The Arabic Translation and Validation of the ICI Vaginal Symptoms Questionnaire Wael Agur MD MRCOG Consultant Urogynaecologist Honorary Senior Clinical.

The Arabic Translation and Validation of the ICI Vaginal

Symptoms Questionnaire

Wael AgurMD MRCOG

Consultant UrogynaecologistHonorary Senior Clinical Lecturer

University of Glasgow

2ndAnnual International Meeting of the RCOG Egyptian Representative Committee

Cairo, March 2012

Objectives

• Importance of Questionnaire Use

• Why the ICIQ-VS?

• Translation and Validation Protocol

Objectives

• Importance of Questionnaire Use

• Why the ICIQ-VS?

• Translation and Validation Protocol

The Surgical Ship

Sea / See Level

Vaginal atrophy

High expectations

Pelvic Organ Prolapse

And the Iceberg

Pelvic Organ Prolapse

Under-diagnosisOver-diagnosis

Vaginal atrophyHigh expectations

‘Loose’ vagina

Inspired by Pescatori et al 2006, A prospective evaluation of occult disorders in obstructed defecation using the ‘iceberg diagram’. Colorectal Disease.

Sexual Matters

Chronic constipation

Reduced sensations

Vaginal digitation

‘Sore’ vagina

‘Tight’ vagina

Sea / See Level

Symptoms and Scores

Clinical need for a VS-Q

• Currently, no clear data on the exact prevalence of prolapse in the Arab world

• Social, cultural and environmental factors are believed to contribute to a ‘culture of silence’ and is likely to imply a high, unmet need for services

Younis N, Khattab H, Zurayk H, El-Moelhy M, Farag A. A community study of gynaecological and related morbidities in rural Egypt. Studies in Family Planning 1993, 24:175-186.

Clinical need for a VS-Q

• To provide Arabic-speaking women and their health professionals with a validated questionnaire in their own language

• To enable them to express their bothersome issues on a confidential, self-completed form

Research need for a VS-Q

√

Objectives

• The importance of questionnaire use

• Why the ICIQ-VS?

• The translation and validation protocol

VS Questionnaires

Copyright ©The ICIQ Group

Arabic ICIQ-VS

Aim

To develop the first validated questionnaire in the Arabic language assessing vaginal symptoms in clinical practice and research contexts in the Middle-East

Objectives

• The importance of questionnaire use

• Why the ICIQ-VS?

• The translation and validation protocol

Translation Protocol

• Literal translation and adaptation– to formal Arabic by a bilingual native

Arabic speakers (completed)

• Back translation – to English by a bilingual native English

speakers (by mid March 2012)

• Review(s) of translations– Panel of native English & Arabic speakers

(May 2012)

Validation Protocol-1

• Content validity – Face validation– 20 patients in Egypt and Saudi Arabia

(Aug 2012)

• Construct validity– relationships to underlying VS theories– difference between community-based

(n=50) women and those attending urogyn clinics (n=120)

• Stability– Scores remain similar after 4 weeks with

no treatment (2012/2013)

• Responsiveness – Significant change in scores following

treatment (2012-2013)

• Internal consistency– Correlation between questions– Cronbach’s alpha coefficient of (0.7–0.8)

Validation Protocol-2

Considerations

• Ethics– North Bristol REC, UK– Individual Institutions

• Funding– The ICIQ Group– Ayrshire Urogynaecology Fund

Conclusion

• Questionnaire use is important in both clinical practice and research contexts.

• The Arabic ICIQ-VS has the potential to prove reliable and valid and be widely used to empower Arabic-speaking women to better express symptoms and monitor treatment

Thank you

wael.agur@gla.ac.uk