixty-four centers in 13 countries (France, Germany, Hungary, Israel, Italy, Norway, Poland, Portugal, South Africa, Spain, Sweden, Switzerland, United Kingdom).

PATIENTS

Five hundred fifty-six patients with CAP, recruited from outpatient clinics, general practice, and hospital centers.

INTERVENTIONS

Randomization 1:1 to moxifloxacin (400 mg once daily), oral or standard oral treatment (amoxicillin, 1 g tid, or clarithromycin, 500 mg bid), alone or in combination, for up to 14 days.

RESULTS

Standard psychometric tests confirmed the acceptability (item nonresponse, item-endorsement frequencies, item/scale floor and ceiling effects), reliability (internal consistency, item-total and inter-item correlations, test-retest reliability), validity (content, construct, convergent, discriminant, known groups), and responsiveness of the CAP-Sym.

CONCLUSIONS

The CAP-Sym is a practical and scientifically sound patient-based outcome measure of CAP-related symptoms that has been developed using "gold standard" methods. As the only fully validated measure of symptoms in patients with CAP, which is quick and easy to administer and is more responsive than the generic Medical Outcomes Study 36-Item Short-Form Health Survey, the CAP-Sym provides a practical and rigorous method for improving the evaluation of outcomes in clinical trials and audit.