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      Brazilian portuguese validation of the patient-reported outcome measure for urethral stricture surgery (USS-PROM) questionnaire


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          Urethral stricture is a common, albeit complex, condition that predominantly affects men. The aim of this study was to translate, culturally adapt, and validate the Patient-Reported Outcome Measure questionnaire for patients undergoing urethroplasty (USS-PROM) into Brazilian Portuguese using validated psychometric criteria.

          Materials and Methods:

          The process involved translating and culturally adapting the original USS-PROM into Brazilian Portuguese (USS-PROMbr), synthesizing, back-translating, cross-culturally adapting, and analyzing the pre-final version with experts from our committee. This pre-version was administered to 10 patients who had undergone urethroplasty by the Reconstructive Urology team at the Hospital de Clínicas de Porto Alegre for face validation, linguistic, and semantic adjustments, resulting in the final USS-PROMbr version. Subsequently, well-established psychometric criteria, including content validity, internal consistency, and test-retest reproducibility, were assessed after administering the questionnaire to a total of 56 patients, with 50 of them responding to the test and retest.


          Evaluation of the pre-final version identified 15 questions as clear, and only one question was considered somewhat unclear necessitating modifications based on patient suggestions and subsequent reassessment by the research team. Psychometric criteria demonstrated good content validity, with a content validity index exceeding 0.80 for all questions; good internal consistency, Cronbach's alpha of 0.77, ranging from 0.70 to 0.78 with the exclusion of any item, and item-total correlations ranging from 0.33 to 0.67. The test-retest intraclass correlation coefficient was 0.74 for the lower urinary tract symptoms construct (Q1-Q6).


          The USS-PROMbr demonstrated acceptable cross-cultural adaptation and psychometric properties, making it a valid and useful tool for evaluating patients undergoing urethroplasty.

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          Most cited references38

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          Coefficient alpha and the internal structure of tests

          Psychometrika, 16(3), 297-334
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            Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures

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              Quality criteria were proposed for measurement properties of health status questionnaires.

              Recently, an increasing number of systematic reviews have been published in which the measurement properties of health status questionnaires are compared. For a meaningful comparison, quality criteria for measurement properties are needed. Our aim was to develop quality criteria for design, methods, and outcomes of studies on the development and evaluation of health status questionnaires. Quality criteria for content validity, internal consistency, criterion validity, construct validity, reproducibility, longitudinal validity, responsiveness, floor and ceiling effects, and interpretability were derived from existing guidelines and consensus within our research group. For each measurement property a criterion was defined for a positive, negative, or indeterminate rating, depending on the design, methods, and outcomes of the validation study. Our criteria make a substantial contribution toward defining explicit quality criteria for measurement properties of health status questionnaires. Our criteria can be used in systematic reviews of health status questionnaires, to detect shortcomings and gaps in knowledge of measurement properties, and to design validation studies. The future challenge will be to refine and complete the criteria and to reach broad consensus, especially on quality criteria for good measurement properties.

                Author and article information

                Int Braz J Urol
                Int Braz J Urol
                International Brazilian Journal of Urology : Official Journal of the Brazilian Society of Urology
                Sociedade Brasileira de Urologia
                10 April 2024
                May-Jun 2024
                : 50
                : 3
                : 261-276
                [1 ] orgnameUniversidade Federal do Rio Grande do Sul Porto Alegre RS Brasil originalPrograma de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil;
                [2 ] orgnameHospital de Clínicas de Porto Alegre orgdiv1Divisão de Urologia orgdiv2Grupo de Urologia Reconstrutiva e Infantil Porto Alegre RS Brasil originalGrupo de Urologia Reconstrutiva e Infantil, Divisão de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil
                Author notes
                Correspondence address: Tiago Elias Rosito, MD, PhD Grupo de Urologia Reconstrutiva e Infantil, Serviço de Urologia, Hospital de Clínicas de Porto Alegre Rua Ramiro Barcelos, 2350/835 Porto Alegre - RS, 90035-903, Brasil Fax: + 55 51 3359-8262 E-mail: trosito@ 123456hcpa.edu.br

                CONFLICT OF INTEREST

                None declared.

                Author information

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 11 December 2023
                : 04 March 2024
                Page count
                Figures: 3, Tables: 3, Equations: 0, References: 30, Pages: 16
                Original Article

                urethral stricture,patient satisfaction,quality of life


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